HomeMy WebLinkAboutChange Order No 1 - Eagle Way Sewer Extension Proj No. 119-095 - Indiana Earth, Inc.
GARY A. GILOT ELIZABETH A. MARADIK THERESE J. DORAU JORDAN V. GATHERS JOSEPH R. MOLNAR
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
November 24, 2020
Mr. Mark Osler
Indiana Earth, Inc.
10343 McKinley Hwy.
Osceola, IN 46561
jkabelearth10@yahoo.com; earth92inc@sbcglobal.net
RE: Change Order No. 1 – Eagle Way Sewer Extension – Project No. 119-095
Dear Mr. Osler:
The Board of Public Works, at its meeting held on November 24, 2020, approved the above
referenced Change Order for an increase of $28,737, bringing the current contract amount to
$268,181.56.
Enclosed is a copy of the Change Order for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-9251.
Sincerely,
s/Linda M. Martin, Clerk
Enclosure
DEPARTMENT OF PUBLIC WORKS
DIVISION OF ENGINEERING
Project Number: _______________ Project Name: __________________________ Change Order #: ____
DATE INITIATED: BPW DATE:
Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.).
Attachments: (List documents support change – required)
Amount of ☐Increase / ☐Decrease: $____________________ Categories (Pick One):
☐ Scope of Work
☐ Differing Site Conditions, Changed Conditions
☐ Conflicted Specifications and Drawings
☐ Failed Materials
☐ Error
☐ Omission
☐ Final Quantity Adjustment
☐ _______________________
Previously approved Change Order(s): $___________________
Current Percent of Change: ____________________ %
New Total Amount: $____________________
Total Percent of Change: ____________________ %
Funding Secured From: __________________________
(filled out by PM)
RECOMMENDED BY:
Project Inspector (Print Name) (Signature) (Date)
REVIEWED BY:
Construction Manager (Print Name) (Signature) (Date)
APPROVED BY:
Engineering Project Manager (Print Name) (Signature) (Date)
APPROVED BY:
City Engineer (Print Name) (Signature) (Date)
November 24, 2020
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 11/16/20
Name Kyle Silveus
Department
Engineering
BPW Date 11/24/20 Phone Extension 9083
Review and Approval Required Prior to Submittal to Board
Diversity Compliance
and Inclusion Officer Officer Name
BPW Attorney Attorney Name Clara McDaniels
Dept. Attorney Attorney Name
Purchasing
Check the Appropriate Item Type – Required for All Submissions
Professional Services Agreement Contract Proposal
Open Market Contract Amendment/Addendum Special Purchase, QPA
Bid Opening Bid Award Req. to Advertise Title Sheet
Quote Opening Quote Award Reject Bids/Quotes
Proposal Opening C/O & PCA No. PCA
Chg. Order, No. 1 Traffic Control Resolution
Other: Ease./Encroach
Required Information
Company or Vendor Name Indiana Earth, Inc.
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name Eagle Way Sewer Extension
Project Number 119-095
Funding Source RWDA TIF
Account No. 324-1050-460-31.02
Amount
Terms of Contract
Purpose/Description Revised Connection to existing manhole based on differing site conditions,
additional slope stabilization
For Change Orders Only
Amount of Increase
Decrease
$ 28,737.00
($ )
Previous Amount $
Current Percent of Change:
Increase
Decrease
12%
( %)
New Amount $268,181.56
Total Percent of Change:
Increase
Decrease
12%
( %)
Time Extension Amount:
New Completion Date: