HomeMy WebLinkAboutChange Order No 1 - Western Ave. Streetscape, Phase III Proj No. 118-076 - 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. 5 – Western Ave. Streetscape, Phase III – Project No. 118-076
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 $41,135, bringing the current contract amount to
$2,885,401.94.
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 Department Public Works
Name Kyle Silveus Division/Bureau Engineering
BPW Date 11/24/20 Phone Extension 9083
Required Prior to Submittal to Board
Legal Attorney Name: Clara McDaniels
Controller Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing Michael Schmidt
Check the Appropriate Item Type – Required for All Submissions
Agreement Contract Proposal Addendum
Professional Services Resolution
Bid Opening Bid Award Req. to Advertise Title Sheet
Quote Opening Quote Award
Change Order No. 5 C/O & PCA No. PCA
Ease/Encroach. Traffic Control:
Other:
Required Information
Company or Vendor Name Indiana Earth, Inc.
New Vendor Yes No If Yes, Approved by Purchasing
MBE/WBE Contractor MBE WBE
MBE/WBE Contractor Requested No Yes Name of Company
Project Name Western Ave. Streetscape - Phase III
Project Number 118-076
Funding Source RWDA TIF
Account No. 324-1050-460-42-03
Amount $N/A
Terms of Contract
Purpose/Description Final Quantity Adjustment, Added Bench
Required Contractor’s Certification Forms Attached (Non-
Collusion, Non-Discrimination, Non-Debarment, E-Verify, Iran, etc.)
Required For Change Orders Only
Amount of Increase
Decrease
$ 41,135
$
Previous Amount $ 2,844,266.94
Current Percent of Change: 1.45%
New Amount $ 2,885,401.94
Total Percent of Change: 9.53%
Dispersal After Approval
Copy Original