HomeMy WebLinkAboutSupplemental Agreement No. 3 - Additional Bridge Inspection Work and Soil Boring for Retaining Wall – United Consulting
ELIZABETH A. MARADIK GARY A. GILOT JORDAN V. GATHERS JOSEPH R. MOLNAR MURRAY L. MILLER
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
April 13, 2021
Mr. Michael Rowe, PE
United Consulting
8440 Allison Pointe Blvd., Suite 200
Indianapolis, IN 46250
michael.rowe@ucindy.com
RE: Supplemental Agreement No. 3
Dear Mr. Rowe:
At its April 13, 2021 meeting, the Board of Public Works approved the above referenced
agreement for additional bridge inspection work and soil boring for the retaining wall near Notre
Dame’s softball fields for the Coal Line Trail Phase 2 in an amount not to exceed $33,300.
Enclosed please find a copy of the agreement for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-9251.
Sincerely,
/s/ Anne Fuchs
Anne Fuchs, Clerk
Enclosures
AF/lh
IN WITNESS WHEREOF, the parties hereto have executed this
Supplemental Agreement No. 3
UNITED CONSULTING LOCAL PUBLIC AGENCY
BY: BY:
Elizabeth A. Maradik, President
BY: 11U.£ �
Michael Rowe, ice President
BY:
Gary A. Gilot, Member
BY:
DATE: Murray L. Miller, Member
BY:
Jordan V. Gathers, Member
BY:
Joseph R. Molnar, Member
DATE:
Anne Fuchs, Clerk
Supplemental Agreement version 6-2011 llt@Hi@EI
City of South Bend
Department of Administration & Finance
Change Order Request Form
Multiple PO lines:
Project POs:
PO Number 0000011-1
Line Number
Original Dollar Amount $465,370 ($432,448 on DFO PO)
New Dollar Amount
(For liquidation request, enter $0)$498,670.00
Reason Code (if changed)
Financial Dimensions (fund-dept-
division-subdivision-main account)324-10-102-121-431001
Project Code (if applicable)PROJ00000018
Description of change (include
budget impact)
Additional Bridge Inpection services, additional geotechnical investigation for
retaining wall
APPROVED BY PROJECT
ACCOUNTING TEAM (if applicable)A.Pietsch - use category 324-431001
PO Number
Line Number
Original Dollar Amount
New Dollar Amount
(For liquidation request, enter $0)
Reason Code (if changed)
Financial Dimensions (fund-dept-
division-subdivision-main account)
Project Code (if applicable)
Description of change (include
budget impact)
APPROVED BY PROJECT
ACCOUNTING TEAM (if applicable)(PAT member's name and date to be completed by PAT member)
PO Number
Line Number
Original Dollar Amount
Changing the line amount:
You can only change a line amount if it has NOT been invoiced against.
•If the line has NOT been invoiced – reduce the line amount to equal what it should be.
•If the line has been invoiced – cancel the delivery remainder and finalize the individual line, then add a new line for the
amount that should be remaining.
If you have changes to more than one line on the same PO, fill out a separate section for each line affected by the change
order.
For change orders on project-related POs, this form must be approved by the Project Accounting Team as described in
Supplement 508.
CLT Phase II_Supplement 508 Form - Change Order Request Form 1 of 3