HomeMy WebLinkAboutChange Order No 1 & PCA - 2020 Community Crossings Round 2 (Div. 1 & 2) Proj No. 120-059 - Rieth-Riley Construction Co., Inc.
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
September 14, 2021
Mr. Ruben Alvarado
Rieth-Riley Construction Co., Inc.
25200 State Road 23
South Bend, IN 46614
ralvardo@rieth-riley.com
RE: Change Order No. 1 (Final)/Project Completion Affidavit
2020 Community Crossings Round 2 (Div. 1 & 2) – Project No. 120-059
Dear Mr. Alvarado:
At its September 14, 2021 meeting, the Board of Public Works approved the Final
Change Order for this project, for a decrease of $29,239.23. The final contract amount is
$253,103.97.
In addition, the Project Completion Affidavit for this project was approved in the amount
of $253,103.97. Copies of the Change Order and Project Completion Affidavit are enclosed 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
September 14, 2021
September 14, 2021
City of South Bend
Department of Administration & Finance
Change Order Request Form
Multiple PO lines:
Project POs:
PO Number 9041
Line Number 1
Original Dollar Amount $282,343.20
New Dollar Amount
(For liquidation request, enter $0)$253,103.97
Reason Code (if changed)
Financial Dimensions (fund-dept-
division-subdivision-main account)265-06-600-506-436008
Project Code (if applicable)
Description of change (include
budget impact)
As part of the project close-out, all of the quantities allocated to the project were not
needed to complete the job.
APPROVED BY PROJECT
ACCOUNTING TEAM (if applicable)A.Pietsch 08/31/21
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.
Change Order Request Form - 2020 CCMG RD 2 1 of 3
Name of Local:
DES Number:
Project Description:
Road 1 with to and from:
Road 2 with to and from:
Road 3 with to and from:
Road 4 with to and from:
Road 5 with to and from:
Road 6 with to and from:
Road 7 with to and from:
Road 8 with to and from:
Road 9 with to and from:
Road 10 with to and from:
* Awarded Amount:
Purchase Order Number:
Purchase Order Amount:
Vendor / Contractor Invoice Number From To Payment Reference Payment
$253,103.97
$253,103.97
$253,103.97
50%
$126,551.99
$126,551.99
$141,171.60
-$14,619.62
* Awarded Amount from CCMG Agreement
List the name of
Vendor/Contractor
who
provided/performed
work. Each payment
will have a separate
line.
Ridgedale Rd from York St to Woodmont Dr
Bowman St from Miami St to Leer St
Community Crossing Matching Grant Close Out - Calculation Sheet
2002890
Negative amount indicates underrun for which the LPA agrees to reimburse based on Funding Match with thirty (30) days from date of billing by INDOT.
** Ineligible Cost: On separate sheet , LPA needs description of Ineligible Costs
** Ineligible Costs
Net Eligible Costs
Funding Match:
CCMG Eligible Amount:
INDOT PO Amount:
Local Eligible Amount:
SOUTH BEND
BALANCE
$141,171.60
00800-002006125
$159,910.00
Service Period
Final Construction Costs
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 0/8/31/2021
Name Scott Kreeger Department Public Works
BPW Date 09/14/2021 Phone Extension 9245
Review and Approval Required Prior to Submittal to Board Diversity Compliance
and Inclusion Officer Officer Name BPW Attorney Attorney Name
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. 1 PCA
Chg. Order, No. Traffic Control Resolution
Other: Ease. /Encroach
Required Information
Company or Vendor Name
2020 Community Crossing - Rd. 2
New Vendor Yes If Yes, Approved by Purchasing
No
MBE/WBE Contractor MBE
WBE Completed E-Verify Form Attached Yes
No
Project Name 2020 Community crossing – Rd. 2
Project Number 120-059
Funding Source Local Roads and Bridge
Account No. 265.06.600.506.436008
Amount $253,103.97
Terms of Contract
Purpose/Description _Project Closeout
For Change Orders Only
Amount of
Increase
Decrease
$
($ 29,239.23)
Previous Amount $ 282,343.20
Current Percent of Change:
Increase
Decrease
%
(10.36%)
New Amount $ 253,103.97
Total Percent of Change:
Increase
Decrease
%
(10.36%)
Time Extension Amount:
New Completion Date: