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Home My WebLink AboutChange Order No 1 - Sample & Mayflower Intersection Improvements Proj No. 120-052R - Milestone Contractors North, Inc. ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT JORDAN V. GATHERS 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 27, 2022 Mr. Dustin P. Hilary Milestone Contractors North, Inc. 24358 State Road 23 South Bend, IN 46614 akrueger@milestonelp.com RE: Change Order No. 1 – Sample and Mayflower Intersection Improvements Project No. 120-052R Dear Mr. Hilary: At its September 27, 2022 meeting, the Board of Public Works approved the above referenced Change Order be decreased by $9,168.61 with an additional two hundred & forty (240) days, bringing the revised contract amount to $338,467.54 with a new completion date of July 10, 2022. Enclosed is a copy of the Change Order for your records. If you have any further questions, please call this office at (574) 235-9251. Sincerely, /s/ Theresa Heffner Theresa Heffner, Clerk Enclosures TH/lh September 27, 2022 City of South Bend Department of Administration & Finance Change Order Request Form Multiple PO lines: Project POs: PO Number PO 10526 26,091.98 PO Remiaing Balance 147,636.15 From Line Number 3 9,168.61 Reduced by this amount ($147,636.15 - $138,467.54)138,467.54 To Original Dollar Amount $0.00 16,923.37 O/S Po Balance for Line 2 9,168.61 Reduction Amt New Dollar Amount (For liquidation request, enter $0)$16,923.37 Reason Code (if changed) Financial Dimensions (fund-dept- division-subdivision-main account)455-442001 Project Code (if applicable)PROJ 220 Description of change (include budget impact)Final contract amount. Balancing change order #1 and final APPROVED BY PROJECT ACCOUNTING TEAM (if applicable)Ron O'Connor 09-13-2022 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) 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 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 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 New Dollar Amount (For liquidation request, enter $0) Reason Code (if changed) 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 two lines 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. Copy of PO-10526 Milestone Contractors PO Change Order Request Form Reduce Line 2 by 9168.61 Leslie 1 of 2 City of South Bend Department of Administration & Finance Change Order Request Form 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 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 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) Copy of PO-10526 Milestone Contractors PO Change Order Request Form Reduce Line 2 by 9168.61 Leslie 2 of 2 BOARD OF PUBLIC WORKS AGENDA ITEM REVIEW REQUEST FORM Date 9/13/2022 Name Leslie Biek, PE Department PW BPW Date 9/27/2022 Phone Extension 9323 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. PCA Chg. Order, No. 1 and Final Traffic Control Resolution Other: Ease./Encroach Required Information Company or Vendor Name Milestone Contractors North, Inc. New Vendor Yes If Yes, Approved by Purchasing No MBE/WBE Contractor MBE WBE Completed E-Verify Form Attached Yes No Project Name Sample and Mayflower Intersection Improvements Project Number 120-052R Funding Source Account No. PO-10526 Amount Terms of Contract Purpose/Description Final balancing change order. ______________________________________ ______________________________________________________________ For Change Orders Only Amount of Increase Decrease $ ($ 9168.61) Previous Amount $ 347,636.15 Current Percent of Change: Increase Decrease % (2.64%) New Amount $ 338,467.54 Total Percent of Change: Increase Decrease % (2.64%) Time Extension Amount: New Completion Date: