HomeMy WebLinkAboutChange Order No 1- Olive Street and Sample Street Reconstruction Proj No 113-0021316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND_ INDIANA 46601-1830
CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR
BOARD OF PUBLIC WORKS
July 12, 2016
Mr. David Barich
INDOT LaPorte District
315 E. Boyd Blvd
LaPorte,IN 46350
RE: Change Order No. 1 — Olive Street & Sample Street Reconstruction
Project No. 113-002
Dear Mr. Barich:
PHONE 574/235-9251
FAX 574/235-9171
The Board of Public Works, at its meeting held on July 12, 2016, approved the above
referenced Change Order for an increase of $10,400.00, bringing the current contract amount
to $8,957,769.00.
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,
Linda M. Martin, Clerk
Enclosure
GARY A. GILOT DAVID P. RELOS ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DORAU
Contract No:R -35727 Change Order No.: 001
INDIANA Department of Transportation Page: 1
Construction Change Order and Time Extension Summary
Contract Information Contract No.: R -35727 Letting Date:02/17/2016
District:LAPORTE DISTRICT AE:Barich, David PE/S:Ludwig, Jack Status:Draft
Change Order Information Change Order No.: 001 EWA: Y or Force Acct: N
Date Generated: 00/00/0000 Date Approved: 00/00/0000
Reason Code: CHANGED COND, Utility Related
Description: Lower Existing Metronet Conduit & Fiber on Sample St
Original Contract Amount $ 8,947,369.00
Current Change Order Amount $ 10,400.00 Percent: 0,116 %
Total Previous Approved Changes $ 0.00 Percent: 0.000 %
Total Change To -Date $ 10,400.00 Percent: 0.116 %
Modified Contract Amount $ 8,957,769.00
Time Extension Information
Date Initiated 00/00/0000 Date Completed 00/00/0000
Original Contract Time SS Completion Date 00/00/0000 or SS Calendar/Work Days 0
SP Date 00/00/0000 or SP Days
(SS = Standard Specification, SP = Special Provision)
Time Element Description:
Current Time Extension SS Days 0 SP Days 0 SP Days Value $ 0.00
Previous Time Approved SS Days by AE: DCE: SCE: DDCM:
SS Days SP Days Value $
Revised Contract Time SS Completion Date 00/00/0000 or SS Calendar/Work Days 0
SS Date 00/00/0000 or SP Days 0
Contract No:R -35727 Change Order No.: 001
INDIANA Department of Transportation Page: 2
Construction Change Order and Time Extension Summary
Review and Approval Information
Required Approval Authority
AE: DCE: SCE: • DDCM:
($ per Change Order)
(- LE $ 250K-) (- LE $ 750K -) (-- LE $ 2 M —) (— GT $ 2 M -- )
(Days per Contract)
(50 SS days) (100 SS days) (200 SS Days) (GT 200 SS days)
Verbal Approval Required?
Y / N If Y, by Date Issued
Total Change To-Date>5%?
Y / N if Y, Copy to Program Budget Manager
Scope/Design Recommendation
Y / N If Y, Referred to Project Manager(PM)
Required?
Date to PM Date Returned
Approval Authority Concurs with PM?
Y / N If Y, Concurrence by Date
If N, Resolution: Approved Disapproved
Resolved by Date
LPA Signatures Required?
Y / N If Y, Date to LPA Date Returned
FHWA Signatures Required?
Y / N If Y, Date to FHWA Date Returned
" Field Engineer Recommendation (Required for SCE or DDCM Approval)
Field Engineer
Date
Comments:
Contract No:R -35727 INDIANA Date:05/0312016
Change Order No:001 Department of Transportation Page: 3
_.
Contract: R -35727 `
Project: 1298579 - $late:12985790OLC
Change Order Nbr: 001
Change Order Description: Lower Existing Metronet Conduit & Fiber on Sample St
Reason Code: CHANGED COND, Utility Related
CLN ' N "PLN Item Code Unit Unit Price ....,....d '6tyty, , ..,,
4 Comment Amouunn t Change
0247 1298579 0226 202-06542 EACH 10,400.000 1.000 C Amount$ 10,400.00
Item Description: RELOCATE
Supplemental Oescriptiont: Lower existing Metronet fiber and conduit for MOT 1A.
Supplemented Description27
Total Value for Change Order 001= S 10,400.00
Whereas, the Standard Specifications for this contract provides for such work to be performed, the following change is recommended,
General or Standard Change Order Explanation
Existing Metronet line on Sample east of Olive did not have enough cover to facilitate the temporary widening of Sample for MOT 1A. Price is for
lowering to a suitable depth for placement of temp HMA. Work took 2 days to complete.
Change Order Explanation for Specific Line Item
It is the intent of the parties that this change order Is full and complete compensation for the work describe above.
Notification and consent
to this �change order is hereby acknowledged.
- j?Kr�-t
Contractor; �-< /" / V �._._C.L ROk5eg-N�jC}Gq�S- aA
Signed 6y: rM6R,
Date:
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NOTE: Other required State and FHWA signatures will. be obtained electronically through the SiteManager system.
Contract No:R -35727 INDIANA Date:05/03/2016
Change Order No:001 Department of Transportation Page: 4
APPRGVEDiFYR L_QCAL.PUBLJC AGENCY
Berard of Public Work,,
(SIGNATURE) rrm r,
(DATE)
(DATE)
APPROVED FOR INDIANA DEPARTMENT OF TRANSPORATION
Approval Level Name of Approver Date Status
Date
Name
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
July 5, 2016 Department Public Works
Roger Nawrot
Division/Bureau Engineering
BPW Date July 12, 2016 Phone Extension 5932
Required Prior to Submittal to Board
Legal ❑ Attorney Name:
Controller El greater
review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing ❑
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. 1 ❑ C/O & PCA No. ❑ PCA
❑ Ease/Encroach. ❑ Traffic Control:
❑ Other:
Required Information
Company or Vendor Name Indiana Department of Transportation
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Amount of
Increase
Decrease
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Chanqe:
py
Original
®
❑
❑
❑
❑
❑
It Yes, Approved by
U MBE U WBE
❑ No ❑ Yes Name of Company
Olive Street and Sample Street Reconstruction
113-002
Major Moves
412-0414-1542.03
$10,400.00
Federal 80%, City 10% & County 10%
This change order is for the lowering of the existing Metronet in
the sidewalk along Sample Street. Currently the City will bore
100 % of the cost because it is a non -participating item by
FHWA.
❑ Required Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
For Change Orders
er Nawrot