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CM-10-01-017rev. 1/10 )IiN11110( IIAA, Contract Quantity Adjustment/Change Order Department: Engineering and Development Services Project Name: Egger Acres & Dennis Drive Improvements City Project ID Number: ST12DENN Page 1 of 3 Date: Change Order/Quantity Adjustment No. 1/7/2010 2 Justification: Change Order # 2 adds the removal and replacement of six (6) residential driveway approaches on Dennis Drive, Sara Drive, Karen Cove, and Heather Drive. SUMMARY Original Contract Price: Total Contract Price with Quantity Adjustment(s): Previous Change Order(s): This Change Order: Total Change Order(s) To Date: Previous Quantity Adjustment(s): This Quantity Adjustment: Total Quantity Adjustment(s): Original Contract Price Plus Change Order(s) Plus Quantity Adjustment(s): Original Contract Time: Contract Time Prior to this Change Order: Contract Time with All Approved Change Orders: Prepared by/ Contractor Approval: City Staff Approval: Signatures and Approvals r Printed Name, Title and/Company Amount $1,237,883.00 $1,225,883.00 $21,200.00 $12,343.55 $33,543.55 -$12,000.00 $0.00 -$12,000.00 0/0 Change $1,259,426.55 210 Calendar Days 1.73% 1.01% 2.74% 210 Calendar Days 210 Calendar Days Da e It i; k Printed Name, Title and Company Date rif.t:., e, ��, ^ ` �^ /17/, Date Signature 1 City Official Approval: ?Signature CM- 10- 01- 011 Printed Name Title Printed Name and Title1=..E k3aiMetrato 1- Date154O rev. 12/09 Contract Quantity Adjustment/Change Order Page 2 of 3 Bid Item# Item Description and Change Unit Qty. Unit Price Amount Contract Time Adjustment (Days) CO 2-1 CO 2-2 CO 2-3 CO 2-4 CO 2-5 CO 2-6 530 Dennis Drive 506 Sara Drive 508 Sara Drive 511 Sara Drive 1604 Karen Cove 501 Heather Drive S.F. S.F. S.F. S.F. S.F. S.F. 270 $8.65 $2,335.50 0 207 $8.65 $1,790.55 0 270 $8.65 $2,335.50 0 230 $8.65 $1,989.50 0 180 $8.65 $1,557.00 0 0 270 $8.65 $2,335.50 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 TOTALS: $12,343.55 0 rev. 12/09 Contract Quantity Adjustment/Change Order Page 3 of 3 TOTALS: $0.00 0 Bid Item# Item Description and Change Unit Qty. Unit Price Amount Contract Time Adjustment (Days) 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 0 $0.00 $0.00 TOTALS: $0.00 0 DATE: January 13, 2010 SUBJECT: City Manager Approval —January 15, 2010 ITEM: Consider executing Change Order # 2 with Nelson Lewis, Inc. for the Egger Acres and Dennis Drive Improvements Project. Department: Engineering and Development Services Staff Person: Danny Halden, P.E., City Engineer Justification: Change Order # 2 adds the removal and replacement of six (6) residential driveway approaches on Dennis Drive, Sara Drive, Karen Cove, and Heather Drive. Strategic Plan Relevance: Goal # 2.0: Prevent neighborhood deterioration. Goal # 29.0: Provide for effective management of storm water. Funding: Cost: $12,343.55 Source of funds: 2002 G.O. Bonds Amount % Change Original Contract $1,237,883.00 N/A Previous Quantity Adjustments ($12,000.00) N/A Previous Change Orders $21,200.00 1.73% Change Order # 2 $12,343.55 1.01% Revised Contract $1,259,426.55 2.74% Outside Resources : Nelson Lewis, Inc. Public Comment: N/A UPDATED APRIL 2008 3/9/2009 Request for City Council/City Manager Action 101 City Council 12 City Manager Submit completed form for all City Manager and City Council approvals. Department Name: Engineering & Development Services Contact Person: Chaz Gordon / Kathy Michna Project Mgr/Resource: Eddie Zapata Project Coordinator: r Tag#: L.11r tO°01' QI 7 Original Documents Received: h Project Name: Egger Acres & Dennis Drive Improvements Contractor/Vendor: Nelson Lewis, Inc. Funding Source: 2002 G.O. Bonds Amount: $12,343.55 Assigned Attorney: Steve Sheets Account Number: City Council or City Manager Approval Date: January 13, 2010 Agenda Wording Consider executing Quantity Adjustment/Change Order No. 2 with Nelson Lewis, Inc. for the Egger Acres and Dennis Drive Improvements Project. Finance Information Is Funding Required? Yes 1E1 No 0 Q Initial Construction Contract Construction Contract Amendment # 0 Change Order/Quantity Adjustment # 2 =Change in Quantity =Unforeseen Circumstances Initial Professional Services Agreement Q Supplemental Professional Service Agreement Purchasing/Service Agreement Q Purchase Order Item(s) to be purchased Other (Please clearly identify action on lines below) Amount $12,343.55 FINANCE N/A Approved CI El Finance/CIP Finance/Acct Purchasing Budget Date Date Date Date APPROVALS (to be completed ONLY by Finance) Final Finance Approval Required Approved Finance Director Date Once approvals have been obtained, please forward the RFA, blue sheet. back up information and originals to City Secretary, Sara White. ITEMS WILL NOT BE PLACED ON THE COUNCIL. AGENDA WITHOUT FINANCE AND LEGAL APPROVAL PRIOR TO SUBMISSION. Required for Submission of ALt 9itvvCouitcil Ntd City Manager Items Project Mgr. Signature: Dept. Director Signature: *City Attorney Signature: City Manager Signature: Date: i f [_ Date: alitifo Date: I "lc—"lc—f� I v Date: I -15", v *City Attorney signature is required for all items. REVISED 1/11/2010 3/9/2009 Request for City Council/City Manager Action E City Council El City Manager Submit completed form for all City Manager and City Council approvals. For Administration Use ONLY Received: Tag #: Original Documents Received: Department Name: Engineering & Development Services Project Name: Egger Acres & Dennis Drive Improvements Contact Person: Chaz Gordon / Kathy Michna Project Mgr/Resource: Eddie Zapata Project Coordinator: ContractorNendor: Nelson Lewis, Inc. Funding Source: 2002 G.O. Bonds Amount: $12,343.55 Assigned Attorney: Steve Sheets Account Number: City Council or City Manager Approval Date: January 13, 2010 Agenda Wording Consider executing Quantity Adjustment/Change Order No. 2 with Nelson Lewis, Inc. for the Egger Acres and Dennis Drive Improvements Project. Finance Information Is Funding Required? Initial Construction Contract Construction Contract Amendment # Change Order/Quantity Adjustment =Change in Quantity Initial Professional Services Agreement Supplemental Professional Service Agreement Purchasing/Service Agreement Purchase Order Item(s) to be purchased Yes No # 2 =Unforeseen Circumstances Other (Please clearly identify action on lines below) Amount $12,343.55 APPROVALS (to be completed ONLY by Finance) FINANCE Final Finance Approval Required N/A Approved Approved Q CI Finance/CIP L. Olsen Date 1/12/2010 0 Cheryl Delaney 0 ED Finance/Acct E. Wilson Date 1/13/2010 Finance Director 0 0 Purchasing EE Bowden Date 1/12/2010 1/13/2010 Q [ Budget P. Bryan Date 1/12/2010 Date Once approvals have been obtained. please forward the RFA, blue sheet, back up information and originals to City Secretary, Sara White, ITEMS WILL NOT BE PLACED ON THE COUNCIL AGENDA WITHOUT FINANCE AND LEGAL APPROVAL, PRIOR TO SUBMISSION. Required for Submission of ALL City Council and City Manager Items Project Mgr. Signature: Date: Dept. Director Signature: Date: *City Attorney Signature: Date: City Manager Signature: Date: *City Attomey signature is required for all items. REVISED 1/13/2010 LEGAL DEPARTMENT APPROVAL FOR CITY COUNCIL/CITY MANAGER ACTION Required for Submission of ALL City Council and City Manager Items Department Name: Pw/Engineering Project Mgr/Resource: Danny Halden/Eddie Zapata Council Action: ORDINANCE Agenda Wording Project Name: Egger Acres and Dennis Drive Improvements ContractorNendor: Nelson Lewis, Inc. RESOLUTION City Manager Approval CMA Wording Consider executing Quantity Adjustment/Change Order No. 2 with Nelson Lewis, Inc. for the Egger Acres and Dennis Drive Improvements Project. Attorney Approval 0Attorney Date Notes/Comments 0:\ardox\SCClnts\0190\7116\MISC\00179985.XLS Updated 6/3/08