HomeMy WebLinkAboutPW06-049 - Change Order - #1 - Earth Tech Inc - S 288th Street Corridor Projects - Construction Coordination Support Services - 12/15/2006 —
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CONTRACT COVER SHEET
This is to be completed by the Contract Manager prior to submission to City Clerks Office. All
portions are to be completed, if you have questions, please contact Mary Simmons, City
Clerks Office.
Vendor Name: Earth Tech Inc.
Contract Number: PCJ0(0- 0`•( q
This is assigned by Mary Simmons
Vendor Number:
Project Name: S. 228th St. Corridor
Contract Effective Date: Date of the Mayor's signature
Contract Termination Date:March 31, 2007
Contract Renewal Notice (Days):
Number of days required notice for termination or renewal or amendment
Contract Manager: Pete Tenerelli
Department: Engineering
Abstract:
Extend the time for completion for proiect coordination services.
ADCL7832 07/02
40000
KENT
CHANGE ORDER NO. 1
NAME OF CONTRACTOR, CONSULTANT, OR VENDOR Earth Tech Inc ("Contractor")
CONTRACT NAME &PROJECT NUMBER: S 228th St. Corridor Proiect Coordination Services
ORIGINAL CONTRACT DATE. May 11, 2006
This Change Order amends the above-referenced contract; all other provisions of the contract that are
not inconsistent with this Change Order shall remain in effect For valuable consideration and by mutual
consent of the parties, the project contract is modified as follows:
1. Section I of the Agreement, entitled"Description of Work," is hereby modified as follows:
Provide all labor, materials, and equipment necessary to:
No change is necessary to the description of work, however a change order is
necessary to extend the time for completion to March 31, 2007.
2. The c ontract amount and time f or p erformance p rovisions o f S ection I I "Compensation," and
Section III, "Time for Completion," are hereby modified as follows.
Original Contract Sum, $909000.00
including applicable alternates and WSST.
Net Change by Previous Change Orders $0.00
(incl applicable WSST)
Current Contract Amount $90,000.00
(zncl Previous Change Orders)
Current Change Order $0.00
Applicable WSST Tax on this Change Order $0.00
Revised Contract Sum $90,000.00 (no change)
Original Time for Completion 12/31/06
(insert date)
Revised Time for Completion under 0
prior Change Orders
(insert date)
Days Required ± for this Change Order 90 calendar days
Revised Time for Completion March 31, 2007
(insert date)
Pursuant to Section XIII F , entitled "Changes," of the Contract executed by the parties, the Contractor
accepts all requirements of this Change Order by signing below Also, pursuant to the above-referenced
contract, Contractor agrees to waive any protest it may have regarding this Change Order and acknowledges
and accepts that this Change Order constitutes final settlement of all claims of any kind or nature arising from
or connected with any work either covered or affected by this Change Order,including, without limitation,
claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits
The parties whose names appear below swear under penalty of perjury that they are authorized to enter
into this contract modification, which is binding on the parties of this contract.
3. The C ontractor will adjust the amount o f i is p erformance b and (if any) f or this p roj ect to b e
consistent with the revised contract sum shown in section 2, above
IN WITNESS, the parties below have executed this Agreement, which will become effective on the
last date written below.
CONTRAC CITY OF KENT:
By: By:
(segnalur (signature)
Print Name 8�un K✓s SG� Print N e: Su to Cooke
Its Viez nsi �i•-� f Its Mayor
(1 ode/ Title //
DATE /Z foblz006, DATE:_/�
AP P OVED AS TO FORM:
1
ent aw Dapa ent
Earth Tech-228th Project Coordination COUTenereth
CONTRACT MODIFICATION-2 OF 2
MARSH CERTIFICATE OF INSURANCE _ CERTIFICATE NUMBER
LOS-000513364-17
PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Marsh Risk&Insurance Services NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
License# 0437153 POLICY THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE
777 S Figueroa Street AFFORDED BY THE POLICIES DESCRIBED HEREIN
Los Angeles,CA 90017-5822 COMPANIES AFFORDING COVERAGE
Attn Helen Shamma(213)346-5530 Fax(213)346-5886 -
COMPANY
8880-ETECH-PL-06/07 ATTPL 98004 12 06 A American Home Assurance Company
INSURED COMPANY
EARTH TECH,INC B WORKERS COMPENSATION,SEE ATTACHED SCHEDULE
10800 N E 8TH STREET,7TH FLOOR
BELLEVUE,WA 98004 COMPANY
C LLOYD'S OF LONDON
COMPANY
D NIA
COVERAGES This certificate supersedes and replaces any previously Issued certificate for the policy period noted below.
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED
NOTWITHSTANDINGANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRAC—CR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS CONDITIONS AND EXCLUSIONS OF SUCH POLICIES AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
CO TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE(MM/DDIYY) DATE(MMIDDIYY)
GENERAL LIABILITY
GENERAL AGGREGATE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY GL5759120 i10/01/06 10/01/07 PRODUCTS-COMPIOPAGG $ 1,000,000
CLAIMS MADE � OCCUR PERSONAL&ADV INJURY $ 1,000,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE(Anyone fire) $ 1,000,000
MED EXP An one erson $ 10,000
A AUTOMOBILE LIABILITY CA 5836482(AOS) 10/01/06 10/01/07
COMBINED SINGLE LIMIT $ 1,000,000
A X ANYAUTO CA 5836481 (MA) 10/01/06 10/01/07
A ALL OWNED AUTOS CA 5836480(TX) 110/01/06 10/01/07 BODILY INJURY $
A I SCHEDULEDAUTOS CA 5836479(VA) 10/01/06 10/01/07 (Per person)
X HIRED AUTOS BODILY INJURY $
X (Per acudent)
NON-0W N ED AUTO$
PROPERTY DAMAGE $
GARAGE LIABILITY AUTOONLY EAACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND X WC LIMITS OTH.EMPLOYERS LIABILITYER
A SEE PAGE TWO 10/01/06 10/01/07 EL EACH ACCIDENT $ 1,000,000
B I THE PROPRIETOR/ INCL SEE PAGE TWO 10/01/06 10/01/07 EL DISEASE-POLICY LIMIT $ 1,000,000
PARTNERSIEXECUTIVE
OFFICERS ARE EXCL EL DISEASE-EACH EMPLOYEE 1$ 1,000,000
C OTHER OF 054306-SIR$50,000(PL) 10/15/06 10/15/07 Per Claim
Professional Liability Aggregate 1,000,000
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESISPECIAL ITEMS
S 228th Street Corridor Project Coordination CITY OF KENT(IS/ARE)NAMED AS ADDITIONAL INSURED FOR GL&AL COVERAGES, BUT ONLY AS
RESPECTS WORK PERFORMED BY OR ON BEHALF OF THE NAMED INSURED
CL^RTIFICATE-HOLDER' CANCELLATION
SHOULD ANY OF THE POLCIES DESCRIBED HEREN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF
THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL lA DAYS WRITTEN NOTICE TO THE
CITY OF KENT ENGINEERING DEPARTMENT CERTIFICATE HOLDER NAMED HEREIN BUT FAILURE TO MAIL SUCH NONCE SMALL IMPOSE No OBLIGATION OR
ATTN Nancy Yoshitake
220 4TH AVE SOUTH LIABILRY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE ITS AGENTS OR REPRESENTATIVES OR THE
KENT,WA 98032 ISSUER OF THIS CERTIFICATE
MARSH USA INC
BY Michael J Vizio
MM1(3102) VALID AS OF' 12/13/06
DATE IMMIDDIYY)
ADDITIONAL INFORMATION Los-000513364-17 12/13/06
PRODUCER COMPANIES AFFORDING COVERAGE
n M i Marsh Risk&Insurance Services COMPANY
License# 0437153
777 S Figueroa Street E
Los Angeles,CA 90017-5822
Attn Helen Shamma(213)346-5530 Fax(213)346-5886 COMPANY
F
58880-ETECH-PL-06/07 ATTPL 98004 12 06
INSURED COMPANY
EARTH TECH,INC
10800 N E 8TH STREET,7TH FLOOR G
BELLEVUE,WA 98004
COMPANY
H
TEXT
WORKERS COMPENSATION COVERAGE
1 0101/06-1 0101/07
INSURANCE POLICY# STATE
(A)AMERICAN HOME ASSURANCE CO CA
WC 2920280
(A)AMERICAN HOME ASSURANCE CO DE
WC 2920285
(A)AMERICAN HOME ASSURANCE CO FL
WC 2920287
(A)AMERICAN HOME ASSURANCE CO NJ
WC 2920290
(A)AMERICAN HOME ASSURANCE CO PA
WC 2920291
(B)NATIONAL UNION FIRE INS CO NV
WC 2920283
(B)NATIONAL UNION FIRE INS CO OR
WC 2920284
(B)ILLINOIS NATIONAL INS CO IL
WC 2920286
(B)ILLINOIS NATIONAL INS CO MI
WC 2920289
(B)INS CO STATE OF PA AR,MA,TN,VA
WC 2920288
(B)NEW HAMPSHIRE INS CO NY,WI
WC 2920282
(B)Al SOUTH INSURANCE CO GA
WC 2920281
(A)AMERICAN HOME ASSURANCE CO ALL OTHER STATES
WC 2920292
CERTIFICATE HOLDER
CITY OF KENT ENGINEERING DEPARTMENT
ATTN Nancy Yoshltake
220 4TH AVE SOUTH
KENT,WA 98032
MARSH USA INC BY
Page Michael J Vlzio
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY,
ENDORSEMENT#
This endorsement,elfectr4e 12 01 A,M 10/01/2006 forms a part of
Policy No GL 575-91-20 issued to C+tnne Management Corporation Ey
American Home Assurance Company
ADDITIONAL INSURED-WHERE REQUIRED UNDER CONTRACT ORAGREEMENT
This endorsement moVies insurance provided under the fotiownV
COMME 2CtALGENERAL LIABILITY CCtv'EAAGE FORM
Section If-Who is an Insured,I., is amended to add,
f) Any person or organization to whom you become obligated to include as an additional
Insured under this policy, as a result of any contract or agreement you enter into which
requires you to rumrsh insurance to that person or organization a the type provided by this
policy,but only with respect to Inability arising out Y your operations or premises owned
by or rented to you However,the insurance provided will not exceed the lesser of
1 The coverage and/or limits ofthis policy, or
2 The coverage and/or limits required
g q by said contract or agreement
61712 (9101)