The URL can be used to link to this page

Home My WebLink AboutPW09-034 - Amendment - #3 - David Lanning - S 212th St BNSF Grade Separation - 12/08/2010 Records Ma*jwagemer KENT W.s„,„Gro„ Document 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 City Clerk's Office. Vendor Name: David Lanning Vendor Number: JD Edwards Number °1- Contract Number: DPW 0 03q This is assigned by City Clerk's Office Project Name: S. 212th St. BNSF Grade Separation Overcrossing Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract ❑ Other: 3 Contract Effective Date: 12/8/10 Termination Date: 12/31/11 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Mark Madfal Department: Engineering Detail: (i.e. address, location, parcel number, tax id, etc.): Extend the time for completion to December 31, 2011 so the Consultant can continue to assist with a cost estimate for the project. S Public\RecordsManagement\Forms\ContractCover\adcc7832 1 11/08 KENT W P S H I N G T O N AMENDMENT NO. 3 NAME OF CONSULTANT OR VENDOR: David Lannin4 CONTRACT NAME & PROJECT NUMBER: S. 2121h St. BNSF Grade Separation Overcrossin4 ORIGINAL AGREEMENT DATE: January 22, 2009 This Amendment is made between the City and the above-referenced Consultant or Vendor and amends the original Agreement and all prior Amendments. All other provisions of the original Agreement or prior Amendments not inconsistent with this Amendment shall remain in full force and effect. For valuable consideration and by mutual consent of the parties, Consultant or Vendor's work is modified as follows: 1. Section I of the Agreement, entitled "Description of Work," is hereby modified to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, the Consultant or Vendor shall: No change is necessary to the scope of work, however an amendment is needed to extend the time of completion to December 31, 2011 so the Consultant can continue to assist with a cost estimate for the project. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are modified as follows: Original Contract Sum, $5,730.025 including applicable WSST Net Change by Previous Amendments $0 including applicable WSST Current Contract Amount $5,730.25 including all previous amendments Current Amendment Sum $0 Applicable WSST Tax on this $0 Amendment Revised Contract Sum $5,730.25 AMENDMENT - 1 OF 2 Original Time for Completion 3/31/09 (insert date) Revised Time for Completion under 12/31/10 prior Amendments (insert date) Add'I Days Required (t) for this 365 calendar days Amendment Revised Time for Completion 12/31/11 (insert date) The Consultant or Vendor accepts all requirements of this Amendment by signing below, by its signature waives any protest or claim it may have regarding this Amendment, and acknowledges and accepts that this Amendment constitutes full payment and final settlement of all claims of any kind or nature arising from or connected with any work either covered or affected by this Amendment, including, without limitation, claims related to contract time, contract acceleration, onsite or home office overhead, or lost profits. This Amendment, unless otherwise provided, does not relieve the Consultant or Vendor from strict compliance with the guarantee and warranty provisions of the original Agreement. All acts consistent with the authority of the Agreement, previous Amendments (if any), and this Amendment, prior to the effective date of this Amendment, are hereby ratified and affirmed, and the terms of the Agreement, previous Amendments (if any), and this Amendment shall be deemed to have applied. The parties whose names appear below swear under penalty of perjury that they are authorized to enter into this Amendment, which is binding on the parties of this contract. IN WITNESS, the parties below have executed this Amendment, which will become effective on the last date written below. CONSULTANT/VENDOR: CITY ENT: By: _ By: (s nature) ( ignature) Print Name: I LAiVFJ 6v Print Name: Timothy J. LaPorte, P.E. Its Its Public Works Director La, le) (title) DATE: P�-�r DATE: lT� ZO/y APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department Wmmn9-2W BNSF Am7 3/Madfai AMENDMENT - 2 OF 2 TEMPORARY AUTO IDENTIFICATION CARD STATE FARM INSURANCE COMPANIES This card is invalid if the policy for which it was issued lapses or is terminated. ` •` ` IF YOU HAVE AN ACCIDENT- CAR INSURANCE CARD NOTIFY POLICE IMMEDIATELY POLICY NUMBER 256 8596-B08-47M 1 Write down names, addresses telephone numbers and license numbers of Slate Farm Mutual Automobile Insurance Company persons involved and of witnesses Also write down the license plate number and Pany state of each vehicle involved INSURED LANNING DAVID&MAVIS M 2 Notify your agent promptly or log on to i tatelarm comO to inmate the Unlm filmg process EFFECTIVE DATE DEC-01-2010 EXPIRATION DATE FEB-08-2011 3 Do not admit fault Do not discuss the accident with anyone except State Farm or Police CAR-YEARIMAKEfVEHICLE IDENTIFICATION NUMBER li 2007 LEXUS ES 350 4DR JTHBJ46G872081070 SEE POLICY FOR FULL NAME AND DEFINITION COVERAGES (All coverages not available in all states I A BODILY INJURY/PROPERTY DAMAGE LIABILITY Aor AB Liability(Bodily Injury/Property R Car Rental P PERSONAL INJURY PROTECTION Damage) Rl,R2 Car Rental and Travel Expense D COMPREHENSIVE$100 C,M Medical Payments S Death Dismemberment G COLLISION$1000 D Comprehensive or Other Than T Disability H,R1,U,U1 41` Collision(OTC) U Uninsured Motor Vehicle NAIC#25178 DWG Comprehensive with Full Glass U Undennsured Motor Vehicle E Fire Theft Other Specified jr Washington AGENT MICHAEL G MANDICK,CLU Perils U1 Uninsured Motor Vehide-PO 10233 BRIDGEPORT WAY SW F,G,or J Collision U2 Uninsured and Undennsured LAKEWOOD,WA 98499 H Emergency Road Service Motor Vehicle PD L Physical Damage UNOC Use of Nonowned Cars N Property Protection W Undennsured Motorist PHONE#253-588-3633 (Name vanes by state) Y Limited Property Damage PO Personal lnlurylNO Fault Liability(Miahigan) STATF FARM INSURANCE COMPANIES (Name vanes by state) z Loss of Earnings Because many states require evidence of insurance on demand, one copy of this form should be carried In the vehicle at all times. 1001022 2003 136768 202 10-13-2010