HomeMy WebLinkAboutPW09-033 - Amendment - #3 - David Lanning - S 212th St UPRR Grade Separation - 12/08/2010 � >
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VYPSHINGTON EMOP-
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
Contract Number: Pli 0- p 33
This Is assigned by City Clerk's Office
Project Name: S. 212th St. UPRR Grade Separation Overcrossing
Description: ❑ Interlocal Agreement ❑ Change Order ® Amendment ❑ Contract
❑ Other:
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 Madfai 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
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KENT
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AMENDMENT NO. 3
NAME OF CONSULTANT OR VENDOR: David Lanning
CONTRACT NAME & PROJECT NUMBER: S. 212th St. UPRR Grade Separation Overcrossing
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 OF KENT:
By: (mot- By:
(signature) s/gnature)
Print Name: Z>AVID3Jl Print Name: Timothy J. LaPorte, P.E.
Its Prtr7 Cr'b Its Public Works Director
(tr e) ftle)
DATE: DATE: 17,161 Z01y
APPROVED AS TO FORM:
(applicable if Mayor's signature required)
Kent Law Department
Lammnq-2W UPRR Am0 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.
KEEP THIS O' YOUR IF YOU HAVE AN ACCIDENT-
OCAR INSURANCE CARD NOTIFY POLICE IMMEDIATELY
POLICY NUMBER 256 8596-808-47M 1 Wnte down names addresses telephone numbers, and license numbers of
persons involved and of witnesses Also wnte down the license plate number and
State Farm Mutual Automobile Insurance Company state of each vehicle involved
INSURED LANNING,DAVID&MAVIS M 2 Notify your agent promptly or log on to statefarm coin®to initiate the claim filing
process
EFFECTIVE DATE DEC-01-2010 EXPIRATION DATE FEB-OB-2011 3 Do not admit fault Do not discuss the accident with anyone except Slate Farm or
Police
CAR-YEARIMAKEIVEHICLE IDENTIFICATION NUMBER • ® • ® • • • °
2007 LEXUS ES 350 4DR
JTHBJ46G872081070 SEE POLICY FOR FULL NAME AND DEFINITION
COVERAGES (All coverages not available in all states)
A BODILY INJURY/PROPERTY
DAMAGE LIABILITY A or AB Lability(Bodily Inlury/Property, R Car Rental
P PERSONAL INJURY PROTECTION Damage) R1,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 Collision(OTC) U Uninsured Motor Vehicle
NAIC#25178 DWG Comprehensive with Full Glass u Undernsured Motor Vehicle
E Fire Theft Other Specified in Washington
AGENT MICHAEL G MANDICK,CLU Penis U1 Uninsured Motor Vehicle-PD
10233 BRIDGEPORT WAY SW F,G,or Collision U2 Uninsured and Undennsured
LAKEWOOD,WA 98499 H Emergency Road Bowles 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
P,Q Personal InturylNo Fault Lability(Michigan)
STATE 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