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HomeMy WebLinkAboutPW15-238 - Change Order - #1 - ICON Materials dba CPM Development Corporation - Asphalt Overlay Project No. 15-3003 - 08/12/2015 r ;Age m WASHINGTON e. .'. 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. Ef you have questions, please contact City Clerk's Office. Vendor Name: t L,0iN i K aecyi Q11 Vendor Number: _ JD Edwards Number Contract Number: PVIJ1�3 - -3IR-7 - 00 This is assigned by City Clerk's Office Project Name: 2 11 1C{ oy(wl f Description: ❑ Tnterlocal Agreement ( Change Order ❑ Amendment ❑ Contract ❑ Other: Contract Effective Date: t } I5 Termination Date: Contract Renewal Notice (Bays): Number of days required notice for termination or renewal or amendment Contract Manager: (('k[)ff`� 1 epartment: PV Contract Amount: r 1o , ljoq - Approval Authority: ❑ Department Director ❑Mayor E16ty Council Detail: (i.e. address, location, parcel number, tax id, etc.): adccW10877 8 14 d�EN7' CHANGE ORDER NO. # 1 NAME OF CONTRACTOR: Icon Materials, Inc. ("Contractor") CONTRACT NAME & PROJECT NUMBER: 2015 Asphalt Overlays, 15-3003 ORIGINAL CONTRACT DATE: June 30, 2015 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 to add additional work or revise existing work as follows: In addition to work required under the original Agreement and any prior Amendments, Contractor shall provide all labor, materials, and equipment necessary to: Add two additional locations to the 2015 Overlay project on 42Id Ave South near Reith Road and 40th Avenue South near South 272Id due to competetive bid prices allowing the opportunity to add additional locations to the project. 2. The contract amount and time for performance provisions of Section II "Time of Completion," and Section III, "Compensation," are hereby modified as follows: Original Contract Sum, $1,066,044.05 (including applicable alternates and WSST) Net Change by Previous Change Orders $0.00 (incl. applicable WSST) Current Contract Amount $1,066,044.05 (incl, Previous Change Orders) Current Change Order $519,604.25 Applicable WSST Tax on this Change $0.00 Order Revised Contract Sum $1,585,648.30 I i CHANGE ORDER - 1 OF 3 Original Time for Completion 60 (insert date) Revised Time for Completion under o prior Change Orders (insert date) Days Required—(I—) for this Change 15 calendar days Order Revised Time for Completion 75 (insert date) In accordance with Sections 1-04.4 and 1-04.5 of the Kent and WSDOT Standard Specifications, and Section VII of the Agreement, 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. This Change Order, unless otherwise provided, does not relieve the Contractor from strict compliance with the guarantee and warranty provisions of the original contract, particularly those pertaining to substantial completion date. All acts consistent with the authority of the Agreement, previous Change Orders (if any), and this Change Order, prior to the effective date of this Change Order, are hereby ratified and affirmed, and the terms of the Agreement, previous Change Orders (if any), and this Change Order 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 contract modification, which is binding on the parties of this contract. 3. The Contractor will adjust the amount of its performance bond (if any) for this project to be 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. CONTRACTOR: CITY,_Gf—_ ENT ;J r ( natu ( nature Print Na�rrpp thsot�C� Print Name: �Ivf\L'i�lU �t�1ta'1C' Its V ��M Its "v' ck-or f (�ltlel_ (tits ) II DATE: ��lr.. DATE: f CHANGE ORDER - 2 OF 3 APPROVE® AS TO FORM: (applicab if Mayor's sig ature requi pd,) fff� 4f�9y1 I Kent Law Department [in this fleld,you may enter the eleRroNc fl ,th where the m t,ad has been saved] i I i i CHANGE ORDER - 3 OF 3 ® FILE NO: 200.2 CHANGE ORDER WORKSHEET NO. I Construction Management Division - Public Works Project: 2015 Aspahlt Overlays Project No.: 15-3003 Project Engineer: Joseph Araucto Fed-Aid No.: N/A Owners Rep: Jason Bryant Contractor: Icon Materials Date: 8/7/2015 I. PROPOSED CHANGE Add two additional locations to the 2015 Overlay project on 42nd Ave So. near Reith rd and 40th Ave So. near So. 272nd II. REASON AND BACKGROUND FOR CHANGE Competetive bid prices allowed the opportunity to add additional locations to the project scope. III. METHOD OF PAYMENT NEW PAY ITEM(S) L] Not Applicable � Change Order No. _ FOR ACCOUNTING USE ONLY Sch. No. Item Description Total Est. Qty this Unit Unit Price Total Estimated Cost of Qty PE Item 4 40tt' Ave South _ 1 0 LS $311,087 25 $311 087.25 5 42nd Ave South 1 0 1 LS__ _ - _....- $2D8 517 00 $208,517.00 -- -- - I I _ i Independent Estimate Attached ® CREATE PAY ITEM ONLY — Payment to be made PAY THIS PAY ESTIMATE REQUIRED _ _ at a later date-upon completion of work Material Submittals Required — CC: Construction Coordinator I New Sub Reqrd? I No DELETE EXISTING PAY ITEM(S) per 3-09.S ® Not Applicable Change Order No. - I j FOR ACCOUNTING USE ONLY Sch No i B I. No. Item Description Qty Unit _ Unit Price Cost of Item ._. ----- - ------7- ------ ------ ---- -------- -__ -----i -._.-.._---------- I Independent Estimate Attached - REQUIRED I INCREASE/DECREASE TO EXISTING PAY ITEM(S) ® Not Applicable Change Order No. r 1 _l ( I FOR ACCOUNTING USE ONLY Sch. No. B.I. No. j Item Description Qty Unit Unit Price I Cost of Item - - - — -- Independent Estimate Attached - REQUIRED 1 O ! -- - 1 REV, DATE: 4/01/10 . i ® T FILE NO: 200.2 ...''. 6CEN i TOTAL ESTIMATED COST OF CHANGE ORDER * $19,604.25 *Total of the Cost of Item Columns THIS PAY ESTIMATE IV. WORKING DAYS Original Contract 160 Due This Change Order 15 Previous Total 1 60 -DATE 17/28/15 T _-I DATE: 1.7 28 15__,_ * i Exolanation/Justification Required: '..... i TOTAL WORKING DAYS* E— 75 *This Change Order + Previous Total All work, materials and measurements to be in accordance with the Standard Specifications and Contract Special Provisions for the type of work described. Prepared By: /i, i` =` Date: 3890n Bryant Construction Supervisor: „�,.p%�/ (r�� _ Date: PaUl Kuehne` f.. Construction Manager: ��- Date: Eric Connor i 2 REV. DATE: 4/01/10 J e °�-' KENT 2015 Asphalt Overlays Engineer's Opinion of Cost - Change Order No 1 Prepared By:JSA Revised: 8/12/2015 8:19 0. a: ik°lv,�,r TPD1kI cr A.>. e, r eh;4 a� 'ENPS)USGRIP�I�TN } . q;i},} v 'a '�` , '1711TST' ` U'AIITLTY 'A7�C0*S` a"`t`T TAIr J30ST".-. �`.��t* ,i...v,C%•..:.E.�t,�,.#�..?.�nc°''r�,tr,....�'. 7.,4Y_, "u a,ti'E„�s ��:.54 SCHEDULE V 42m]Ave S between Refth Rd and S 261th St 5000 # Mobilization(SCHEDULE IV) LS 1 $ 6,000,00 $ 6,000.00 5005 # Saw Cut Existing Asphalt Concrete Pavement LF 90 $ 2.15 $ 193.50 50 00 # Roadway Excavation Incl.IIact CY 60 $ 16.05 $ 963,00 5015 # Unsuitable Foundation Excavation]net.Haul CY 100 $ 25.00 $ 2,500.00 5020 # Remove Existing Asphalt Concrete Pavement SY 20 $ 5.60 $ 112.00 5025 # Remove Cement Concrete Sidewalk SY 45 $ 57,00 $ 2,565.00 5030 # Remove Cement Concrete Curb and Gutter LF 95 $ 12.00 $ 1,140.00 5035 # Gravel Borrow,Including Haul and Compaction TON 24 $ 19.00 $ 456.00 5040 # Crushed Surfacing Top Course,5/8 Inch Minus TON 200 $ 33.00 $ 6,600,00 5045 # E-Z-Street Mix for Temporary Pavement Patch TON 38 S 163.00 $ 6,194.00 5050 # Planing Bituminous Pavement SY 1,185 S 2.70 $ 3,19950 5055 # Fabric Reinforcement SY 3,720 $ 3.25 $ 12,090.00 5060 # HMA Class 1/2",PG 64-22 TON 550 S 70.00 $ 38,500.00 5065 # Cement Concrete Sidewalk Ramp Type Single Direction B EA 1 S 1,200,00 $ 1,200.00 5070 # Cement Concrete Sidewalk Ramp Type Combination EA 1 S 1,500.00 $ 1,500.00 5075 # Cement Concrete Curb and Gutter LF 95 S 17.50 $ 1,662.50 5080 # Pedestrian Curb LF 160 $ 17.00 $ 2,720.00 5095 # Cement Concrete Sidewalk SY IS $ 37.50 S 562.50 5090 # Replace Existing Valve Box Top Section and Lid and Adjust to Finished Grade EA 7 $ 445.00 S 3,115.00 5095 # Adjust Existing Manhole Frame and Cover to Finished Grade FA 5 $ 410.00 S 2,050.00 5100 # Adjust Existing Monument Case Cover to Finish Gradc EA 3 $ 302.00 S 906.00 5105 # Traffic Control Labor HR 960 $ 50.00 S 48,000.00 5110 # Traffic Control Supervisor HR 240 $ 60.00 S 14,400.00 5115 # Temporary Traffic Control Devices(SCHEDULE IV) LS 1 $ 2,800.00 $ 2,800.00 5120 # Portable Changeable Message Sign(PCMS) DAY 86 $ 70.00 $ 6,020.00 5125 # Sequential Arrow Sign(SAS) DAY 20 $ X00 S 600.00 5130 # Inlet Protection EA 3 $ 46.00 S 138.00 5135 # ESC Lead IIR 40 $ 56.00 $ 2,240.00 5140 # Street Cleaning Sweeping FIR 80 $ 132.00 $ 10,560.00 5145 # Permanent Channotization(SCHEDULE IV) LS l $ 11,930.00 $ 11,930.00 5150 Temporary Frosion/Water Pollution Control FA 1 $ 5,000.00 $ 5,000.00 5155 Minor Changes CALC 1 $ 5,000.00 $ 5,000.00 5160 Speed Bumps EA 2 $ 3,800.00 S_ 7,600.00 SCIEDULE V(42nd Ave S behveen Rcith Rd and S 261th St)-'LOYAL S 208,517.00 SCHEDULE IV 40 Ave S behveen S 272nd St mid approximately 150 If north of Cambridge Ct 4000 # Mobilization(SCHEDULE IV) LS I $ 10,000.00 $ 10,000.00 4005 # Saw Cut Existing Asphalt Concrete Pavement LF 200 $ 2.15 $ 430.00 4010 # Roadway Excavation Incl.Haid CY 120 $ 16.05 $ 1,926.00 4015 # Unsuitable Foundation Excavation Incl.Haul CY 100 $ 25.00 $ 2,500.00 4020 # Remove Existing Asphalt Concrete Pavement SY 45 $ 5,60 $ 252.00 4025 # Remove Cement Concrete Sidewalk SY 120 $ 57.00 $ 6,940.00 4030 # Remove Cement Concrete Curb and Gutter LF 190 $ 1200 $ 2,280.00 4035 # Gravel Borrow,Including Haul and Compaction TON 32 $ 19.00 $ 608.00 4040 # Crushed Surfacing Top Course,5/8 Inch Minus TON 220 S 33.00 S 7,260.00 4045 # E-Z-Street Mix for Temporary Pavement Patch TON 2 $ 163.00 $ 326.00 4050 # Planing Bituminous Pavement SY 3,015 S 2,70 $ 8,140.50 4055 # Fabric Reinforcement SY 7,645 $ 3.25 $ 24,846.25 4060 # HMA Class 1/2",PG 64-22 TON 1,050 $ 70.00 S 73,500.00 4065 # Cement Concrete Sidewalk Ramp Type Parallel A EA 3 .$ 2,000.00 $ 6,000.00 4070 # Cement Concrete Sidewalk Ramp Type Single Direction A EA 3 $ 2,000.00 $ 6,000.00 4075 # Cement Concrete Sidewalk Ramp Type Single Direction B EA 0 $ 1,200.00 $ - 4080 # Cement Concrete Sidewalk Ramp Type Combination FA 0 $ 1,500.00 $ - 4085 # Cement Concrete Curb and Gutter LF 190 $ 17.50 $ 3,325.00 4090 # Pedestrian Curb LF 245 $ 17.00 $ 4,165.00 . 4095 # C en Co cret 'dewa SYOve $ 3 SA $ 0625 Multiple Schedules.xlsm 8/12/20158:19 AM urnn t s - T�'Etyl DUSCRII'TI011 r�s , � r r, ,. TWIT Q(7ANTTT] UNIT-COS -- TOTAL�OST'.i 4100 # Detactable Warning Surface SF 90 $ 50.00 $ 4,500.00 4105 # Replace Existing Valve Box Top Section and Lid and Adjust to Finished Grade EA 15 $ 445.00 $ 6,675.00 4110 # Adjust Existing Manhole Frame and Cover to Finished Grade FA 7 $ 410.00 S 2,870.00 4115 # Adjust Existing Monument Case Cover to Finish Grade EA 6 S 302.00 S 1,812.00 4120 # Traffic Control Labor HR 900 S 50.00 S 45,000,00 4125 # Traffic Control Supervisor I-IR 300 $ 60.00 S 18,000.00 j 4130 # Temporary Traffic Control Devices(SCHEDULE IV) LS 1 S 2,800.00 $ 2,800,00 4135 # Portable Changeable Message Sign(PCMS) DAY 100 $ 70.00 $ 7,000,00 4140 # Sequential Arrow Sign(SAS) DAY 25 $ 30.00 $ 750.00 4145 # Inlet Protection EA 29 $ 46.00 $ 1,334.00 4150 # ESC Lead HR 50 $ 56.00 $ 2,900.00 4155 # Street Cleaning Sweeping I-IR 100 $ 132.00 $ 13,200.00 4160 # Coir Log i,F 120 $ 5.00 $ 600.00 4165 # Permanent Channelization(SCHEDULE IV) LS 1 $ 18,085.00 $ 18,085,00 4170 Tem orary Erosion/Water Pollution Control FA 1 $ 5,000.00 $ 5,000.00 4175 Minor Changes CALL 1 $ 5,000.00 $ 5,000.00 4180 Speed Bumps EA 4 $ 3,800.00 $ 15,200.00 4185MO # $ SCHEDULE IV(40 Ave S between S 272nd St and approximately 150 ft north of Cambridge Ct)-TOTAL $ 311.087.25 SUMMARY SCHEDULE V(42nd Ave S between Reith Rd and S 261th St)-TOTAL $ 208,517.00 SCHEDULE IV(40 Ave S benveen S 272nd St and approximately 150If north of Cambridge Ct)-TOTAL $ 311,087.25 CONSTRUCTION CONTRACT TOTAL $ 519,604.25 Bid Estimate Range Minimum $ 460,000,00 Maximum $ 540,000.00 i C:\Users\1Bryant\AppOata\Local\Microsoft\Windows\Temporary Internet Flles\Content.Outlook\EOP7KKUE\Revised Copy of 2015 HMA Overlays-Engineers Opinion of Cost Form2 of 2 Multiple Schedu les.xlsm 6/12/2015 8:19 AM Bryant, Jason From: Connor, Eric Sent: Tuesday, July 28, 2015 2:38 PM To: Bryant, Jason Subject: Fwd: 201S Asphalt Overlay Project -Icon Change Order Authorization Sent from my iPhone Begin forwarded message: I From: "Viseth, Cheryl" <CViseth I<entwa.aov> Date:July 28, 2015 at 10:18:00 AM PDT To: "Connor, Eric" <EConnor@I<entwa.Rov> Subject: RE: 2015 Asphalt Overlay Project-Icon Change Order Authorization Could you send me the cover sheet for the CO, just in case. Thank you for getting it back to me so quickly! From: Connor, Eric Sent: Monday, July 27, 2015 1:46 PM To: Viseth, Cheryl Cc: Bieren, Chad; Bryant, Jason; Kuehne, Paul Subject: FW: 2015 Asphalt Overlay Project - Icon Change Order Authorization Cheryl, The actual Change Order amount will be $519,604.25, Will cover sheet for the CO or anything to include as an Exhibit? Thank you, Eric Eric Connor, Construction Engineering Manager Construction Management I Public Works Department Phone 253-856-5533 I Cell 253-797-0693 CITY OF KENT, WASHINGTON PLEASE CONS3OF R TIIII ENVIRONMENT"[FURL P It II I If Q'CIitS E-HAIL From: Connor, Eric Sent: Monday, July 27, 2015 11:25 AM To: Viseth, Cheryl Cc: Bryant, Jason Subject: RE: 2015 Asphalt Overlay Project- Icon Change Order Authorization Except for the Exhibit reference—it mentions the Consultant Services Agreement for KBA. 1 (nice catch Jason!) Eric Connor, Construction Engineering Manager Construction Management I Public Works Department Phone 253-856-5533 1 Cell 253-797-0693 CITY OF KENT,WASHINGTON PLEASE CONSIDER I e FNVIR0N14F_NT BEFORE PRLNHNG THIS'E-E1AIL From: Connor, Eric Sent: Monday, July 27, 2015 10:54 AM To: Viseth, Cheryl Cc: Bryant, Jason Subject: 2015 Asphalt Overlay Project - Icon Change Order Authorization Cheryl, I made a minor revision to this one...also, the final$ amount is still not established with the contractor. Please let me know if this is a problem for the Council Meeting. Thank you! Eric i I 2 5 Q ❑ ���'� k �� �av>'`� � �c i.f t-".r � ,«f r� Chi LD GFN m a � .`Ytm''w'`C• M� C ,• 7 Syn:C .. 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At ffi (< M1 A N•% W 9Sx �p Al, LF' J L sler ae Z 3zGaS ® I W r5H111GTGX Kent City Council Meeting Minutes August 4, 2015 The regular meeting of the Kent City Council was called to order at 5:01 p.m. by Mayor Cooke. Councilmembers present: Ralph, Berries, Boyce, Fincher, Ranniger, and Thomas. CHANGES TO THE AGENDA FROM COUNCIL ADMINISTRATION OR STAFF. Chief Administrative Officer Derek Matheson recommended adding an excused absence for Councilmember Thomas who was absent for the Council meeting of July 28, 2015. He also suggested adding an executive session concerning property negotiations as per RCW 42.30.110(1)(b) for a period of five minutes. PUBLIC COMMUNICATIONS A. Historical Note from Kent's 125th Anniversary - Craig Allen Reitan, Chief Financial Officer of the Greater Kent Historical Society and Kent resident, presented the history of long-time Kent business, Pay N Pak and its hydroplane boats. He noted that Pay N Pak Corporation opened in the City of Kent in 1969 and highlighted the success of the Pay N Pak hydroplane boats over the years. He informed the audience that the Hydroplane and Race Boat Museum is located at 5917 South 196th Street and the Greater Kent Historical Museum is at 855 East Smith Street, B. Public Recognition - None. C. Community Events - Council President Ralph highlighted that the Seattle Thunderbirds hockey team preseason games begin on September 16. She added that the circus will be there on September 24 and 27 and the Thunderbirds home opener is October 3. She added that the Scorpions and Queensryche will be at the ShoWare is on October 9. Mayor Cooke communicated that Bryan Reil from the Kent Municipal Court is the Employee of the Month for July. Mayor Cooke communicated that there are several history focused events going on in the City on August 15th, such as the open house at the Hydroplane and Race Boat Museum, the Garden Walking Tour for the Mill Creek Historic Neighborhood District, the Neely-Soames open house, the Seas Creek Botanical Garden and Heritage Center's "Experience Historical Kent" event, and the historic downtown Kent walking tour. D. Intergovernmental Reports. - Council President Ralph communicated that she attended the Regional Law Safety and Justice Committee meeting in Seattle. Mental health was the topic at this meeting as well as a discussion on legislative revisions regarding involuntary treatment, commitment and criminal competency. She also noted positive revisions to the laws concerning families being able to appeal the commitment of family members to treatment, She noted that treatment beds are 1 i Kent City Council Meeting Minutes F. Overlay Project Change Order — ICON — Authorize. The Mayor was authorized to sign a Construction change order with ICON Materials for $519,604,25 to provide additional asphalt work on 40th Avenue South between South 272nd and north of Cambridge Court, and 42nd Ave South between Reith Road and South 261st Street, subject to final terms and conditions acceptable to the City Attorney and Public Works Director. G. Water District #111 Service Boundary Change Agreement - Approve. The Mayor was authorized to sign an agreement with Water District #111 that would adjust the water service area and corporate boundary of the Kent water utility to include the On Rainier Pond Plat, subject to final terms and conditions acceptable to the City Attorney and Public Works Director. H. 2014 Downtown Parking Sign Replacement — Accept as Complete. The Mayor was authorized to accept the 2014 Downtown Parking Sign Replacement Project as complete and release retalnage to Transportation Systems, Inc. upon receipt of standard releases from the state and the release of any liens. I. 2015 Crack Sealing Proiect — Accept as Complete. The Mayor was authorized to accept the 2015 Crack Sealing Project as complete and release retainage to C.R. Contracting, upon receipt of standard releases from the state and the release of any liens. J. Grant Application Resolution to Recreation and Conservation Office for Turf Renovation at Hogan Park - Adopt. Resolution No. was adopted, authorizing the submittal of a grant application to the Recreation and Conservation Office to assist in funding the conversion of Hogan Park baseball field number one to a synthetic turf, multi-use field. K. Excused Absence for Councilmember Les Thomas - Approve. An excused absence for Councilmember Thomas as he is unable to attend the City Council meeting of July 28, 2015. OTHER BUSINESS A. 2015 LTGO Refunding Bonds ordinance — Adopt. Aaron BeMiller, Finance Director communicated the item. He communicated that this ordinance is to refund the 2006 series bonds. He noted that the City will be refunding $8,600,000, He highlighted the six conditions that need to be met for the designated representative to approve j the final refunding. Council President Ralph moved to adopt Ordinance No. 4160, providing for the issuance of one or more series of limited tax general obligation refunding bonds in the aggregate principal amount not to exceed $30,000,000 to refund certain outstanding bonds and to pay costs of issuing the bonds; providing the form and terms of the bonds; and delegating the authority to approve the final terms of the bonds, seconded by Councilmember Boyce. Motion carried 6-0. 3 e. :sue P u..ing information �(AU ;3:QU..w_ r,S7 77RST 3E,.4L i_rJ THROUGH T 8i. L e L ?j',9TM,xE T) Approve PP 'IIj�.1>(!'P414T Originator: Phone (Originator): 253-856-5651 e Ilanle Andel' On Date Sent: 9/9/2015 i Date Required: � Return Signed Document to Contract Termination Date:. S. Anderson 12/31/2015 VENDOR NAME. Date Finance Notified: rr�� _ f (Only required on cwnact5 �'1 Icon 2tP,r181S, IR C. _ *?o 0007 no over or on any Grants / 1S "' 1" 5 DATE OF COUNCIL APPROVAL: O / f Date ManagerRisk ' Notified; _ _U/ t v15 Re cared nn Non C, Standard Contrac[SJAgreemerts Has this Document been Specifically Account (Number: R20112,64 1 1 t0. 12.0 Authorized in the Budget? OES ONO Brief Explanation of Document: 2015 Asphalt Overlays Change Order #1 for $519,604.25 Approved by Council on August 4,2015, Item F; (see attached minutes), V I r . All Contra is .mue't 8e R'eutad Through T,,he Law Department Kfi ps ipr ;+.q@ b "'�ed by the Lave ecartrrent) Received: �a Approval of Law Dept.: a Law Dept Comments: e �( � ; Date Forwarded to Ma or t w� Shaded Areas is Be t~airp;eted By,Aumintstra_ion:Staff Received': n f b 'Recon��irendations�and _omrTtet,ts. offkoe of Date Returned f