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HomeMy WebLinkAboutPW17-445 - Change Order - #1 - Forest Clouds, LLC - Meridian Valley Creek Erosion Repair - 10/19/2017 nr i//Dl,�ni /y //l1?lrvl A l Ii ,y ip� INN 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: Forest Clouds LLC Vendor Number: JD Edwards Number Contract Numben F d �f This is assigned by City Clerk's Office Project Name: _Meridian Valley Creek Erosion Repair Description: ❑ Interlocal Agreement ® Change Order ❑ Amendment ❑ Contract ❑ Other: Contract Effective Date: 9/19/17 Termination Date: 12/31/18 Contract Renewal Notice (Days): Number of days required notice for termination or renewal or amendment Contract Manager: Matt Knox Department: Enqineerinq Contract Amount: $0.00 Approval Authority: (CIRCLE ONE) Department Director Mayor City Council Detail: (i.e. address, location, parcel number, tax" cd;etc.): Reinstate the oricginal agreement which expired on October 13, 2017, and extend the time m of copletion to December 31, 2018 11 or physical completion plus 90 days, whichever comes first. As of: 08/27/14 V T CHANGE ORDER NO. 1 NAME OF CONTRACTOR: Forest Clouds_LLC ("Contractor") CONTRACT NAME & PROJECT NUMBER: Meridian valley Creek Erosion Repair ORIGINAL CONTRACT DATE: September 20. 2017 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: No change to the scope of work, however a change order is necessary to reinstate the original agreement which expired on October 13, 2017 and extend the time of completion to December 31, 2018 or physical completion plus 90 days, whichever comes first. 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, $45,460.00 (including applicable alternates and WSST) __ _. Net Change by Previous Change Orders $0 (incl. applicable WSST) Current Contract Amount $45,460.00 (incl. Previous Change Orders) ..... _ ........................ Current Change Order $0 _.__. .._........ Applicable WSST Tax on this Change $0 Order _..... _..................... Revised Contract Sum $45,460.00 The parties acknowledge that the Agreement terminated by its own terms on October 13, 2017. However, the City and Contractor express their mutual intent and desire to reinstate the Agreement; extend its term through December 31, 2018 or Physical Completion plus 90 days, whichever comes first; and amend the work to include additional duties to be performed in accordance with the same provisions set forth in the original Agreement, except as modified within this Change Order. In addition, the CHANGE ORDER - 1 OF 3 parties wish to ratify and affirm any and all acts consistent with the authority of the Agreement and prior to the effective date of this Change Order. Original Time for Completion 10/13/17 (insert date) Revised Time for Completion under "/a prior Change Orders (insert date) Days Required (±) for this Change xsa calendar days Order Revised Time for Completion 12131118 or Physical Completion + 90 (insert date) days,whichever comes first In accordance with Sections 1-04.4 and 1-04.5 of the Kent and WSOOT 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 Of KENT: �- v - ay �24 n��u1 Print Name' 0 i)1c , rl" �" + + ° Print Name: Tir�rothy ]a taPr .. P Its V ?(-5 °r Its_,,.. Pu li � A Es Djrector li � 01 h) DATE: E:_.�e 2c - CHANGE ORDER - 2 OF 3 APPROVED AS TO FORM: (applicable if Mayor's signature required) Kent Law Department Forest Cloues-MVC Eros Ion Rep a I r CC Y/Knox CHANGE ORDER - 3 OF 3 CERTIFICATE OF LIABILITY INSURANCE A-Lurie 01 0 Sni 9O109i 7 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). RRooucaR TACT NAME' Michelle Mckinnev _" Heritage Insurance, Inc. aeLlGgo.CVu..ks$1 253-636-8142 Tg1�,Np) 800-975-5311 24401 104th Ave SE, Ste 102 E-MAIL mmckimge hor4ta ansurancenc.com Agg_wtss, Kent, WA 98030 I NSURERISI AFFORDI NO,COVERAGE -II INSURER Builders and Tradesmen's Insurance Services ... .. ....... ._-. .. ........ RE wsuRE° wsu— Atain Snar.ialty ForestClouds, LEG - 26339 116th Ave SE INSURER Neu Apt# 1303 RER n _ - Kent,WA 98030-8499 INSURERE INSURER F: COVERAGES CERTIFICATE NUMBER: 00000000-316987 REVISION NUMBER: 7 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR� 40HEOUJDA ,..._..._ POLTCY EFF.,. 11 POLICY E%V.,. ..... ...- ............. tTR TYPE OF INSURANCE nen w✓en POLICY NUMBER IMMlonnyyp l lMMlnnrcvvn LIMITS w .u._ _.... ..... -___.. A X COMMERCIAL GENERAL LIABILITY Y Y NA117065400 10/04/2017 10/04/2018 EACHOCCURRENCE �$ 1 000.000 CLAIMSMADE XIOCCUR 'PRILM k7CShN`RYEIY- ..- ..0 rRLM1 Lyc4aM:pu aPwy $ . 100,000 t MEDEXPIAnvuner aun) 3 5,000 PER OINALCADVINJURY $ 1,0001000 GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 }f, Pr"jNlpY JECaT U Loc PRODUCTS COM_POPAcc S _ 2,000;000. avHErR 1 _ $ AUTOMOBILE LIABILITY - !GA a 1119"NGLE LIMIT $ ANY AUTO '. BODILY INJUFIY(Pnr Veson) $ OWNED "SCHEDULED BODILY INJURY(PE, dpt) $ AUTOS ONLY AUTOS HIRED PON OWNED PROPER TY DAMAGE $ AiJi ONLY AUTOS ONLY „fP Tact dart} . A UMBRELLA LIAR accun QEXR4163297 09/1412017 09/14/2018 EACH OCCURRENCE $ 1,000,000 X EXCESS FAA X LLAIMfrMADL AGGREGATE $ 1 000.000- nEo RETENTIONS $ WORKERS COMPENSATION PER T1 OTM AND EMPLOYERS'LIABILITY STATUTE N ANY PROPRIETORIPARTNERIE%ECUTIVE E L EACH{GGDEN T OFF ICEtor,m BER EXCLUDED? ❑ N!A -__.._--.... ..........�`I`$ _._._._.__ ._.. (fyes.doryln NH) - EL DISEASE EAEMPLOYEE $ _ DESCRIPTION OF OPERATIONS below f EL DISEASE-POLICY LIMIT $ B Pollution Liability Y Y EC005978636 11211312016 112n3r2017 1 Contractors P 1,000,000 A Stop Gap Y Y NA117065400 10/0412017 110/04/2018 1,000,000 DESCRIPTION OF OPERATIONS;LOCATONS I VEHICLES IACCRO 101,Additional Remarks Schedule,maybe attached it mare space is required) Excess Policy does not extend to the Pollution Liability Policy CERTIFICATE HOLDER CANCELLATION'. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN City of Kent ACCORDANCE WITH THE POLICY PROVISIONS. 220 Fourth Ave S Kent, WA 98032 AUTHonk2EBREPR SEN'waTVE IMLM) ©1g&Sr2015 AQI 0 RPORATION. AVii reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD Printed by MLM on October 09,2017 at 10'.27AM i "� rx CERTIFICATE OF LIABILITY INSURANCE _ )&2926n THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT; If Nye certificate holder Is an ADOITIONAL INSURED,Fhe pDl ry(da's)must be emlOssarl If SUBROGATION 15 WAIVED,%Object to Me terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate doe%not conifer rights to the certificate holder in lieu Or such alndorsenxlnl{a). PaooucEH NARR� 'E CO GEICO `mA da1 EIn T-afAB-500,949d E.MAB.' VAX ONE GEICO BLVD HPPWA5d_JR1CCMIAJDIDQGEIC'O.CCOA;_... -. .. ........ ...... FREOERICKSBURG r INSURERN)AFFONOW10 COVERAGE NAle,n JP. .72a 12 IW5VA@m A: GOVERNMENT EMPLOYEES I Nt3URANCL CO 22063 FOREST CLOUDS,LLC InsuRea e 'IIWGWWEfl C'. 26339110TH AVE SE APT Ida$ NsuneX a: KENT WA 90030 VNl4REA E, WREN F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: IIRS I Ta L RIWI ISIA 114E r AN IL`, f IMiMNUll^p4,TI I d ➢III I!CONDITION IM I tlA Y 0Nfl IT IRE -UHI tX NrANIED Hflr)I�I t H iHl N I I y PERIC) I M L' I elr PIIOI6SMI D ANY I LMlum MINI Nr TI SUFro 4IP L 4,1ITI IN(IF ANY TIFF Pol 1G1 ,rR(MI LP D c,UKENr .IIH RFSNFpr I(, Cmi ii THIli u IIrIGAG oI it IS' UI fi IWH F t(IANI 711f IN t ItAll+.f AFF 1RI)i,ll f;V rkE I'OI ILIFS IR ut k r1Fi) HERFIN F 'M0,)Li.,i fo h1.- TFRNIS. 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I.q A,11 AlIVI, 910011950507 U23ir54201P G8/bli4U18 v N.10 p rIR.Ln11.J J. x,rn � rr O,np YY UMBRELLA 11A9 '� .....—""""'"—""•""" mm...".�....._ EI fr^v`LA IIF".YI d �_ a%CE®s 11A8 • .l. taco rF' �.........._._ ._—_—_....__...",.... ..."..u� FF -r,,4" ' TM"."'1 Nrv>wXans coMPENal nox " tNR BhIrvLONgRR Uri911AM F N. rv,Kv Adl I5 PNFx Nmaaev Owrotl I - 1 aEtiCRIPTIONOP OPEX11T10Na1LOf.6r10115•VBHICLE]IAtt cM1 ACORD 101 Addlm,A n—n aWoaiM,x M,an u:a lu re lrmq city OF KENT IS NAMED AS ADDITIONAL INSURED IP/TH WAIVER OF SUBROGATION THE TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US CONDITION OCES NOT APPLY TO THE PERSONS OR ORGANIZATIONS SHOWN ABOVE.COVERAGE IS PRIMARY AND INON-CONTRIBUTORI' CERTIFICATE HOLDER CANCELLATION CITY OF KENT SHOULD ANY Of THE ABOVE DESCRIBED VLOCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEPEOV NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, 220 4TH Avl=5 A V mOARED REAReaMTATI VE KENT NIA 98032-5838 AS 1988-2010 ACORD CORPORATION. All tights reserved. ACORD 29(2010/015) The ACCORD name and logo are registered marks of ACORD Customer Communication Page 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSUREDS - OWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following, COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Policy Number: NA1 1 706 5400 Endorsement Effective: 10/04/16 12:01❑.m. Named Insured Authorized Representative: FDRESTCLOUD LLC � .�tf� �1 1 ........_..... N� \I'L 1I 1d� ~-y..._........_..._ SCHEDULE Name of Person or Organization: Any person or organization that the named insured is obligated by virtue of a written contract or agreement to provide insurance such as is afforded by this policy. Location: (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) A. Section II —Who Is An Insured is amended to Include as an Insured the person or organization shown in the Schedule, but only to the extent that the person or organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that insured. B. With respect to the insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This Insurance does not apply to "bodily injury"or"property damage" occurring after: (1) All work, including materials, parts or equipment furnished In connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed, or (2) That portion of"your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. The words "you"and "your" refer to the Named Insured shown in the Declarations, D. "Your work" means work or operations performed by you or on your behalf, and materials, parts or equipment furnished in connection with such work or operations. Primary Wording If required by written contract or agreement Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self-insurance maintained by the above additional insured(s)shall be excess of the insurance afforded to the named insured and shall not contribute to II. Waiver of Subrogation If required by written contract or agreement:We waive any right of recovery we may have against an entity that is an additional insured per the terms of this endorsement because of payments we make for injury or damage arising out of"your work" done under a contract with that person or organization. 49-0108 07 11 May Include Copyrighted Material of Insurance Services Offices, Inc. Page 1 of 1 Used with permission THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSUREDS - OVWNERS, LESSEES OR CONTRACTORS This endorsement modifies insurance provided under the following, COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Policy Number: NA1 1 706 5400 Endorsement Effective: 10/04/17 12:01 a.m. Named Insured Authorized Representative: FORESTCLOUD LLC SCHEDULE Name of Person or Organization: Any person or organization that the named insured is obligated by virtue of a written contract or agreement to provide insurance such as is afforded by this policy. Location: (If no entry appears above, information required to complete this endorsement will be shown in the Declaralions as applicable to this endorsement.) A. Section II—Who Is An Insured is amended to include as an insured the person or organization shown in the Schedule, but only to the extent that the person cr organization shown in the Schedule is held liable for your acts or omissions arising out of your ongoing operations performed for that insured. B. With respect to the Insurance afforded to these additional insureds, the following exclusion is added: 2. Exclusions This insurance does not apply to "bodily injury"or "properly damage" occurring after: (1) All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the site of the covered operations has been completed, or (2) That portion of "your work"out of which the injury or damage arises has been put to its intended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project. C. The words "you" and "your" refer to the Named Insured shown in the Declarations, D. "Your work" means work or operations performed by you or on your behalf; and materials, parts or equipment furnished in connection with such work or operations. Primary Wording If required by written contract or agreement: Such insurance as is afforded by this policy shall be primary insurance, and any insurance or self-insurance maintained by the above additional insured(s)shall be excess of the Insurance afforded to the named insured and shall not contribute to it. Waiver of Subroqation If required by written contract or agreement: We waive any right of recovery we may have against an entity that is an additional insured per the terms of this endorsement because of payments we make for injury or damage arising out of"your work" done under a contract with that person or organization. 49-0108 07 11 May Include Copyrighted Material of Insurance Services Offices, Inc. Page 1 of 1 Used with permission POLICY NUMBER: 9100119565 01 COMMERCIAL AUTO BA 20 48 08 10 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An In- sured Provision of the Coverage Form. This endorsement does not alter coverage provided in the Cov- erage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective Countersigned By 08-04-2017 Named Insured: FOREST CLOUDS, LLC (Authorized Representative) SCHEDULE Name of Persons) or Organization(s): CE,NPRAL PUCET SOUND B,.ECIONAL TRANS rT AfJTHO ETY ("SOUND TRANSIT") 101 S JACKSON ST SEATTI,E, WA 98104--2826 KiwG couwr,C 401 STH AVE I°L 3RD SEATTLE, WA 98101-181.8 PACIFIC PILE & MAFJNZ� 700 S R.IVERSJDE DR. SEAT'TLE, WA 98108....9364 THE CITY OF MERCER ISLAND 9611 SE 36TH ST MERCER ISLAND, WA 98040-3732 BA 20 48 08 10 Includes copyrighted material of Insurance Services Office, Page 1 of2 ❑ Inc., with its permission. INSURED . Name of Person(s) or Organ ization(s): REYNOLDS GENERAL CONTRACTENG INC AND CITY OF SEATTLI,; MEAD, WA 990PI 1116 CITY OF SMATVI,E PO BOX 94681 JANSEN INC. 1215 IN HOLLY ST CITY UP KENT' CITY OF EVERETT , 1211 CLEAR ST 1 5 (|fn0 entry appears abOvo, ink)nnatoo required to COmp1e(o 0lis endorsement will be shown in the Declarations 3& applicable to the ondoroomenL) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization quaMes as an 4nsured' oder Te VAo Is An Insured Provision 000tanodin Section || nf the Coverage Form. Page Zof2 includes copyrighted material V/ |nSU/8nte Services Office, BAZU48O81O � Ino, with its permission.