The URL can be used to link to this page

Home My WebLink About2018-103SECTION 00942 - Change Order Form No. 1 DATE OF ISSUANCE: May 10, 2018 EFFECTIVE DATE: May 10, 2018 OWNER: Indian River County CONTRACTOR Blue Goose Construction. Project: 128th Court, 82nd Court, and 83rd Avenue Water Main Ext. OWNER'S Bid No. WA 2018-001 You are directed to make the following changes in the Contract Documents: Description: Deduct line items/quantities from contract. Reason for Change Order: Reduce contract amount to reflect actual constructed material and quantities. Attachments: See itemized schedule CHANGE IN CONTRACT PRICE: Time Description Amount Original Contract Price $35,634.06 Net Increase (Decrease) $0.00 from previous Change Orders No. : (days) Contract Price prior to this $35,634.06 Change Order: Net increase (decrease) of ($4,988.36) this Change Order: (days or dates) Contract Price with all $30,645.70 approved Change Orders: ACCEPTED: By: CONTRACTOR (Signature) Date: -Tf o// CHANGE IN CONTRACT TIMES Description Time Original Contract Time: (days or dates) Substantial Completion: Final Completion: Net change from previous Change Orders No.: (days) Substantial Completion: Final Completion: Contract Time prior to this Change Order: (days or dates) Substantial Completion: Final Completion: Net increase (decrease) this Change Order: (days or dates) Substantial Completion: Final Completion: Contract Time with all approved, Change Orders: (days or dates) Substantial Completion: Final Completion: RECOMMENDED: B&V y: / I � Z�--' E INEER (Signage) Date:/`//ZD/6 ET-NIT917153 OWNER (Signature) gob Solari, Vice Chairman Date: June 5, 2018 a� 0 9 U b 0 U 4-40 APPROVED AS TO FORM : a �t S!o;�•. A'i'NsID LEGAL. SUFFICIENCY BY , ID L..AN REI17,0,-OL 0 COUNTY ATTORNEY `• moi'• � . � C:\Users\tgorman\AppData\Local\Microsoft\Windows\INetCache\Content.Outlook\7DX40179\CO-1 WA2018-001.docx CO -1 WA'd�� CSO'• 00942-1 '•'°R COUN:•"" APPLICATION FOR PAYMENT NO. 1 FINAL To: Indian River County Utilities From: Blue Goose Construction, LLC (CONTRACTOR) Contract: WA No. 2018-001 PO #: 34,604.70 Project: 1319 -128th Ct Water Main Extension For Work completed through the date of April 2018 1 Original Contract Price: $ 35,634.06 2 Net change by Change Orders and Written Amendments (+ or -): (4,988.36) do- ntractor^Purchased Material w 3,959.001 3 Current Contract Price (1 plus 2) 34,604.70 4 Total completed and stored to date: 34,604.15 5 Retainage (per Agreement) 30,645.70 of completed work of stored material $ - Total Retainage: - 6 Total complete and stored to date less retainage (4 minus 5) 34,604.70 7 Less previous Application for Payments - 8 DUE THIS APPLICATION (6 MINUS 7) $ 34,604.70 Accompanying Documentation: CONTRACTOR'S Certification: The undersigned CONTRACTOR certifies that (1) all previous progress payments received from OWNER on account of Work done under the Contract referred to above have been applied on account to discharge CONTRACTOR' legitimate obligations incurred_in.connection with Work covered by prior Applications for Payment numbered 1 through 1 inclusive; (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond acceptable to OWNER indemnifying OWNER against any such Lien, security interest or encumbrance); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and not defective. Dated: :S Ll? l8 State of X10 r i d.Q County of SLkscribed and sworn to before me this Blue Goose Construction LLC CONTRACTOR By: ^i Greg Hampton, Contrdi err 10-03 day of /"IGI , 2017 ��vyv—may �w MUhiZ Notary Public Q t NOTARY PUBLIC My Commission expires: STATE OF FLORIDA Expires 4/23/2022 Payment of the above AMOUNT DUE THIS APPLICATION is recommended. Dated: ENGI R By; A) u Prepared by the engineers Joint Contract Documents Committee and endorsed by The Associated General Contractors of America and the Construction Specification Institute. Indian River County Utilities 128th Ct Water Main Extension Pay Application 1 - Final ITEM NO ITEM DESCRIPTION CONTRACT QUANTITIES UNIT UNIT PRICE TOTAL AMOUNT PREVIOUS PERIOD QUANTITY VALUE INSTALLED THIS PERIOD QUANTITY VALUE INSTALLED TOTAL TO DATE QUANTITY VALUE INSTALLED 216.1319 PERCENT % COMPLETE COMPLETE 01c Install 6" PVC Water Main 1064.00 LF $6.00 $6,384.00 $0.00 1064.00 $6,384.00 1064.00 $6,384.00 100.00% 100.00% 02c Install 6" DIP Water Main 144.00 LF $9.00 $1,296.00 $0.00 0.00 $0.00 0.00 $0.00 0.00% 0.00% 9 Install MJ Fittings 1.00 ton, $4,100.00 $4,100.00 $0.00 0.25 $1,025.00 0.25 $1,025.00 25.00%, 25.00% 16b Install Stainless Steel Wet Tap assemblyw/gate valverunl "-1 " B 4"-8") & min 1.00 EA $1,400.00 $1,400.00 $0.00 1.00 $1,400.00 1.00 $1,400.00 100.00% 100.00% 18g Install water service -single long with 3/4x5/8 meter & box - more than 6.00 EA $425.00 $2,550.00 $0.00 6.00 $2,560.00 6.00 $2,550.00 100.00% 100.00% 18j Install water service -double long With 3/4x5/8 meter & x - more than 2.00 EA $425.00 $850.00 $0.00 2.00 $850.00 2.00 $850.00 100.00% 100.00% 181 1 Install 2" PVC Service Casing 1.00 EA $400.00 $400.00 $0.00 1 1.00 $400.00 1.00 $400.00 100.00% 100.00% 18m Install 3" VC Service Casing 2.00 EA $600.00 '$1,200.00 $0.00 0.00 $0.00 0.00 $0.00 0.00% 0.00% 19b Install 6" NRS Resilient Seated Gate Valve or Butterfly Valve 4.00 EA $125.00 $50000 . $0.00 4.00 $500.00 4.00 $500.00 100.00% 100.00% 20b Install new fire hydrant assembly w/6" tapping valve & sleeve$2,000.00 1.00 EA $2,000.00 $0.00 1.00 $2,000.00 1.00 $2,000.00 100.00% 100.00% 23 Test Holes / Potholes 10.00 EA $250.00 $2,500.00 $0.00 10.00 $2,500.00 10.00 $2,500.00 100.00% 100.00°/" 25 Install 2" blow off 1.00 1 EA $400.00 $400.00 $0.00 1.00 $400.00 1.00 $400.00 100.00% 100.00% 28 Install Temporary Jumper 1.00 EA 1 $500.00 $500.00 $0.00 1.00 $500.00 1.00 $500.00 100.00% 1 100.00% 29b Fill Pressure Test Chlorinate & Flush WM 1208.00 LF $1.50 $1,812.00 $0.00 1208.00 $1,812.00 1208.00 $1,812.00 100.00% 100.00% 30b I Install & Remove Sample Point 4.00 EA $275.00 $1,100.00 $0.00 4.00 $1,100.00 4.00 $1,100.00 100.00% 100.00% 30c Take & Test Bacterialoclical Sample 8.00 EA $150.00 $1,200.00 $0.00 0.00 $0.00 0.00 $0.00 0.00% 0.00% 86a Lawn Restoration (Topsoil & Sod) Includes Watering 1182.22 SY $2.25 $2,660.00 $0.00 1182.22 $2,660.00 1182.22 1 $2,660.00 100.00% 100.00% 91 Mobilization, Demobilization, MOT (based on 10% Labor Cos • 1.00 LS $3 085.20 $308520 ,. $0.00 1.00 $3,085.20 1.00 $3,085.20 100.00% 100.00% Contingency 1.00 LS $1,696.86 $1,696.86 $0.00 0.00 $0.00 0.00 $0.00 0.00% 0.00% ,Original Contract Price $35,634.06 Additional Items 01c Install 6" PVC Water Main 144.00 LF $6.00 $864.00 144.00 $864.00 144.00 $864.00 100.00% 18g Install water service -single long with 3/4x5/8 meter & box - more than 0 1.00 EA $425.00 $425.00 $0.00 1.00 $425.00 1.00 $425.00 100.00% 100.00% 181 Install 2" PVC Service Casing 2.00 EA $400.00 $800.00 2.00 $800.00 2.00 $800.00 100.00% 86a I Lawn Restoration (Topsoil & Sod Includes Waterinq 618.00 SY $2.25 $1,390.50 $0.00 618.00 $1,390.50 618.00 $1,390.50 100.00% 100.00% $3,479.50 Work Deleted 02c Install 6" DIP Water Main -144.00 LF $9.00 -$1,296.00 $0.00 $0.00 0.00 $0.00 0.00% 0.00% 9 Install MJ Fittings -0.75 ton $4,100.00 -$3,075.00 $0.00 $0.00 0.00 $0.00 0.00% 0.00% 18m Install 3" PVC Service Casing -2.00 EA $600.00 -$1,200.00 $0.00 $0.00 0.00 $0.00 0.00% 0.00% 30c Take & Test Bacterialo ical Sample -8.00 EA $150.00 -$1,200.00 1 $0.00 $0.00 0.00 $0.00 0.00% 0.00% Continclenc -1.00 1 LS 1 $1,696.86 -$1,696.86 $0.00 $0.00 0.00 1 $0.00 0.00% 0.00% -$8,467.86 $30,645.70 $30,645.70 $30,645.70::[-- 30 645.70Contractor ContractorPurchased Material $3,959.00 $3,959.00 __$34,604,70 „ $34,604.70 Amount Completed to Date $30,645.70 Contractor Purchased material $ 3,959.00 Total Contract Amount $ 34,604.70 Retainage @ 0% $ Total Completed & Stored Less Retainage $ 3a,soa.7o Less Previous Payment $ Amount Due Contractor $ 34,604.70 K:\1-Projects\1- Projects Awarde&NDIAN RIVER UTILITIES LABOR CONTRACT\Billing\1319 128th Ct Water Main Extension\1319- Pay application 1 With Letter changed 1 of 1 SOV NAIL FARMS, INC. 4430 Nail Farm Rd. MELBOURNE, FL 32934 (321)254-6746 thesodfather@aol.com BILL TO Blue Goose Growers 1900 Old Dixie Highway Fort Pierce, FL 34946 JOB DESCRIPTION 83rd St. ACTIVITY QTY _.._......_._.....__.___......._.____ ........ _.... ............ Bahia Pallet 32 Thank you for your business! 4'3 -- Invoice 27395 DATE PLEASE PAY 0 $3,424.Q0', THANK YOU. *****Please make note of our new mailing address.***** RATE AMOUNT 100.00 3,200.00T SUBTOTAL 3,200.00 TAX (7%) 224.00 TOTAL 3,424.00 TOTAL DUE $3,424.00 THANK YOU. *****Please make note of our new mailing address.***** NAIL FARMS, INC. 4430 Nail Farm Rd. MELBOURNE, FL 32934 (321)254-6746 thesodfather@aol.com Invoice 27450 BILL TO Blue Goose Growers 1900 Old Dixie Highway DATE, ,PLEASE PAY Fort Pierce, FL 34946 04/02/2018'.00 JOB DESCRIPTION Sebastian ACTIV QTY RATE AMOUNT Floratam 2 150.00 300.00T Pallet Bahia Pallet 2 100.00 200.00T Thank you for your business! SUBTOTAL 500.00 TAX (7%) 35.00 TOTAL 535.00 TOTAL DUE $535.00 0 *****Please make note of our new mailing address.***** THANK YOU.