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Home My WebLink About2018-104SECTION 00942 - Change Order Form No. 1 DATE OF ISSUANCE: April 18, 2018 EFFECTIVE DATE: April 18, 2018 OWNER: Indian River County CONTRACTOR: Blue Goose Construction. Project: Pelican Pointe Water Service Replacement OWNER'S Bid No.: WA 2017-006 You are directed to make the following changes in the Contract Documents: Perform additional work under Labor Contract pay items not included in WA 2017-006. Reason for Change Order: Additional work was necessary to complete the project including: the replacement of additional water services, casing pipe, exploratory excavations ("potholes") to locate existing service connections, repair of underground electric and irrigation lines, lawn restoration, demolition and removal of existing concrete sidewalk and driveways, contractor -purchased material, etc. Change Order amount reflects deduction of contingency for final pay application. Attachments: See itemized schedule CHANGE IN CONTRACT PRICE: Time Description Amount Original Contract Price $70,809.75 Net Increase (Decrease) $0.00 from previous Change Orders No. : (days) Contract Price prior to this $70,809.75 Change Order: Net increase (decrease) of $68,330.95 this Change Order: (days or dates) Contract Price with all $139,140.70 approved Change Orders: 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: r\G lJ\JIVIIVI G I V VGV. APPROVED AS TO FORM AND LEGAL SUFFIC15NC COUNTY ATTORNEY a� H U 0 U w 0 Contractor's Application for Payment Pelican Pointe Water Service Lateral Replacement Application for Payment No. 1 FINAL For Work Accomplished through the period of 04/30/18 To: Indian River Countv Utilities From: Blue Goose Construction County WIP Project No.: BG 1311 1 Original Contract Price: 2 Net change by Change Orders and Written Amendments (+ or 3 Current Contract Price (1 plus 2): Contractor Purchased Material 4 Total completed and stored to date: 5 Retainage (per Agreement): 0 % of retainage: 6 Total completed and stored to date less retainage (4 minus 5): 7 Less previous Application for Payments: 8 DUE THIS APPLICATION (6 MINUS 7): CONTRACTOR'S CERTIFICATION: 70,809.75 68,330.95 $ 139,140.70 $ 6.990.86 $ 146,131.56 Total Retainage: $ $ 146,131.56 11 146,131.56 UNDER PENALTY OF PERJURY, the undersigned CONTRACTOR certifies that (1) the labor and materials listed on this request for 1 payment have been used in the construction of this Work; (2) payment received from the last pay request has been used to make payments to all subcontractors, laborers, materialmen and suppliers except as listed on Attachment A, below; (3) 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); (4) all Work covered by this Application for Payment is in accordance with the Contract Documents and not defective; and (5) If this Periodic Estimate is fog a Final Payment to project or improvement, I further certify that all persons doing work upon or furnishing materials or supplies for this project or improvement under this foregoing contract have been paid in full, and that all taxes imposed by Chapter 212 Florida Statutes, (Sales and Use Tax Act, as Amended) have been paid and discharged, and that I have no claims against the OWNER. Dated 5110/(: STATE OF FLORIDA COUNTY OF ST LUCIE B: 44i:4� (CONTRACTOR(- must be &gfied by an Officer of the Corporation) Greg Hampton - Controller Print Name and Title r Before me, a Notary Public, duly commissioned, qualified, and actin per grally appeared e qkkv, ('\, who being by me first duly sworn upon oath, says that he/she is the C � 'er of the CONTRAC R mentioned above and that he/she has been duly authorized to act on behalf of it, and that he/she executed the above Contractor's Application for Payment and Contractor's Certification statement on behalf of said CONTRACTOR; and that all of the statements contained herein are true, correct, and complete. Subscribed and sworn to before me this `t day of mit 2018. r\ is personally known to me or has produced as identification. NOTARY PUBLIC: �t Printed name: ,P,• Commission No.: F945828 Commission Expiration: EWpIREg; December 22, 2019 erv+titets =� A�.r0..•' Bon 00 1 RJU Page 1 Pay Application 1 Indian River County Utilities Pelican Pointe Water Service Lateral Replacement Pay Application 1 - 04/17/18 Item No. DescriptionINSTALLED CONTRACT QUANTITIES UNIT UNIT PRICE PREVIOUS PERIOD TOTAL AMOUNT QUANTITY VALUE THIS PERIOD QUANTITY VALUE INSTALLED TOTAL TO DATE QUANTITY VALUE INSTALLED 216.1251 % COMPLETE 1a Install 2" PE Service3 Line 800 LF $ 4.80 $ 3,840.00 800.00 3,840.00 800.00 3,840.00 100.00% 18a Install Water Service :single short (Multi Family Pipe & Fittings Only)124 Ea $ 300.00 $ 37,200.00 124.00 37,200.00 124.00 37,200.00 100.00 18d Install Water Service Double short (pipe & fittings only) 3 Ea $ 350.00 $ 1,050.00 3.00 1,050.00 3.00 1,050.00 100.00% 18g Install Water Service Signle Lon (pipe & fittings only) 4 Ea $ 425.00 $ 1,700.00 4.00 1,700.00 4.00 1,700.00 100.00% 181 Install Water Service Double Long (pipe & fittings only 2 Ea $ 425.00 $ 850.00 2.00 850.00 2.00 850.00 100.00% 181 Install 2" Service Casing 3 Ea $ 400.00 $ 1,200.00 3.00 1,200.00 3.00 1,200.00 100.00% 19a Install 2" RS Gate Valve w/Box 21 Ea $ 85.00 $ 1,785.00 21.00 1,785.00 21.00 1,785.00 100.00% 23 Test Holes/ Potholes 31 Ea $ 250.00 $ 7,750.00 31.00 7,750.00 31.00 7,750.00 100.00% 67a Install Asphalt Cement Replacement over full trench width including Base & Subgrade compacted to county specification 25 TN $ 44.00 $ 1,100.00 25.00 1,100.00 25.00 1,100.00 100.00% 80a Install 4" sidewalk 200 SF $ 2.25 $ 450.00 200.00 450.00 200.00 450.00 100.00% 86a Lawn Restoration (topsoil & sod up to 12' wide 800 SY $ 2.25 $ 1,800.00 800.00 1,800.00 800.00 1,800.00 100.00% 71 Mobilization 1 LS $ 5,647.50 $ 5,647.50 1.00 5,647.50 1.00 5,647.50 100.00% Contingency 1 LS $ 6,437.25 $ 6,437.25 - 0.00% $ 70,809.75 $ 64,372.50 Additional Work - 01a Install 2" PE Service Line 749 LF $ 4.80 $ 3,595.20 749.00 3,595.20 749.00 3,595.20 100.00% 18a (mod) Install Water Service Single shortMulti Family Pipe & fitting 2 Ea $ 300.00 $ 600.00 2.00 600.00 2.00 600.00 1 100.00% 18d Install Water Service double short(Pipe & Fittings) 1 Ea $ 350.00 $ 350.00 1.00 350.00 1.00 350.00 100.00% 18g Install Water Service Signle Long with meter & box Marina 1 Ea $ 425.00 $ 425.00 1.00 425.00 1.00 425.00 100.00% 18h Install Water Service Single Long with 1" meter & box Clubho 2 Ea $ 525.00 $ 1,050.00 2.00 1,050.00 2.00 1,050.00 100.00% 181 Install Water Service Double Long (pipe & fittings only) 3 Ea $ 425.00 $ 1,275.00 3.00 1,275.00 3.00 1,275.00 100.00% 18i-1 Install Water Service Double Long with 2" saddle corp stop (Replace Saddle) 10 Ea $ 600.00 $ 6,000.00 10.00 6,000.00 10.00 6,000.00 100.00% 18m install 3" PVC Service Casing 5 Ea $ 600.00 $ 3,000.00 5.00 3,000.00 5.00 3,000.00 100.00 24 Remove & Replace or Relocate Existing Meter Box & Meter & Tie-in Service lines into Meter & grade 136 Ea $ 250.00 $ 34,000.00 136.00 34,000.00 136.00 34,000.00 100.00 65 Saw Cut, Remove & Dispose of Asphalt 28 TN $ 30.00 $ 840.00 28.00 840.00 28.00 840.00 100.00% 67a Install Asphalt Cement Replacement over full trench width including Base & Subgrade compacted to county specification 3 TN $ 45.00 $ 135.00 3.00 135.00 3.00 135.00 100.00% 84 Load & Haul Debris to Landfill 50 TN $ 25.00 $ 1,250.00 50.00 1,250.00 50.00 1,250.00 100.00% 86a Lawn Restoration (topsoil & sod up to 12' wide 800 SY $ 2.25 $ 1,800.00 800.00 1,800.00 800.00 1,800.00 100.00% 89e Furnish Labor per man-hour for equipment operator for loading& unloadingmaterials, etc 360 HR $ 56.80 $ 20,448.00 360.00 20,448.00 360.00 20,448.00 100.00 Work Deleted $ - - - - Contingenc -1 LS $ 6,437.25 $ (6,437.25) $ 68,330.95 $ 74,768.20 - - Materials - As hall 1 LS $ 1,212.86 $ 1,212.86 Materials - Sod 1 LS $ 5,778.00 $ 5,778.00 $ 6,990.66 Total $ 146,131.66 $ $ 139,140.70 $ 139,140.70 Amount �ompieteu to nate I S 1^14u.1u I Contractor Purchased Material Fs ---6-,99-08-61 Total Completed & Stored Less Retainage $ 146,131.56 Less Previous Payment Amount Due Contractor $ 146,131.5fi Pelican Point Confidential Page 1 1251_ �;: RANGER CONSTRUCTION INDUSTRIES, INC. s 1` %n e' P.O., Box 15065 L 'I West Palm Beach, FL 33416 (561) 793-9400 Plant: FT Pierce 106128 Blue Goose Growers, LLC 1900 Old Dixie Highway Ft. Pierce FL 34946 0 - INVOICE DATE I NUMBER GE 02/13/18 1 1366006 1 1 JOB JOB NAME LOCATION FCOSTOMER PO 106128 PELICAN POINT WATER 1 1 1251/6488 DATE I TICKET I PRODUCT I METRIC I U.S. PRICE I AMOUNT 02/13/18 0322308 9.5 LEVEL C 7.29 8.04 71.00 570.84 02/13/18 0322330 9.5 LEVEL C 7.26 ----------- 8.00 71.00 ----------- 568.00 16.04 ----------------- 1,138.84 APPROVED- Tax 68.33 By Terri Gorman at 11:35 am, Mar 16, 2018 Surtax 5.69 Total 1,212.86 216202.6315 A2161251 H6488 PAYMENT TERMS: Daae Upon Receipt 216202.6315 A 2161251 H 6961 = NAIL FARMS, INC. Invoice 27316 PO BOX 360054 MELBOURNE, FL 32936 (321)254-6746 APPROVE® 11251/6961 thesodfather@aol.com By Bryan Crain of 8:39 am, Mar 07,'2018 BILL TO Blue Goose Growers 1900 Old Dixie Highway Fort Pierce, FL 34946 P.O. NUMBER ACTIVITY Floratam Pallet Thank you for your businessl DATE PLEASE PAY 02/21/2018 JOB DESCRIPTION Pelican Point OTY RATE AMOUNT 40 135.00 5,400.00T SUBTOTAL 5,400.00 TAX (7%) 378.00 TOTAL 5,778.00 TOTAL DUE $5,778.00 THANK YOU.