HomeMy WebLinkAbout2015-274 CONT Chg Order #1 - Ashland Construction
CITY OF
ASHLAND
DEPARTMENT OF PUBLIC WORKS
CONTRACT CHANGE ORDER NO. I
PROJECT: 1 st Street Sidewalk Repair DATE: 09/23/15
LOCATION: 1st Street - E. Main Street to Hargadine PROJECT NO.: -
CONTRACTOR: Ashland Construction, Inc.
You are requested to perform the following described work upon receipt of an approved copy of this document or as described by the
Engineer:
Item No. Description Quantity Unit Price Amount
Additional Sidewalk Repair @ Amuse
Item #I Restaurant I $ 300.00 $ 300.00
Total this Change Order $ 300.00
Previous Change Order $ -
Original Contract Total $ 2,200.00
Revised Contract Total $ 2,500.00
PERCENT CHANGE OF ORIGINAL CONTRACT 13.6%
This document shall become an amendment to the 1,1pct and all provisions of the contract will apply.
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Recommended By:~
Project I Jrafiager Date
Approved By: C-
u s Di ector Date
Accepted By: Ashland Construction, Inc.
102 Pleasant View
Talent, OR 97540
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on ractor Representative Date
PW/ENGINEERING Tel 541-488-5347
20 E. Main street Fax 541-488-6006 Ashland, Oregon 97520 TTY: 800-735-2900
w~ .ashland.or.us
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CUSTOMER'S ORDER NO. I PHONE I DATE
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NAME
ADDRESS
SOLD BY CASH C.O.D. CHARGE ON ACCT. MDSE. RET'D. PAID OUT
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DESCRIPTION PRICE AMFUNT
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TAX I
RECEIVED BY
TOTAL
All claims and returned goods MUST be accompanied by this bill.
Page 1 / 1
. CITY OF i
ASHLAND DATE PO NUMBER
20 E MAIN ST. 8/5/2015 13046
ASHLAND, OR 97520
(541) 488-5300
VENDOR: 000026 SHIP TO: Ashland Public Works
ASHLAND CONSTRUCTION, INC (541) 488-5587
102 PLEASANT VIEW 51 WINBURN WAY
TALENT, OR 97540 ASHLAND, OR 97520
FOB Point: Ashland, Oreqon Req. Nu.:
Terms: Net Dept.:
Req. Del. Date: Contact: Karl Johnson
Special Inst: Confirming? NO
Quantity Unit Description Unit Price Ext. Price
THIS IS A REVISED PURCHASE ORDER
Replace commercial concrete apron for 2,200.00
Water Department as part of new water
service to 30 S. 1 st Street
Contract for Goods and Services
Beqinninq date: Auqust 3, 2015
Completion date: Auqust 31, 2015
Processed chanqe order 10/06/2015 300.00
1 st Street Sidewalk Repair
Per attached Chanqe Order No. 1
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SUBTOTAL 2,500.00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2010 TOTAL 2,500.00
AS H LAN D, O R 97520
Account Number Project Number Amount Account Number Project Number Amount
E 260.08.12.00.60240 1,100.00
E 670.08.18.00.60240 1,400.00
Authdrized Signature VENDOR COPY
LF9RIVVI#10 CITY OF
CONTRACT AMENDMENT APPROVAL REQUEST FORM
Request for a Change Order S H LAN
Name of Supplier I Contractor/ Consultant: Ashland Construction. Inc. Total amount of this
contract amendment:
Purchase Order Number: #13046
Title I Description: 1St St Sidewalk Repair $300.00
❑ Per attached contract amendment
Contract Amendment
Original contract amount $2,200.00 100 % of original contract
Total amount of previous contract amendments $0.00 0 % of original contract
Amount of this contract amendment $300.00 13.6 % of original contract
TOTAL AMOUNT OF CONTRACT $2,500.00 113.6 % of original contract
In accordance with OAR 137-047-0800: 1) The amendment is within the scope of procurement as described in the solicitation documents, Sole Source notice or approval of special
Procurement. 2) The amendment is necessary to comply with a change in law that affects performance of the contract. 3) The amendment results from renegotiation of the terms and
conditions, including the contract price, of a contract and the amendment is advantageous to the City of Ashland, subject to all of the fallowing conditions: a) goods and services
to be
provided under the amended contract are the same as the goods and services to be provided under the unamended contract; b) The City determines that, with all things considered,
the
amended contract is at least as favorable to the City as the unamended contract; c) The amended contract does not have a total term greater than allowed in the solicitation document,
contract or approval of a Special Procurement. An amendment is not within the scope of the procurement if the City determines that if it had described the changes to be made by
the
amendment in the procurement documents, it would likely have increased competition or affected award of contract.
Contract amendment is within the scope of procurement: YES X NO' (If "NO", requires Council approval 1 Attach copy of CC.)
Sourcing Method:
SMALL PROCUREMENT - Less than $5,000 INVITATION TO BID or COOPERATIVE PROCUREMENT, QRF or
® "YES", the total amount of contract and cumulative REQUEST FOR PROPOSAL EXEMPTION PURSUANT TO AMC 2.50
amendments :5 $6,000. ❑ "YES", the total amount of cumulative amendments ❑ "YES", the total amount of original contract and
❑ If "NO", amount exceeding authority requires s 25% of original contract amount or $250,000 cumulative amendments :5 $100K for Goods & Services, s
Council approval. Attach copy of Council whichever is less. $75K for Personal Services, < $50K for Attorney Fees.
Communication. ❑ If "NO", amount exceeding authority requires ❑ If "NO", amount exceeding authority requires Council
❑ Exempt-Reason: Council approval. Attach copy of Council approval. Attach copy of Council Communication.
PERSONAL SERVICES Communication. ❑ Exempt-Reason:
❑ "YES", Direct appointment s $35,000 ❑ Exempt- Reason:
❑ If "NO", requires approval.
INTERMEDIATE PROCUREMENT SOLE SOURCE EMERGENCY PROCUREMENT
Goods & Services - $5.000 to $100.000 ❑ "YES", the total amount of cumulative amendments ❑ Written Findings: Document the nature of the
Personal Services - $5,000 to $75.000 s 25% of original contract amount or $250,000 emergency, including necessity and circumstances
❑ "YES", the total amount of cumulative whichever is less. requiring the contract amendment
amendments s 25% of original contract amount. ❑ If ❑ If "NO amount exceeding authority requires ❑ Obtain direction and written approval from City
"NO", amount exceeding authority requires Council Council approval. Attach copy of Council Administrator
approval. Attach copy of Council Communication Communication. ❑ If applicable, attach copy of Council Communication
❑ Exempt- Reason: ❑ Exem t-Reason:
❑ Exempt-Reason:
SPECIAL PROCUREMENT INTERGOVERNMENTAL AGREEMENT
❑ "YES", the total amount of original contract and cumulative amendments are ❑ "YES", the original contract was approved by City Council.
within the amount and terms initially approved by Council as a Special Provide date approved by City Council: (Date)
Procurement. If "NO", Council approval is required. Attach copy of Council Communication.
❑ If "NO", amount exceeding authority requires Council approval. ❑ Contract amendment approved and signed by City Administrator.
Attach co of Council Communication.
Project Number _ _ _ _ _ _ - - _ _ Account Number 670.08.18.00.602400 (100%) Account Number _ _ _ - _ - -
'Expenditure must be charged to th pro ccount n bers for the financials to reflect the actual expenditures accurately. Attach extra pages if needed.
Employee Signature: Department Head Signature:
(Total amount of contract? $5,000)
City Administrator:
(Equal to orgreater than $25,000 or 10%)
Funds appropriated for current fiscal year: YES / NO
Finance Director (Equal to or greater than $5,000) Date
Comments:
Form #10 - Contract Amendment Approval Request Form, Request for a Change Order, Page 1 of 1, 9/23/2015