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Home My WebLink About2004-120 CONT Chg Order #16 & #19 - LTM Inc CITY OF ASHLAND DEPARTMENT OF PUBLIC WORKS CONTRACT CHANGE ORDER NO. '16 PROJECT: LOCATION: CONTRACTOR: SISKIYOU BOULEVARD CONSTRUCTION SISKIYOU BOULEVARD LTM INCORPORATED DATE: PROJECT NO.: JUNE 18, 2004 99-38, SCDL B 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 Lump Item A ADA truncated domes Sum $1,724.66 $1,724.66 Lump Item B Pothole maintenance Sum $2,656.76 $2,656.76 Lump Item C 25 ft of curb removal and replacement Sum $433.26 $433.26 Lump Item D Sidewalk area drain at Liberty Street Sum $549.39 $549.39 Lump Item E Sod patching Sum $3'13.50 $313.50 Lump Item F Additional concrete work- Purdy Sum $1,3'10.38 $1,310.38 Lump Item G Traffic loop layout Sum $443.57 $443.57 Lump Item H Sternberg bases at Ashland Street Sum $1,116.35 $1,116.35 Lump Item l Driveway and NC removal various locations Sum $1,8:37.62 $1,837.62 Lump Item J Water service at 987 Siskiyou Blvd. Sum $1,6;B7.08 $1,678.08 Lump Item K Preparation for toplift paving Sum $6:25.74 $625.74 Lump Item L Remove wedges Sum $10,7~S3.00 $10,763.00 Lump Item M Bollards at thE; bowling alley Sum $429.72 $429.72 ENGINEERING Tel: 541-488-5347 20 E. Main Street Fax: 541-488-6006 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.or, us G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT~1999\99-38 Change Orders\Schedule B\99-38 CO Sc B 16.doc 'Original Contract Total this Change Order Previous Change Orders Revised Contract Total $3,277,662.80 $23,882.O2 $186,327.98 $3,487,872.80 Recommended By: Approved By: The time provided for completion of this contract is increased by no calendar days. This document shall become an amendment to the contract and all provisions of the contract will apply. ~~ ,,~~'---- Date' E-'ngi ~ne/e/./,, //' E~gi(eer Date Accepted By: LTM Incorporated PO B.o~1145, Medf~dOR 97501 ~o ntr.~ac~/~ .~~v~.,~ ....~-- ENGINEERING Tel: 541-488-5347 20 E. Main Street Fax: 541-488-6006 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.or, us G:\pub-wrks\eng\dept-admin\ENGINEER\PROJECT~1999\99_38 Change Orders\Schedule B\99-38 CO Sc B 16.doc REQUISTION FORM THIS IS A REQUEST FOR A:: [ X ] Change Order (existing PO# 3742 Schedule B) CITY OF -AS F! LAN D Required Date of Delivery/Service: Vendor Name: LTM INCORPORATED Address: PO BOX 1145 City, State, Zip MEDFORD OR 97501 Project Title: SISKIYOU BOULEVARD RECONSTRUCTION Project Number: 99-38 Services Only Description Siskiyou Blvd Reconstruction Project Change Orders 1 thru 15 Change Order 16 - Itemized Below (Total $23,882.02) ADA truncated domes Pothole maintenance 25 feet of curb removal and replacement Sidewalk area drain at Liberty Street Sod patching Additional concrete work - Purdy Traffic loop layout Sternberg bases at Ashland Street Driveway and NC removal various locations Water service at 987 Siskiyou Boulevard Preparation for toplift paving Remove wedges Bollards at the bowling alley Solicitation Process: [ ] Exempt [ ] 3 Written Quotes (copies attached) ] Sole Source [ X ] Invitation to Bid (copies on file) ] Less than $5000 [ ] Request for Proposal (copies on file) Total Cost Account Number 260.08.12.00.704200 / *Please attach the Original signed contract and Insurance Certificates. ,,d,.~ Employee Signature: Supervisor/Dept. Head Signature: {hi~ re quisti~ tha the above request meets with Ctiy of Ashland Solicitiation Process requirement~/~nd~/an-be pro,/ided when necessary. NOTE: By signing ~rm,~ify G:Pubwrks\Eng\99-38 LTM CO Scl B 16 Requisition Updated on: 7/15/02 CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 CITY RECORDER'S COPY Page 1 /3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541 ) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No THIS IS A REVISED PURCHASE ORDER Contract for the Siskiyou Blvd Redes gn 3,277,662.80 applicable to Bid Schedule B ONLY Bid Completion Date: December 30, 2003 Revised purchase or0er 03/20/2003, 3,139.00 Pipe SIA 37+75 Inlet at Morton Crossing at STA 14+50 Union St Harrison Stoppage 12/19/02 Planter at Omars Se~ice at STA 37+00 Arrows S H BILL TO: T~ FREIGHT TOTAL E 260.08.12.00.704200 3,766,517.71 Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 Page 2 / 3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No Change Order No, 9: Dewatedng Med ans Change Order No. 10, Items A - I detailed list) Ghange Order No 11, Items A-I (Please list) Change Order No 12, Items A-J (Please list) Schedule B Rovisod purchaso order 03/05/2004 ~8,3~ 2.78 Chan~e Order ~ 5 (Items Change Order 17 Gompensation for quantity adiustment Schedule B Revised purchase order 07/12/2004 107,725.15 8HBIOT~[ TOl~k Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 7/i/2003 Page 3 / 3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541 ) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No Schedule B fo~ ~it~ ov~ , Revised purchase order 07/15/2004 20,153.52 Change Order 19 SUBTOTAL 3,766,517.71 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 3,766,517.71 , OR 97520 Authori~,~ Signature VENDOR COPY CITY OF ASHLAND DEPARTMENT OF PUBLIC WORKS CONTRACT CHANGE ORDER NO. '19 PROJECT: LOCATION: CONTRACTOR: SISKIYOU BOULEVARD CONSTRUCTION SISKIYOU BOULEVARD LTM INCORPORATED DATE: PROJECT NO.' JULY 9, 20O4 99-38, SCDL B You are requested to perform the following described work upon receipt of an apl)roved copy of this document or as described by the Engineer: Item No. Description Quantity Unit Price Amount Dash numbers 337, 346, 347, 348, 350, 351,352, 353, Lump Item A 354, 355 Sum $20,153.52 $20,153.52 Original Contract Total this Change Order Previous Change Orders Revised Contract Total $3,277,662.80 $20,153.52 $364,507.26 $3,662,323.58 The time provided for completion of this contract is increased by no calendar days. This document shall become an amendment to the contract and all provisions of 'the contract willappl,. .~~ ~ ,~~________ at~e Recommended By: Approved By: . /;~ J~,c ~-- Date Accepted By: LTM Incorporated PO Box 1145, Medford OR 97501 Contractor /' "~ Date ENGINEERING Tel: 541.488-5347 20 E. Main Street Fax: 541-488-6006 Ashland, Oregon 97520 TTY: 800-735-2900 www.ashland.or, us G:\pub-wrks\eng\dept-admin\ENGINEER\PROJEC'R1999\99_38 Change Orders\Schedule B\99-38 CO Sc B 19.doc REQUISTION FORM THIS IS A REQUEST FOR A: [ x ] Change Order (existing PO# 3742 Schedule B) CITY OF ASHLAND Vendor Name: LTM INCORPORATED Address: PO BOX 1145 City, State, Zip MEDFORD OR 97501 Project Title: SISKIYOU BOULEVARD RECONSTRUCTION Project Number: 99-38 Solicitation Process: [ ] Exempt [ ] 3 Written Quiotes (copies attached) [ ] Sole Source [ X ] Invitation to Bid (copies on file) [ ] Less than $5000 [ ] Request for Proposal (copies on file) Services Only Description Siskiyou Blvd Reconstruction Project Change Orders 1 thru 18 Change Order 19 -Itemized Below (Total $20,153.52) Dash numbers 337,346, 347, 348, 350, 351,352, 353, 354, 355 Bollards at the bowling alley Total Cost Account Number 260.08.12.00.704200 ~//j~/~,.._._~ *PleaseattachtheOfiginalsignedcontractandlnsuranceCertificates. ,~ f~//,~ Employee Signature: Supervisor/Dept. Head Signature: NOTE: By signing this requistii~orm~/l'~ertify tha the above request meets with Ctiy of Ashland Solicitiation Process requirements ~(3d c~n be pn)vided when necessary. / G:Pubwrks\Eng\99-38 LTM CO Scl B 19 Requisition Updated on: 7/15/02 C T¥ O. ^s.,^N C!TY RECORDER'S COPY 20 E MAIN ST. ASHLAND, OR 97520 7/i/2003 (541) 488-5300 Page 1 / 3 03742 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No THIS IS A REVISED PURCHASE ORDER Contract for the Siskiyou Blvd ~design 3,277,662.80 applicable ~ Bid Schedule B ONLY Bid Completion ~ate: December 30, 2~03 ~ ~ Revised~purchase order 03/20/2003, 3,139.~0 Pipe STA 37+75 ~ Inlet at Modon Crossing at STA 14+50 Union St Harrison Stoppage 12/19~02 Planter at Omars Se~ice at STA 37+00 Arrows SUBTOT~ BILL TO: T~ FREIGHT TOTAL E 260.08.12.00.704200 3,746,364.19 Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 7/1/2OO3 Page 2 / 3 03742 III VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Work.,; (541 ) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? NO ?:i~i:;iii!?iiiii~iii!i~!~iii Change Order No. 9- D~waterin9 Medians , 142.10 Chan~e ~rder No. 10, Items A - I detailed list) , Change ~¢~der No 11, Items A-I (Please list) Chan~Order No ~2, Items A-3 (Please ~ list) Schedule B Revised purchase order 03105/2004 68,312.78 Change Order 15 (Items A-U) Change Order 17 Compensation for quanti~ adjustment Schedule B Revised pu[?ase order 07/12/2004 ,, ~ , 107,725.15 SUBTOT~ BILL TO: T~ FREIBHT TOT~ Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No Page 3 / 3 I~PONUMBER :: :I ' 03742' *** This isa chan~ ~rder. *** BILL TO: Account Payable 20 EAST MAIN ST 541-552-2028 ,~SHLAND, OR 97520 SUBTOTAL TAX FREIGHT TOTAL VENDOR COPY REQUISTION FORM THIS IS A REQUEST FOR A: [ X ] Change Order (existing PO# 3742 Schedule B) CITY OF SHLAND [)ate of Request:~ Required Date of Delivery/Service: Vendor Name: LTM INCORPORATED Address: PO BOX 1145 City, State, Zip MEDFORD OR 9750'1 Project Title: SISKIYOU BOULEVARD RECONSTRUCTION Project Number: 99-38 Services 0nly Description Siskiyou Blvd Reconstruction Project Change Orders I thru 19 Change Order 20 - Itemized Below (Total $107,725.15) Bid adjustment for quantity overruns SoliCitation ProceSs: Exempt I[ ] 3Written QUotes(copies attached) SOle Source [X] Invitation to Bid (copies on · file) LeSS'than $50(X) [ ] ReqUe~St for proposal (copies on file) Total Cost. $ 492,385.93 Bollards at the bowling alley Account Number 260.08.12.00.7'04200 *Please attach the Odginal signed contract and Insurance Certificates. ~ Ernploye;OSTiEg..n;tvusr~ Supervisor/Dept. Head Signature: ·: y ig: ing this requistiio~fo cessa nl tha the above request meets with Cb'y of Ashland Solicitiation Process requiremen 3n be provided when ne ry. ./ G:Pubwrks~Eng~99-38 LTM CO Scl B 20 Requisition Updated on: 7115/02 CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 CITY RECORDER'S COPY :: DATE :: :. Page 1 / 3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No THIS IS A REVISED PURCHASE ORDER applicable to Bid Schedule B ONLY Bid Completion Date: December 30, 2003 Revised purchase order 03/20/2003, 3,139.00 Pipe STA 37+75 Inlet at MoAon Crossing at STA ~4+50 Union St Harrison Stoppage 12/19/02 Planter at Omars Se~ice at STA 37+00 Arrows S~IBTOTAL BILL TO: FREIGHT TOTAL E 260.08.12.00.704200 3,614,757.02 Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541) 488-5300 7/i/2°031 Page 2 / 3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541 ) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No Change Or;der No, 9 -Dewatering Medians 142.10 Change Order No. 10, Items A - I ¢¢.t~!lgd list) Change Order No 11, Items A-I (Please !~ i::i i::.:: :i~i: :!!!i list) Change Order No 12, Items A-J (Please list) Schedule B Revised purchase order 03/05/2004 68,312.78 Change Order 15 (Items A-U) Ghsnge Or, er ~ 7 Compensmion for qusn~ity 8~justment ::::::::::::::::::::::::::::::: :: :~;j:~ ::;::~:~: ~: ~::~ :.; :~::~: ~;: :::: ~.:~ :: :~ ?: ?. :~ ?: ~:::~: ~ : :. SUBTOTAL BILL TO: T~ FREIGHT TOTAL Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 Page 3 / 3 03742 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No :? :.,: :: :.:.: ::::::::::::::::::::::::::::: SUBTOTAL 3,614,757.02 BILL TO: Account Payable TAX 0.00 20 EAST MAIN ST FREIGHT 0.00 541-552-2028 TOTAL 3,614,757.02 ASHLAND, OR 97520 Authorize?~ VENDOR COPY REQUISTION FORM THIS IS A REQUEST FOR A: [ x ] Change Order (existing PO# 3742 Schedule B) CITY OF Ft LAN D DatE; of Request: Required Date of Delivery/Service: l !i!iiii:i!ii!ii!iiii. I Vendor Name: LTM INCORPORATED Address: PO BOX 1145 City, State, Zip MEDFORD OR 97501 Project Title: SlSKIYOU BOULEVARD RECONSTRUCTION Project Number: 99-38 Solicitation Process: [ ] Exempt [ ] 3 Written Quotes (copies attached) [ ] Sole Source [ X ] Invitation to Bid (copies on file) [ ] Less than $5000 [ ] Request for Proposal (copies on file) Services Only Description Total Cost Siskiyou Blvd Reconstruction Project Change Order 17- Itemized Below (Total $154,297.24) Compensation for quantity adjustment Bollards at the bowling alley Account Number 260.08.12.00.704200 Employee Signature: ~/'/~.~;/,~ /~~/,'~ Z~ue~erv~a~t~t#~i~a~e~t~n~c~ttr~t~a~d~ns~rance~erti~cates~/~~.~-~----~-"---- ' , NOTE: By signing this requistiij~Yl~orm, l c)¢~/ ~a the above request meets with Ctiy of Ashland Solicitiation Process requirement~/and/~an be provided when necessary. / G:Pubwrks\Eng\99-38 LTM CO Scl B 17 Requisition Updated on: 7/15/02 CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 CITY RECORDER'S COPY Page 1 / 3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR !;)7501 SHIP TO: Ashland Public Works (541 ) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No THIS IS A REVISED PURCHASE ORDER Contract for the Siskiyou BIvd Redesign 3,277,662.80 applicable to Bid Schedule B ONLY Bid Completion Date: December 30, 2003 Revised purchase order 03/20/2003, 3,139.00 Pipe STA 37+75 Inlet at Morion Crossing at STA 14+50 Union St Harrison Stoppage 12/19/02 Planter at (:::)mars Service at STA 37+00 Arrows s u BTOTAL BILL TO: TAX FREIGHT TOTAL E 260.08.12.00.704200 3,638,639.04 Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5:300 7/1/2oo3"I Page 2 / 3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No Change O!~de[ No. 9 ~ Dewatering Med ans 142.10 Change Order No. 10, Items A - I detailed list) Change Order No 11, Items A-I (Please list) Change Order ~o 12, Items A-J {P ease list) : ......... :::::::::::::::::: ::::, ......... :::: :;:: Schedule B Revised purchase order 03~05~2004 68,312.78 Change Order 15 (Items A-U) Change Order 17 Compensation for quantity adiustment Schedule B BILL TO: SUBTOTAL TAX FREIGHT TOTAL Authorized Signature VENDOR COPY CITY OF ASHLAND 20 E MAIN ST. ASHLAND, OR 97520 (541 ) 488-5300 7/i/2003 Page 3 / 3 VENDOR: 000100 LTM INC P O BOX 1145 MEDFORD, OR 97501 SHIP TO: Ashland Public Works (541) 488-5587 51 WINBURN WAY ASHLAND, OR 97520 FOB Point: Terms: Net 10th of Month Req. Del. Date: 12/1/2002 Special Inst: Req. No.: Dept.: PUBLIC WORKS Contact: Paula Brown Confirming? No BILL TO: Account Payable SUBTOTAL 3,638,639.04 20 EAST MAIN ST TAX 0.00 541-552-2028 FREIGHT 0.00 -A?,I-II Al'dF) n~ Q7r-,gn TOTAL 3,638,639.04 , )%Ir zed Signature VENDOR COPY