HomeMy WebLinkAbout2010-197 CONT AMND #1 - Polaris Land Surveying
ENGINEERING SERVICES CONTRACT
AMENDMENT NO.1
Engineering services contract made on the date specified below in Recital A between
the City and Engineer as follows:
Recitals:
A. The following information applies to this contract:
CITY: CITY OF ASHLAND ENGINEER: Polaris Land Surveying, LLC
City Hall PO Box 459
20 E. Main St. Address: Ashland, OR 97520
Ashland, Oregon 97520 TelePhone\ 541/482-5009
(541) 488-5347 FAX: (541) 488-6006 Fax: 541/488-0797
Date of this agreement: Nov. 22, 2010 I January 6, 2008
B: RFP Date: Prooosal D~te: November 5, 2008
~2.3 City Contracting Officer: Michael R. Faught. Director of Public Works
~2.4. Project: Flexible Surveying Services
~6.1. Engineer's Representative: Shawn Kampmann
~8.3. Maximum Contract Amount: $5.000.00
B. AMENDMENT NO.1
1. Modification to "Services to be provided"
Add services as requested by City Public Works staff.
2. Modification to "Compensation"
A. Add cost of exlra work = $1,000.00
B. Adjusted total contract amount = $6,000.00
CONSULTANT
CITY
BY 5\'t~~
Fed.ID# tS-/3074l'7
BY
Finance Director
BY
REVEIWED AS TO CONTENT
~Qt
City Department Head
Date: 1/ I !!:O//o
Coding:
(for City use only)
G:lpub-wrkslengldept-adminIENGINEERIPROJECT\2008108 21 Polaris Contract Amend 1.doc
CITY RECORDER
Page 1/1
r~'
CITY OF
ASHLAND
20 E MAIN ST.
ASHLAND, OR 97520
(541) 488-5300
DATE '."
7/1/2010
"I
.; ',POiN1!JMBER ,,' ,.,
09151
I'
VENDOR: 008064
POLARIS LAND SURVEYING INC
PO BOX 459
ASHLAND, OR 97520
SHIP TO: Ashland Public Works
(541) 488-5587
51 WINBURN WAY
ASHLAND, OR 97520
FOB Point:
Tenn.: Net
Req. Del. Date:
Speciallnst:
Req. No.:
Depl:
Contact: Jim Olson
Confirming? No
'ciQ'iJaiititV": '~Unitt~ ;~ t!,."..,. .. .. . . ; :[)e'sC'riDliOii'~. .. " .> ,,",',<,,",. ;,. .....,. ;lJniflp.ricef~,-~ ~f .:~~tiE~e;g~;~:~!
THIS IS A REVISED PURCHASE ORDER
Contract for secondary flexible general 5,000.00
surveying services to be provided on an
as needed basis. (Initial PO 08808
issued inFY 2009 - unable to carry
forward PO because an a/c # was no
longer valid) RFP, Contract for
Personal Services, Beginning date:
February 1, 2009, Completion date: June
30, 2011, Contract may be extended for
two additional one year terms.
Insurance required/On file. Not to
exceed $5,000, per attached fee
schedule, for initial 29 month
contract. Approved by City Council
February 17:2009.
Processed change order 12/01/2010 1,000.00
Change Order NO.1
..
SUBTOTAL 6 000:00
BILL TO: Account Payable TAX 0.00
20 EAST MAIN ST FREIGHT 0.00
541-552-2028 TOTAL 6,000.00
ASHLAND, OR 97520
.:.:j.SA"t:coHnt1NumDerd;i,>;~~ ~~:r!:5~rcijeCt,Number:,. ,~ .,~ ,.::,','_Amouiif!).~-.~,_,~ ,';AccouHtjNumoer,; .; " r'~iPh)je'ctlNumoerj: <r.~,_'2 &~~!fi~o:unt~F~
':'
E 260.08.12.00.70420 1 000.00
E 260.08.12.00.70420 E 200821.400 500.00
E 260.08.17.00. 70420C E 200821.400 500.00
E 670.08.15.00. 7042PC E 200821.400 500.00
E 670.08.18.00.70420 E 200821.400 500.00
E 675.08.17.00.70420 E 200821.400 500.00
E 710.08.11.00.60410 E 200821.400 2 500.00
Lh,..;h
~~
Aut orized Signature
VENDOR COPY
I FORM #13 I
CONTRACT AMENDMENT APPROVAL REQUEST FORM
Request for a Change Order
CITY OF
ASHLAND
Description of Contract Amendment resulting from:
~)~c::o?>p;';titive-S_~a,leil-Bid' iii'll), 2) ,i::-ori!p~tit~v~~Se,~I.od.p~opOS_';I,{RF.P), o~3) 'Sole Sou~i:e Procur'e,!,e~nt;
Supplier 1 Contractor;
~ ?p-, U- r t:-q,/
,I 61.9' C ~ /
~ tfe!< 4\ 'P' cf}-y L.e r- ~ . ('
~:r attached contract amendment
Purchase Order Number;
Description:
cori'ti-iict..Amlindmerit
Original contract amount
$
7t:? -t:' c:J. ..--~
~ % of originai contract
Total amount of previous contract amendments
.---.
/' c1? t:? tfJ. /~
$ ~ ~_~~, tP--<!7
% of original contract
,.;2. CI % of original contract
Amount of this contract amendment
TOTAL AMOUNT OF CONTRACT
,/ .:zcY
% of original contract
Is the total amount of the cumulative amendments less than or equal to 25'1. of the original contract amount or.$25,D;00o
iV,hichev'er'fs,les:5? . /' ,--.
YES </' NO'
'If 'No", a Special Procurement is required for the amount tI1at exceeds autl1ority. Council approved on
(Date)
. In accordance with OAR 137-047-0800, the amendment is; 1) Within the scope 0' procurement 2) Necessary to comply with a change in
law that affects performance of the contract. 3) Results from renegotiation of the terms and conditions, including the contract price
making it advantageous to the contracting agency a) Provided goods and services are the same as in the unamended contract b) The'
amended contract does not have a total term greater than allowed in the solicitation document
YES
/'
NO'
'If 'No", a Special Procurement is required for the amount that does not meet tI1ese criteria. Council approved on
(Date)
(;Ul tJ g :'L/ / (' CI-C? ,;< ? t' 0.& /'.:< ,p &-;, . /' :z t:7-O
Project Number ______. ___ Account Number ___' __ - __' __' __'!':_"C_. Account Number ___' __ - __' __' ______
Account Number ___' __' __' __' ______ Account Number ___' __' __' __ - ______
'Expendilure must be charged t~!h';..-IIJ'Zi"te account numbers for the financials 10 reflect:e :ctu~1 expe~dilures accura iy. Affech extre peges if needed.
Prepared by; ~tv '. ~ Department' ~ ". (p,< --< Date; .
;;;;:: a...-.~/~ <!.~-~asecircle
Reviewed by; ru.e:u<G't.r'<'~~ Approved I Not Approved Date;
~epartment Head
Comments:
Funds appropriated for current fiscal year:
vQ, NO
/Jf~
mance Irec or
t'~h
, Date
Comments:
Form #13 - Contract Amendment Approval Request Form - ITS, RFP or SOLE SOURCE PROCUREMENT, Page 1 of 1, 12/6/2010
CITY OF
ASHLAND
A request for a Purchase Order
REQUISTION FORM Date of Request:I~212Q;1:~1
THIS IS A REQUEST FOR A; Required Date of Delivery/Service: I
[X ] Change Order (existing PO; 9151
Vendor Name:
Address:
City, State. Zip
Phone:
Project Title:
Project Number:
Polaris Land Surveying, LLC
PO Box 459
Ashland, OR 97520
541-482-5009
Flexible Surveying Services
2008-21
Services Only Solicitation Process:
[ ] Exempt [ ] 3 Written Quotes (copies
, attached)
[ ] Sole Source { ] .Invitation 10 Bid (copies on
file)
[ ] Less than $5000 ( X J . Request for Proposal
(copies' on file)
Description
Total Cost
Change Order NO.1
1m.. III ~
.,o..~~
m.. n," II
m. I'!I
III II . . -.
Account Number
Account Number
260.08.12.00.704200-$1,000.00
Employee Signature:
NOTE: By signing thi
*Please attach the Original signed contract and Insurance Certificates.
~ Supervisorl Depl Head Signature: ~-;:L\...."" .~\LL
certify tha the above request meets with Ctiy of Ashland SoHeitiation Process requirem nts and can be provided when necessary.
/~,
61"" ,
G:pub-wrks\Eng\depl-admin\ENGINEERING\Project\2008\08-21 PO request form.doc
Updated on: 7115102