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LIFT STATION 16 - 20-0008-UT - CHANGE ORDER 1Change Order 1 PROJECT: CONTRACTOR: Lift Station 16 Pierce St Rehab TLC Diversified, Inc 2719 17th St E Palmetto, Florida 34221 DATE: PROJECT NUMBER: PO REFERENCE: COUNCIL AWARD: DATE OF CONTRACT: CODE: January 16, 2024 20 -0008 -UT 23001004 July 17, 2023 August 8, 2023 SCOPE OF CHANGE: Approve a Change Order to TLC Diversified, Inc. of Palmetto FL, to extend the project completion by One Hundred Eighty (180) days from May 28, 2024, to November 28, 2024, and authorize the appropriate officials to execute same. (consent). The increase is mainly due to maniple factors that are out of TLC Diversified, Inc.'s control, that include the global supply crisis, shipping delays, global shortages, u well as manufacturing delays from component manufacturers, STATEMENT OF CONTRACT AMOUNT ORIGINAL CONTRACT AMOUNT Change Order 1 - City Council Approval NEW CONTRACT AMOUNT Brian J Aungst Sr, APPROVED TO FORM: $ 7,933,000.00 $ 0.00 $ 7,933,000.00 Mayor Jerrod Sim ATTEST: Senior Assistant City Attorney Date: L AS A CITY OF CLEARWATER, in PINELLAS Jennifer Change Order 1: Lift Station 16 Pierce St Rehab Project ITEM Decreases: Increases• DESCRIPTION N/A N/A ACCEPTED BY: TLC Diversified, Inc. Recommended By: City of Clearwater Rama Pandkar, Project Manager Digitally signed by Richard Gardner DN: cn=Richard Gardner, o=City of Clearwater, ou=Public Utilities, . jam email=dchard.gardner@myclearwater.co m, c=US Date: 2024.01.17 17:22:22 -0500' City Manager Richard G. Gardner, PE PU Director UNIT UNIT COST TOTAL COST Total (Decreases): $ $ 0.00 $ 0.00 $ TotalIncreasea: $ 0.00 Total Net (Decrease)/Increases: $ 0.00 APPLICATION AND CERTIFICATE FOR PAYMENT To: City of Clearwater Project: Lift Station 16 Pierce Street PU Engineering - Rama Pandkar 1650 N Arcturas Ave N Bldg C Contract No: 20 -0008 -UT Clearwater, Florida 33765 Contract Date: 8/8/2023 P UEngineeri nd@MyClearwater.com From: TLC Diversified, Inc. 2719 17th Street East Palmetto, FL 34221 Application: Period to: PO: Distribution to: OWNER ARCHITECT CONTRACTOR 23001004 _ ENGINEER CHANGE ORDER SUMMARY Change Orders approved in previous months by Owner TOTAL ADDITIONS DELETIONS Approved this month Number Date Approved TOTALS Net Change by Change Orders The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and belief, the work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for work for which previous Certificates for Payment were issued and payments received from the Owner, and that current payment shown herein is now due. CONTRACTOR: Signature: Print Name: AlexZettel Application is made for payment, as shown below, in connection with the Contract. Continuation Sheet is attached. 1 Original Contract Sum 2 Net Change by Change Orders 3 Contract Sum to Date (Line 1 + 2) 4 Total Completed 5 Retainage (5% of completed work) 6 Total Earned Less Retainage (Line 4 less Line 5 Total) 7 Less Previous Certificates for Payment (Line 6 from prior certificate) 8 Current Payment Due (Line 6 leas line 7) 9 Balance to Finish, Plus Retainage (Line 3 less line 6) Date: S 7,933,000.00 $ - $ 7,933,000.00 $ - $ - $ - $ $ - $ 7,933,000.00 OWNERS CERTIFICATE FOR PAYMENT In accordance with the Contract Documents, based on onside observations and the data comprising the above application, the Architect/Engineer certifies to the Owner that to the best of his/her knowledge, information and belief, the Work has progressed as indicated, that the quality of work is in accordance with said Contract Documents, and the Contractor is entitled to payment of the Richard G. Gardner, P.E., Public Utilities Director Page AMOUNT CER I'll''1t D: $ (Attach explanation if amount certified differs from that applied for) Anthony Trant, Construction Inspector Kaylynn Price, Acting Utilities Eng Mgr Rama Pandkar, Project Manager By: Date: This Certificate is not negotiable. The AMOUNT CERTIFIED is payable only to the Contractor named herein. Issuance, payment and acceptance of payment are without prejudice to any rights of the Owner or Contractor under this Contract. 2040118 -UT Idle Station 16 Pkrce Street Draw 1 Date Item No. Description Unit Qty Unit Price TContractAmount Previous Amount Earned Qty this Draw Amount this Draw Qty to Date Amount Earned to Date Percentage Complete 1 Demolition - Demolition of the existing LS -16 facilities. This includes the existing wetwell, valve vaults, concrete slab, valves, piping, conduits/cables, electricaUcontrol panels, light fixtures, instrumentation/control equipment, fencing, etc. as shown in the Contract Documents. LS I $ 131,000.00 1 $ 131,000.00 S - 0.00 $ - 0.00 $ - 0.00% 2 Site civil - Site civil work associated with the WORK, including site preparation grading, erosion control, excavation and backfill materials. Modifications to manholes and bypass pumping as shown in the Contract Documents as well as restoration work of pervious and impervious areas affected by the construction activities. LS 1 $ 232,000.00 $ 232,000.00 S - 0.00 $ - 0.00 $ - 0.00% 3 New Lift Station -Installation of a new 15 -ft diameter, cast in place wetwell with three submersible, solids handling pumps, inclusive of all accessories and appurtenances as shown in the Contract Documents. The wetwell rim shall be installed at elevation 15.0 -ft. this includes commissioning and start up services including individual equipment startup and testing, piping system testing, providing the services of manufacturer field technician and representatives to provide services for installation, startup, and training, coordination with the OWNER, ENGINEER, other CONTRACTORS, and regulatory agencies. LS 1 $ 5,092,000.00 $ 5,092,000.00 S - 0.00 $ - 0.00 $ - 0.00% 4 Electrical Work - Furnish and install cable, conduits, Tight fixtures, electrical panels, transformer(s), automatic transfer switch, lightning protection system and equipment (including new natural gas backup generator), flow meter, pressure gauge, level transducers, floats, telemetry control units (TCU), and control panels shown in the Contract Documents. The Contractor shall also perform a short circuit and coordination study as part to the WORK. Electrical panels shall be installed at elevation 17.0 -ft. The existing communications antenna should also be relocated as part of this work. LS 1 $ 1,209,000.00 $ 1,209,000.00 S - 0.00 $ - 0.00 $ - 0.00% Printed : Page 1 of 2 20•SO111-UT UR Station IA Puree Street Draw 1 Date Item No. Description Unit Qty Unit Price Contract Amount Previous Amount Earned Qty this Draw Amount this Draw Qty to Date Amount Earned to Date Percentage Complete 5 Structural Work - Furnish and install elevated structures, retaining walls and platforms to service and maintain the wetwell, electrical, control and instrumentation equipment as shown in the Contract Documents. LS 1 $ 265,000.00 $ 265,000.00 $ - 0.00 $ - 0.00 $ - 0.00% 6 Landscape Work - Protection, removal, replacement, and overall improvements of landscape features at the site. This includes furnish and installation of irrigation system, trees, grasses, plants, and shrubs as shown in the Contract Documents. LS 1 $ 31,000.00 $ 31,000.00 $ - 0.00 S - 0.00 S - 0.00% SUBTOTAL $ 6,960,000.00 S - $ - 0.00 S - 0.00% ,10% CONTINGENCY 1 $ 696,000.00 $ 696,000.00 S - 0.00 $ - 0.00 $ - 0.00% Bid Allier nate No. 1 Aluminum Canopy Work - Furnish and install extruded aluminum protective cover, inclusive of fixed, extruded aluminum louvers and structural elements as show in the Contract Documents. The structural components of the protective cover shall be coordinate such as it will be supported from structural platform components, but not be integral to these components. LS 1 $ 277,000.00 $ 277,000.00 $ - 0.00 S - 0.00 $ - 0.00% SUBTOTAL BID ALTERNATE NO.1 $ 277,000.00 $ - $ - 0.00 $ - 0.00% _ TOTAL CONTRACT $ 7,933,000.00 $ - $ - ' 0.00 $ - GRAND TOTAL $ 7,933,000.00 $ - $ - 0.00 $ - 0.00^,6 • Total Contract $ 7,933,000.00 $ - $ - $ - o.ocft 1:. $ y . CurrentPi.yuaet S. - Printed : Page 2 of 2