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HomeMy WebLinkAbout3D Company, Inc./ENG/$10,222.54/20-ENG-02 106th St and College Ave RAB - CO #4 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 City of Carmel Project 20-ENG-02 _Pr-. Intersection Improvements : 106th Street and College Avenue Roundabout CHANGE ORDER #4 This change order will add pay items for a yard drain on the property on the northwest corner of Arthur Drive and College Avenue;additional water main work at 106th and Broadway intersection; downtime for rental materials for STR 125A; and payment for materials due to deletion of STR 174 and STR 176 on the east leg of the project; and a liquidated damages pay item. There is no time extension for this work. This change order will also adjust the substantial and final completion dates. The substantial completion date is changing from December 2, 2022 to March 31,2023. The final completion date is changing from January 3, 2023 to June 2,2023. Contract Price prior to this Change Order $3,804,245.77 Contract Price will be changed by this Change Order $10,222.54 New Contract Price including this Change Order $3,814,458.31 Amount Adjusted Contract Cumulative%Change Price from Original Contract Original Contract $3,660,000.00 N/A N/A CO1 $99,360.21 $3,759.360.21 2.71% CO2 $21,026.40 $3,780,396.61 3.29% CO3 $23,849.16 $3,804,245.77 3.94% C04 $10,222.54 $3,814,458.31 4.22% DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CITY OF CARMEL TO: Jeremy Kashman CONTRACT CHANGE ORDER NO.: 4 City Engineer DATE: October 17,2023 City of Carmel Indiana PROJECT NAME: 106th and College Ave RAB One Civic Square CITY REQ. NO.: Carmel, IN 46032 CITY PO NO.: 20-ENG-02 CITY PO DATE: I. You are directed to make the following changes in this Contract: This change order will add pay items for a yard drain on the property on the northwest corner of Arthur Drive and College Avenue; additional water main work at 106th and Broadway intersection;downtime for rental materials for STR 125A; payment for materials due to deletion of STR 174 and STR 176 on the east leg of the project;and a liquidated damages pay item. There is no time extension for this work. This change order will also adjust the substantial and final completion dates. The substantial completion date is changing from December 2,2022 to March 31,2023. The final completion date is changing from January 3,2023 to June 2,2023. SCHEDULED ADJUSTMENT ITEM AMOUNT (+)OR(-)DAYS II. The following referenced Documents further describe the changes outlined in Paragraph I, and are to be considered a part of this Change Order:R.F.P.: N/A W.D.C.NO.: N/A The changes result in the following adjustment of Contract Price and Contract Time: Contract Price prior to this Change Order $ 3,804,235.77 Contract Price will be increased by this Change Order $ 10,222.54 New Contract Price including this Change Order $ 3,814,458.31 Contract Time prior to this Change Order Days Closure 12/2/2022 Substantial Completion Date Contract Time prior to this Change Order 1/3/2023 Final Completion Date Net increased/decreased resulting from this Change Order Days Current Contract Time including this Change Order Days Closure 3/31/2023 Substantial Completion Date Current Contract Time including this Change Order 6/2/2023 Final Completion Date This Change Order is for full and final settlement of all direct,indirect,impact costs and time extensions incurred at any time resulting from the performance of the changed work. The Above Changes Are The Above Changes Are Accepted Approved Recommended American StructurenoinL Inc. 3D Company,Inc. Not Present ENGINEER CONTRACTOR James Brainard,Mayor �ooisea Uy: 9025 River Road.Suite 200 7240 North State Road 3 haini 1l th. I. Address Address M ari.�ai cco iiri Burke,Member o Indianapolis.IN 46240 Muncie,IN 47303 ten (1i i-sw. City/State/Zip City/State/Zip �dfi�zz3aea:aaoo Lort Watson,Member Jer y Kashman,PE, testy Engineer By: D cL��2%eAoJ By: �s, sv�C��� ATTES,T.:DocuSigned by: Phone: 317-281-9563 Phone: (765)288-3326 wdlc Sue Wolfg ;°ettk Date: 11/1/2023 Date: October 17,2023 Date: October 23,2023 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 coco N w a) CoH cl c. cm'' 0 N O a4 O a) .-, a) a) a cd a a) o `� o f2I a) o• .01) a) n o on ar 3 a o C._) 4 cd 3 v 5 o o a) a �. 4" o w P •i-' 0 y 0 U ++6) CI . 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U] A E. v1 U d d U co s d O N DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 co m C 10 00 0 o O 1 m r-, 0,1 0 c o Cl (0) v, o o N N O d an — N _ hi ir) 00 - C '..O N N 69 N N — 0) K enen •— O O M OLIS 69 69 69 64 O o 0 C ii Q 3 O O 0 O O O O O of p p� V DO O O O '6. ,o \o O Cl O kr) r+ M M 0 69 69 69 69 11 O O O O O M N +'+ O O O O O _ N N ,-••' 9 CY M N " O O N r o J t 0 Lo C4 i rj r 0 Il cO CI N E d. 3 N N a) cO +0�+ 7y O N I� tOOA85. CO E 76 CDN O CO w + O WI Ud - O CO C NO EN O' CO •CO N Vl f') fr' Cn CO C/D CO On0 0000 -] , ° 9C 00 iJ00 tll O4. U ~ U o U o¢ U L Ea •.b N O < Ei C 0 U •� N N N Q U ) U Y O m 61 Q cd -., c� N co z, ' =i B d - W •.• Q °) CO U 0 o E cC y B O O O O Q ° o g CO P_ N yCO 0 o i ' t a.as cL. o CO� w Z cA o U O U o U o U o .4 U U 0 6 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 co co 0 0 N ti N 0) OJ 0 (6 A— a w ri U A I- 0 m a� rn a� 0 0 iri CEO 0 0 4) 1- 12 N O O Ei a) o� O as Z N L 0 N DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 -ow E a O C O Q U C) O y CD CY) O O 0 O CD O N U C m CCD 0) CO CD CD CO i9 O CO CO r Ea 64 69 e9 O �? N Cn N .E en en (n en O (V N J J J J o t/1 O N O C 69 41 U C Cy 7 Or N CD o U H C C 7 O CO Z U CD CD CD co N CD co O N VO V CD OO CO CO CD O) _ CO CD CO C9 Ea ea E9 0 M U rn N C O L M O r O @ ° H N U 3 en O rn (0 U' C tn a) m m Z c o v m W O U b 2E � o E. CO ix o N CO O H U O E N N j O O Q` CO 0 CO -j C o - CO — N J H < o E H �ix to >- U m C) 2 O _ Z N CO V CD N- E O O O O DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CITY OF CARMEL TO: CONTRACT CHANGE REQUEST NO.: 32 DATE: 8/1/23 PROJECT NAME: 106th St& College Ave. RAB FROM: 3D Company Inc. IT IS REQUESTED THAT A CONTRACT CHANGE BE MADE TO THE ABOVE REFERENCED CONTRACT. 1. SCOPE OF WORK(USE ADDITIONAL PAGES IF REQUIRED. ALSO LIST OTHER CONTRACTS INVOLVED.) Installation of yard drain at College and Arthur. 2. REASON FOR CHANGE: Installation of yard drain was unforeseen and needed to aid in drainage at this intersection. 3. APPROXIMATE COST CHANGE TO CONTRACT PRICE: $1,530.66 4. WILL THE CONTRACT NEED ADDITIONAL CONTRACT TIME TO COMPLETE THE CHANGE IN WORK SCOPE? x -YES -NO .5 -(CALENDAR DAYS) 5. WILL THE CONTRACTOR NEED ADDITIONAL PERSONNEL TO COMPLETE THE CHANGE IN WORK SCOPE? -YES X -NO IF NO, TRADE(S): NO. OF PERSONNEL: DURATION: 6. IDENTIFICATION OF ATTACHMENTS: COR#32 is attached. DATE: DATE: PREPARED REVIEWED BY: Seth Blalock REVIEWED BY: ENGINEER Comments and Recommendation: AR-5 Version 2018-12-19 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 DATE OF SUBMISSION 8/1/23 PROJECT DESCRIPTION 106th Street and College Avenue Roundabout (route/intersection/bridge no(s).) CHANGE ORDER REQUEST SUMMARY Installation of yard drain at College and Arthur intersection. DESCRIPTION PROPOSED SOLUTION SUMMARY Installation of yard drain and connection into newly installed storm system. NOTE:Upon request from Engineer, enter detailed description on page 2. ONSET DATE OF CHANGE 5/24/23 CHANGE ORDER TYPE 104.03 Extra Work PROPOSED COST AND TIME ADJUSTMENT COST COST INCREASE/(DECREASE): $ 1,530.66 The cost adjustment shall include lump sum and/or estimated totaled unit-priced item costs.Attach a separate sheet of unit price items including item description, unit of measurement, estimated quantity and unit price. CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF COST CHANGE: ❑ 109.03 Altered Quantities ❑ 109.05(a)Agreed Price ® 109.05(b) Force Account ❑ 109.05.02 Delay Costs PROPOSED COST CHANGE INCLUDES: ® Labor ® Material ® Equipment ❑ Lease Agreement ❑ Subcontractor Click here to TIME ADJUSTMENT INCREASE/(DECREASE): (work days) enter text. CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF TIME CHANGE: ►Z1 108.08(a) Excusable, Non-Compensable ❑ 108.08(b) Excusable,Compensable NOTE:If Compensable,attach details based on 109.05.2(a)Allowable Delay Costs. SUPPLEMENTAL INFORMATION Additional information. CHANGE ORDER ORIGINATION: ® Owner/Inspection 0 Contractor DOCUMENTS AFFECTED: ® Contract Specifications(ref.doc name/no.) INDOT Standard Specifications 2020 ❑ Contract Plans(ref.doc name/no.) Intersection Improvements 106th Street&College Ave. RAB 20-ENG-02 CHANGE ORDER AFFECTS DBE PARTICIPATION: ❑yes ® no (if yes,attach details) Ver 1018.18 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 UPON WRITTEN REQUEST FROM THE ENGINEER, PROVIDE ADDITIONAL DETAIL DATE RECEIVED REQUEST FOR SUBMITTAL DATE OF ADDITIONAL DETAIL [Select Date] [Select Date] ADDITIONAL DETAIL DETAILED DESCRIPTION/JUSTIFICATION: (Include location(s), actions of contractor, owner, and other stakeholders, key events and related cause(s), discoveries, discussions, meetings, and effect on the contract if no action is taken.Also include references to key documents attached or available to support this change order request.) Installation of yard drain at intersection of College and Arthur. PROPOSED SOLUTION—ADDITIONAL DETAILS: (Include proposed scope of work, means&methods, materials, equipment, utility relocation required,subcontracted scope and the effect on the contract schedule.Also include references to attached documents including, but not limited to,sketches, calculations,photos, material information, and submittals and meeting minutes.) Installation of yard drain and connection into newly installed storm system. SIGNATURE Contractor: 3D Company Inc. Name: (print eanna D.Case (signature) k C C\ . C_CZI)RI__ Date: 8/1/23 NOTE: The Contractor should retain a signed copy of this document for record. pg. 2 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 ATTACHMENT: UNIT PRICE ITEMS DETAIL Attach or paste a unit price item detail. See attached force account sheet for breakdown of cost. pg. 3 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 T&M Spreadsheet INDOT Contract#: 20-ENG-02 Contract Descp: Prime Contractor: 3D Company Inc. Subcontractor: Date Work Performed: 5/24/2023 Inspector: T&M Task Description:Installation of yard drain and connection at College and Arthur. 7 yards of top soil were placed for this work and the AT&T relocation. Labor(includes Fringes & Applicable Taxes) O.H. & Name Classification Rate/Hour Hours Subtotal Profit Amount 1 Foreman $94.00 3.00 $282.00 1.20 $338.40 2 Laborer $62.00 3.00 $186.00 1.20 $223.20 3 4 5 Labor Total: $561.60 Equipment O.H. & Make Classification Rate/Hour Hours Subtotal Profit Amount 1 Kubota 95 Skidsteer $147.00 3.00 $441.00 1.12 $493.92 2 Ford F-550 Single Axle Dump $115.00 2.00 $230.00 1.12 $257.60 3 4 5 6 Equipment Total: $751.52 Materials (See Attached invoices) O.H. & Description _ Location Unit Price Quantity Subtotal Profit Amount 1 Yard Drain/Pipe $128.29 1.00 $128.29 1.12 $143.68 2 Hydralic Cement $21.98 3.00 $65.94 1.12 $73.85 3 4 Material Total: $217.54 Sub Contractors O.H. & Subcontractor Type Unit Price Quantity Subtotal Profit Amount 1 Material Total: $0.00 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 Daily Cost Summary Signature: Prime Contractor Daily Labor Total: $561.60 Daily Equipment Total: $751.52 Signature: Daily Materials Total: $217.54 Inspector Subcontractor Total: $0.00 Bond %Increase Total: Signature: GC (10%-1st$3,000): Subcontractor GC (7%-Over$3,000): Daily Grand Total: $1,530.66 Signature: DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CITY OF CARMEL TO: CONTRACT CHANGE REQUEST NO.: 04 DATE: 2/27/2023 PROJECT NAME: FROM: 3D Company Inc. IT IS REQUESTED THAT A CONTRACT CHANGE BE MADE TO THE ABOVE REFERENCED CONTRACT. 1. SCOPE OF WORK(USE ADDITIONAL PAGES IF REQUIRED. ALSO LIST OTHER CONTRACTS INVOLVED.) „est for change order due to change of snpe of work.for water main tie at Rrnadway & 106th intersection_ 2. REASON FOR CHANGE: Chane in scope of work. 3. APPROXIMATE COST CHANGE TO CONTRACT PRICE: $ 3,631.68 4. WILL THE CONTRACT NEED ADDITIONAL CONTRACT TIME TO COMPLETE THE CHANGE IN WORK SCOPE? X -YES -NO 1 -(CALENDAR DAYS) 5. WILL THE CONTRACTOR NEED ADDITIONAL PERSONNEL TO COMPLETE THE CHANGE IN WORK SCOPE? -YES X -NO IF NO, TRADE(S): NO. OF PERSONNEL: DURATION: 6. IDENTIFICATION OF ATTACHMENTS: time and materials force account breakdown attached along with material invoices. DATE: 2/27/2023 DATE: PREPARED REVIEWED BY: Seth Blalock REVIEWED BY: ENGINEER Comments and Recommendation: AR-5 Version 2018-12-19 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM February 27, CONTRACT NO. 20-ENG-02 DATE OF SUBMISSION 2023 PROJECT DESCRIPTION 106'h Street and College Avenue Roundabout (route/intersection/bridge no(s).) CHANGE ORDER REQUEST SUMMARY Change of scope for watermain tie-in at Broadway & 106'h intersection DESCRIPTION PROPOSED SOLUTION SUMMARY Click here to enter text. NOTE:Upon request from Engineer, enter detailed description on page 2. ONSET DATE OF CHANGE October 28, 2022 CHANGE ORDER TYPE 104.03 Extra Work PROPOSED COST AND TIME ADJUSTMENT COST COST INCREASE/(DECREASE): $ $3,631.68 The cost adjustment shall include lump sum and/or estimated totaled unit-priced item costs. Attach a separate sheet of unit price items including item description, unit of measurement, estimated quantity and unit price. CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF COST CHANGE: ❑ 109.03 Altered Quantities ❑ 109.05(a)Agreed Price ® 109.05(b)Force Account ❑ 109.05.02 Delay Costs PROPOSED COST CHANGE INCLUDES: Labor ® Material ® Equipment ❑ Lease Agreement ❑ Subcontractor TIME ADJUSTMENT INCREASE/(DECREASE): (work days) 1 CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF TIME CHANGE: 108.08(a) Excusable, Non-Compensable ❑ 108.08(b)Excusable, Compensable NOTE:If Compensable,attach details based on 109.05.2(a)Allowable Delay Costs. SUPPLEMENTAL INFORMATION Additional information. CHANGE ORDER ORIGINATION: ® Owner/Inspection 0 Contractor DOCUMENTS AFFECTED: ® Contract Specifications(ref.doc name/no.) INDOT Standard Specifications 2020 ❑ Contract Plans(ref.doc name/no.) Intersection Improvements 106th Street&College Ave. RAB 20-ENG-02 CHANGE ORDER AFFECTS DBE PARTICIPATION: yes ❑ no (if yes,attach details) Ver. 10.18.18 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 UPON WRITTEN REQUEST FROM THE ENGINEER, PROVIDE ADDITIONAL DETAIL DATE RECEIVED REQUEST FOR SUBMITTAL DATE OF ADDITIONAL DETAIL [Select Date] [Select Date] ADDITIONAL DETAIL DETAILED DESCRIPTION/JUSTIFICATION: (Include location(s), actions of contractor, owner, and other stakeholders, key events and related cause(s), discoveries, discussions, meetings, and effect on the contract if no action is taken.Also include references to key documents attached or available to support this change order request.) Click here to enter text. PROPOSED SOLUTION—ADDITIONAL DETAILS: (Include proposed scope of work, means&methods, materials, equipment, utility relocation required,subcontracted scope and the effect on the contract schedule.Also include references to attached documents including, but not limited to,sketches, calculations,photos, material information, and submittals and meeting minutes.) 3D was instructed by onsite inspector on how to proceed. SIGNATURE Contractor: 3D Company Inc. Name: (print) eanna D. Case (signature) t Y' h Date: 2/27/2023 NOTE: The Contractor should retain a signed copy of this document for record. pg. 2 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 ATTACHMENT: UNIT PRICE ITEMS DETAIL Attach or paste a unit price item detail. See attached force account sheet for breakdown of cost involved. p9 . 3 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 fd FERGUSON' INVOICE NUMBER TOTAL DUE CUSTOMER PAGE WATERWORKS 0297710 $2,279.22 14225 , 1 of 1 2126 WEST 400 SOUTH PLEASE REFER TO INVOICE NUMBER WHEN KOKOMO, IN 46902-9615 MAKING PAYMENT AND REMIT TO: C py t) PO E BOX ON 5ATERWORKS#1934 644 Please contact with Questions: 317-546-2013 PITTSBURGH,PA 15264-4054 ;.i.T 9 A2.0 r I F SHIP TO: 3D COMPANY INC 106TH AND COLLEGE 3D COMPANY INC 106TH&COLLEGE AVE ifireti: 7240 N SR 3 CARMEL, IN 46032 106TH&COLLEGE AVE MUNCIE,IN 47303 SHIP SELL TAX CODE CUSTOMER ORDER NUMBER SALESMAN JOB NAME INVOICE DATE BATCH WHSE, WHSE. 10 2930 2930 INE 2563 LMA 106TH&COLLEGE AVE 10/25/22 24424 ORDERED SHIPPED ITEM NUMBER DESCRIPTION UNIT PRICE UM AMOUNT 1 1 DMJTLAI6U DOM 16X6 MJ C153 TEE UA 1099.510 EA 1099.51 2 2 DMJLSLAU DOM 6X12 MJ C153 LONG SLV UA 158.000 EA —316r.96 1 1 AFC2506MMLAOR 6 DI MJ RW OR GATE VLV UA 863.710 EA 863.71 INVOICE SUB-TOTAL 2279.22 LEAD LAW WARNING:IT IS ILLEGAL TO INSTALL PRODUCTS THAT ARE NOT"LEAD FREE'IN ACCORDANCE WITH US FEDERAL OR OTHER APPLICABLE LAW IN POTABLE WATER SYSTEMS ANTICIPATED FOR HUMAN CONSUMPTION PRODUCTS W TM"NP IN THE DESCRIPTION ARE NOT LEAD FREE AND CAN ONLY BE INSTALLED IN NON-POTABLE APPLICATIONS.BUYER IS SOLELY RESPONSIBLE FOR PRODUCT SELECTION. Looking for a more convenient way to pay your bill? - 0 .ta; Log in to Ferguson.com and request access to Online Bill Pay. _ -. I s TERMS: NET 10TH PROX ORIGINAL INVOICE TOTAL DUE $2,279.22 All past due amounts are subject to a service charge of 1.5%per month,or the maximum allowed by law,if lower.if Buyer falls to pay within terms,lthen in addition to other remedies,Buyer agrees to pay Seller all costs of collection,including reasonable attorney fees.Complete terms and conditions are vailable upon request or at https:Nwww.ferguson.comicontent/website-info/terns-of-sale,incorporated by reference.Seller may convert checks to ACH. 'Any reference to or incorporation of Executive Order 14042 and/or the EO-implementing Federal clauses(FAR 52.223-99 and/or DFARS 252.223-7999 's expressly rejected by Seller and shall not apply as Seller is a materials supplier and therefore exempt under the Executive Order.' DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 Time & Materials Spreadsheet INDOT Contract*: 20-ENG-02 Contract Descp: 106th St&College RAB Prime Contractor: 3D Company Subcontractor: Date Work Performed: 10/28/2022-11/01/22 Inspector: Dave Machala T&M Task Description: Change of scope for water main tie at Broadway&106th intersection. T&M Task Provider(Prime or Subcontractor): Weather Conditions: Task Start Time: Task Finish Time: Comments: Labor(Includes Fringes&Applicable Taxes) O.H.& Name Classification Rate/Hour Hours Subtotal Profit Amount 1 Chris Petty Foreman $74.24 3.00 $222.72 1.20 $267.26 2 Nathan Cox Laborer $52.35 3.00 _$157.05 1.20 $188.46 3 Joseph Futrell Laborer $52.35 3.00 $157.05 1.20 $188.46 4 Brennen Hess Operator $69.70 3.00 $209.10 1.20 $250.92 5 Labor Total: $895.10 Equipment O.H.& Make Classification Rate/Hour Hours Subtotal Profit Amount 1 Case 235C Exc.56,000 lb $109.16 3.00 $327.48 1.12 $366.78 2 Cat 914K Wheel Loader 1.5 YD $50.89 3.00 $152.67 1.12 $170.99 3 4 _ 6 Equipment Total:' $537.77 Materials(See Attached Invoices) O.H.& Description Supplier Unit Price Quantity Subtotal Profit Amount I Fittings,Gaskets,Etc Ferguson $1,963.22 1.00 $1.963.22 1.12 $2,198.81 2 Material Total: $2,198.81 Signature: Daily Cost Summary Prime Contractor Daily Labor Total: $895.10 Signature: Daily Equipment Total: $537.77 Inspector Daily Materials Total: $2,198.81 Bond%Increase Total: Signature: GC(10%-1st$3,000): Subcontractor GC(7%-Over$3,000): Daily Grand Total: $3,631.68 Signature: DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CITY OF CARMEL TO: CONTRACT CHANGE REQUEST NO.: 07 DATE: 1/11/2023 PROJECT NAME: 106th St & College Ave. RAB FROM: 3D Company Inc. IT IS REQUESTED THAT A CONTRACT CHANGE BE MADE TO THE ABOVE REFERENCED CONTRACT. 1. SCOPE OF WORK(USE ADDITIONAL PAGES IF REQUIRED. ALSO LIST OTHER CONTRACTS INVOLVED.) Downtime for utility delays with Duke and AT&T at structure 125A. 2. REASON FOR CHANGE: Multiple utility conflicts 3. APPROXIMATE COST CHANGE TO CONTRACT PRICE: $3,864.00 4. WILL THE CONTRACT NEED ADDITIONAL CONTRACT TIME TO COMPLETE THE CHANGE IN WORK SCOPE? X -YES -NO 3 -(CALENDAR DAYS) 5. WILL THE CONTRACTOR NEED ADDITIONAL PERSONNEL TO COMPLETE THE CHANGE IN WORK SCOPE? -YES X -NO IF NO, TRADE(S): NO. OF PERSONNEL: DURATION: 6. IDENTIFICATION OF ATTACHMENTS: time and materials force account breakdown attached. DATE: 1/11/2023 DATE: PREPARED REVIEWED BY: Deanna Case REVIEWED BY: ENGINEER Comments and Recommendation: AR-5 Version 2018-12-19 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM January 11, CONTRACT NO. 20-ENG-02 DATE OF SUBMISSION 2023 PROJECT DESCRIPTION 106th Street and College Avenue Roundabout (route/intersection/bridge no(s).) CHANGE ORDER REQUEST SUMMARY Downtime for utility delays with Duke and AT&T at structure 125A. DESCRIPTION PROPOSED SOLUTION SUMMARY Click here to enter text. NOTE:Upon request from Engineer, enter detailed description on page 2. ONSET DATE OF CHANGE September 27, 2022 CHANGE ORDER TYPE 104.02 Changed Conditions PROPOSED COST AND TIME ADJUSTMENT COST COST INCREASE/(DECREASE): $ 3,864.00 The cost adjustment shall include lump sum and/or estimated totaled unit-priced item costs.Attach a separate sheet of unit price items including item description, unit of measurement,estimated quantity and unit price. CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF COST CHANGE: ❑ 109.03 Altered Quantities ❑ 109.05(a)Agreed Price 1Z1 109.05(b)Force Account ❑ 109.05.02 Delay Costs PROPOSED COST CHANGE INCLUDES: ❑ Labor ❑ Material El Equipment ❑ Lease Agreement ❑ Subcontractor TIME ADJUSTMENT INCREASE/(DECREASE): (work days) 3 CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF TIME CHANGE: ❑ 108.08(a) Excusable, Non-Compensable ® 108.08(b)Excusable,Compensable NOTE:If Compensable,attach details based on 109.05.2(a)Allowable Delay Costs. SUPPLEMENTAL INFORMATION Additional information. CHANGE ORDER ORIGINATION: [Si Owner/Inspection ❑ Contractor DOCUMENTS AFFECTED: ® Contract Specifications(ref.doc name/no.) INDOT Standard Specifications 2020 ❑Contract Plans(ref.doc name/no.) Intersection Improvements 106th Street&College Ave. RAB 20-ENG-02 CHANGE ORDER AFFECTS DBE PARTICIPATION: ®yes ❑ no (if yes,attach details) Ver 10 18.18 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 UPON WRITTEN REQUEST FROM THE ENGINEER, PROVIDE ADDITIONAL DETAIL DATE RECEIVED REQUEST FOR SUBMITTAL DATE OF ADDITIONAL DETAIL [Select Date] ADDITIONAL DETAIL [Select Date] DETAILED DESCRIPTION/JUSTIFICATION: (Include location(s), actions of contractor, owner, and other stakeholders, key events and related cause(s), discoveries, discussions, meetings, and effect on the contract if no action is taken.Also include references to key documents attached or available to support this change order request.) Downtime for utility delays with Duke and AT&T at structure 125A. PROPOSED SOLUTION—ADDITIONAL DETAILS: (Include proposed scope of work, means&methods, materials, equipment, utility relocation required,subcontracted scope and the effect on the contract schedule.Also include references to attached documents including, but not limited to,sketches, calculations, photos, material information, and submittals and meeting minutes.) 3D was instructed by onsite inspector on how to proceed. SIGNATURE Contractor: 3D Company Inc. Name: (print) eanna D. Case (signature) t ����r�SL Date: 1/11/2023 NOTE: The Contractor should retain a signed copy of this document for record. pg. 2 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 ATTACHMENT: UNIT PRICE ITEMS DETAIL Attach or paste a unit price item detail. See attached force account sheet for breakdown of cost involved. pg. 3 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 Change Order Spreadsheet INDOT Contract#: 106th&College RAB Contract Descp: Prime Contractor: 3D Subcontractor: Date Work Performed: 9/27/2022-9/29/2022 Inspector: Dave Machala T&M Task Description: Downtime for utility delays with Duke and AT&T at structure 125A. T&M Task Provider(Prime or Subcontractor): Weather Conditions: Task Start Time: Task Finish Time: Comments: Labor(Includes Fringes &Applicable Taxes) O.H.& Name Classification Rate/Hour Hours Subtotal Profit Amount 1 3 6 Labor Total: $0.00 Equipment O.H.& Make Classification Rate/Hour Hours Subtotal Profit Amount 1 Trench Box $2.550.00 1.00 $2,550.00 1.12 $2,856.00 2 Manhole Box $900.00 1.00 $900.00 1.12 $1,008.00 6 Equipment Total:I $3,864.00 Materials(See Attached Invoices) 1,0.H.& Description Location Unit Price Quantity Subtotal Profit Amount 1 2 3 Material Total: $0.00 Sub Contractors O.H.& Subcontractor _Type Unit Price Quantity Subtotal - Profit Amount 1 2 6 Material Total: $0.00 Daily Cost Summary Signature: Prime Contractor Daily Labor Total:I $0.00 Daily Equipment Total:i $3,864.00 Signature: Daily Materials Total: $0.00 Inspector Subcontractor Total: $0.00 Bond%Increase Total: Signature: GC(10%-1st$3,000): Subcontractor GC(7%-Over$3,000): Daily Grand Total: $3,864.00 Signature: DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 0 T H f 8686 BROOKVILLE RD Rental INDIA17--7US, IN 791-2323 46239 3 S T 0 0 [ MacAllister Rentals Contract No. Invoice No. ' Date R-E C I T T) Please Remit Your Payment to: 48249 5 R71482495501 28SEP2022 MacAllister Rentals ';,,,' Dept. 78731 P.O. Box 78000 Page 1 Detroit, MI 48278-0731 4 WEEK INVOICE 6:39 PM Late'o tixt a Date in 6866305 125EP2022 12:58 PM 100CT2022 3D COMPANY I NC 7 NumberI, Purchase Order7240 N STATE ROAD 3 MUNC I E, I N 47303 106TH AND COLLEGE 2563 Jab Location I Ordered by Phone: 765-288-3326 108 AND COLLEGE, IHDIAHAPOLIS SETH 765 730 1831 Cell: 765-288-3326 CYCLE BILL 000208 Qty Equipment # Min Day Week I 4 Week Amount 1 4" X 8' X 20' TRENCH BOX 350.00 350.00 800.00 2200.00 2200.00 B4B2056 Make: EFFICIENCY Model: XLD-620 Ser #: 165239 1 4" X 4' X 20' TRENCH BOX 350.00 350.00 600.00 1700,00 1700.00 B442020 Make: EPI Model: XLD-420 Ser It 160714 8 8" X 5' SPREADERS 50.0C 50.00 100.00 150.00 1200.00 4 TRENCH BOX STACKING PINS 10.00 10.00 20.00 25.00 100.00 16 2" TRENCH BOX SPREADER PINS W 10.00 10.00 20.00 25.00 400.00 SALES ITEMS: Qty Item number Unit Price 1 I NEX EA 129.713 129.71 INDIANA RENTAL EXCISE TAX 1 ENVIRONMENTAL FEE EA 19.000 19.00 ENVIRONMENTAL FEE DELIVERY CHARGE 165.00 Pi 111 BILLED FOR FOUR WEEKS 9/12/22 THRU 10/10/22 12:58 PM ek42,,,J-- Sub-totaG- 59 1 �_1 BILLED FOR FOUR WEEKS 9/12/22 THRU 10/10/22 12:58 PM INDIANA STATE SALES TAX 404.88 `� Total . . \s r „,..,—.....",,,,,, ( 1 ic5\q,,F. )0(\. IMPORTANT! Please note and acknowledge safety instruction by initialing here: Y------ --''''. I By his/her Initial.Lessee will provide All safety accessories as required,per safety instructions.Initial here: — L'4'�"" PAYMENT: Nat-30 days from invoice date unless otherwise specified herein.A service charge will apply to all past due accounts. RENTAL EQUIPMENT PROTECTION PLAN("REP"): Lessee will purchase REP(terms at www.macallister.com/rep and incorporated herein by reference)if Lessee fails to obtain insurance coverage and provide MacAllister with proof of such coverage or if such insurance contains coverage amounts that are inadequate to cover the Equipment al any time. TERMS AND CONDITIONS:The rental agreement terms and conditions found at www.macallister.com/rentallerms("Rental Terms")are incorporated herein by this reference and apply to your rental of Equipment from or provision of Services by MacAllister(as defined in the Rental Terms).Reese read carefully.This agreement includes an indemnification clause,a Jury waiver,warranty disclaimers,and limitations of MacAllister's liability.By accepting delivery of or using the Equipment or Services or making payment(s)to MacAllister for the same,Lessee agrees to be bound by the Rental Terms and REP Terms,even if this Rental Out form has not been fully executed. ACCEPTED BY CUSTOMER MOM (290tt2920) - DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CITY OF CARMEL TO: CONTRACT CHANGE REQUEST NO.: 29 DATE: 3/28/2023 PROJECT NAME: 106th St & College Ave. RAB FROM: 3D Company Inc. IT IS REQUESTED THAT A CONTRACT CHANGE BE MADE TO THE ABOVE REFERENCED CONTRACT. 1. SCOPE OF WORK(USE ADDITIONAL PAGES IF REQUIRED. ALSO LIST OTHER CONTRACTS INVOLVED.) Structures 174& 176 were submitted, approved, produced, and then deleted from the contract. 3D is requesting compensation for the material costs. 2. REASON FOR CHANGE: Existing AT&T utilities were in conflict with the proposed locations of str's 174& 176. Existing str's were used to avoid relocating utilities which deleted the proposed str's. 3. APPROXIMATE COST CHANGE TO CONTRACT PRICE: $1195.20 4. WILL THE CONTRACT NEED ADDITIONAL CONTRACT TIME TO COMPLETE THE CHANGE IN WORK SCOPE? -YES X -NO -(CALENDAR DAYS) 5. WILL THE CONTRACTOR NEED ADDITIONAL PERSONNEL TO COMPLETE THE CHANGE IN WORK SCOPE? -YES X -NO IF NO, TRADE(S): NO. OF PERSONNEL: DURATION: 6. IDENTIFICATION OF ATTACHMENTS: COR#29 is attached. DATE: 3/28/2023 DATE: PREPARED REVIEWED BY: Seth Blalock REVIEWED BY: ENGINEER Comments and Recommendation: AR-5 Version 2018-12-19 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 DATE OF SUBMISSION 3/28/2023 PROJECT DESCRIPTION 106th Street and College Avenue Roundabout (route/intersection/bridge no(s).) CHANGE ORDER REQUEST SUMMARY Structures 174 & 176 were submitted, approved, produced, and then DESCRIPTION deleted from the contract. Reason for deletion was existing AT&T utilities were in conflict with the proposed locations. PROPOSED SOLUTION SUMMARY 3D is requesting compensation for the material costs. NOTE:Upon request from Engineer, enter detailed description on page 2. ONSET DATE OF CHANGE CHANGE ORDER TYPE 104.03 Extra Work PROPOSED COST AND TIME ADJUSTMENT COST COST INCREASE/(DECREASE): $ 1195.20 The cost adjustment shall include lump sum and/or estimated totaled unit-priced item costs. Attach a separate sheet of unit price items including item description, unit of measurement,estimated quantity and unit price. CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF COST CHANGE: ❑ 109.03 Altered Quantities ❑ 109.05(a)Agreed Price /l 109.05(b) Force Account ❑ 109.05.02 Delay Costs PROPOSED COST CHANGE INCLUDES: ❑ Labor Material ❑ Equipment ❑ Lease Agreement ❑ Subcontractor Click here to TIME ADJUSTMENT INCREASE/(DECREASE): (work days) enter text. CHECK APPROPRIATE BOXES PER APPROPRIATE BASIS OF TIME CHANGE: 108.08(a)Excusable, Non-Compensable ❑ 108.08(b)Excusable,Compensable NOTE:If Compensable,attach details based on 109.05.2(a)Allowable Delay Costs. SUPPLEMENTAL INFORMATION Additional information. CHANGE ORDER ORIGINATION: ® Owner/Inspection 0 Contractor DOCUMENTS AFFECTED: ® Contract Specifications(ref.doc name/no.) INDOT Standard Specifications 2020 ❑ Contract Plans(ref.doc name/no.) Intersection Improvements 106th Street&College Ave. RAB 20-ENG-02 CHANGE ORDER AFFECTS DBE PARTICIPATION: ❑yes ® no (if yes,attach details) Ver.10.18.18 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 UPON WRITTEN REQUEST FROM THE ENGINEER, PROVIDE ADDITIONAL DETAIL DATE RECEIVED REQUEST FOR SUBMITTAL DATE OF ADDITIONAL DETAIL [Select Date] [Select Date] ADDITIONAL DETAIL DETAILED DESCRIPTION/JUSTIFICATION: (Include location(s), actions of contractor, owner, and other stakeholders, key events and related cause(s), discoveries, discussions, meetings, and effect on the contract if no action is taken.Also include references to key documents attached or available to support this change order request.) Structures 174& 176 were submitted,approved, produced,and then deleted from the contract. Reason for deletion was existing AT&T utilities were in conflict with the proposed locations. PROPOSED SOLUTION—ADDITIONAL DETAILS: (Include proposed scope of work, means& methods, materials,equipment, utility relocation required,subcontracted scope and the effect on the contract schedule.Also include references to attached documents including, but not limited to,sketches, calculations,photos, material information, and submittals and meeting minutes.) Existing structures were used to avoid timely utility relocations.This resulted in the deletion of str. 174 and 176. SIGNATURE Contractor: 3D Company Inc. Name: (print) eanna D. Case (signature) U 1 Date: 3/28/2023 NOTE: The Contractor should retain a signed copy of this document for record. pg. 2 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 CHANGE ORDER REQUEST FORM CONTRACT NO. 20-ENG-02 ATTACHMENT: UNIT PRICE ITEMS DETAIL Attach or paste a unit price item detail. See attached force account sheet for breakdown of cost. P9. 3 DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 Change Order Spreadsheet INDOT Contract#: 20-ENG-02 Contract Descp: 106th St&College RAB Prime Contractor: 3D Company Inc. Subcontractor: Date Work Performed: Inspector: Dave Machala T&M Task Description: Strucutres were submitted,approved,made,and then deleted from the contract. T&M Task Provider(Prime or Subcontractor): Weather Conditions: Task Start Time: Task Finish Time: Comments: Labor(Includes Fringes&Applicable Taxes) O.H.& Name Classification Rate/Hour Hours Subtotal Profit Amount 1 1.20 $1.20 2 1.20 $1.20 _ 3 4 5 Labor Total: $2.40 Equipment O.H.& Make Classification Rate/Hour Hours Subtotal Profit Amount 1- $0.00 1.12 $0.00 2 $0.00 1.12 Equipment Total: $0.00 Materials(See Attached Invoices) O.H.& Description Location Unit Price Quantity Subtotal Profit Amount 1 Str.174 $570.00 1.00 $570.00 1.12 $638.40 2 Str.176 $495.00 1.00 $495.00 1.12 $554.40 Material Total: $1,192.80 Sub Contractors O.H.& Subcontractor Type Unit Price Quantity Subtotal Profit Amount j 1 $0.00 1.07 $0.00 2 Material Total: $0.00 Daily Cost Summary Signature: Prime Contractor Daily Labor Total: $2.40 Daily Equipment Total: $0.00 Signature: Daily Materials Total: $1,192.80 Inspector Subcontractor Total: $0.00 Bond%Increase Total: Signature: GC(10%-1st$3,000): Subcontractor GC(7%-Over$3,000): Daily Grand Total: $1,195.20 Signature: DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 INVOICE 09 � � •(800)289-2569 Fax:(715)443-3768 P.O.BOX 100 SHIPPED INVOICE DATE ORDER NO. MATERIALS C Q R P O R AT I O H MARATHON,W 154448-0100 10/15/22 10/17/22 3832786-00 P.O.NO. PAGE# 57 jh01 2563-5 L1 of 1 cusr#: 150010 106TH ST&COLLEGE AVE RAB v.','''°a 17- SHIP TO: *0089-22*CHRIS 765-748-1328 - NEAR 10602 E 106TH ST CARMEL IN 46280 3D COMPANY INC 7240 NORTH STATE RD 3 BILL TO: MUNCIE IN 47303 e LINE PRODUCT QTY. QTY. UNIT AMOUNT NO. AND DESCRIPTION SHIPPED UIM . PRICE (NET) 1 sp057-0089-22-006 1.00 EA 570.00 570.00 STR#131 17X30(R13) INLET 2 sp057-0089-22-013 1.00 EA 570.00 570.00 STR#167 17X30(R13)INLET 3 sp057-0089-22-014 1.00 EA 570.00 570.00 STR# 169 17X30(R13) INLET 4 sp057-0089-22-015r 1.00 EA 570.00 570.00 „AIN,F II I it l\J'U II11ay IIVL.I sp057-0089-22-016 1.00 EA 570.00 570.00 STR# 174 17X30(R13)INLET �e-tltitar-21-vz, 595.00 STR# 168 17X30(MOD R13) INLET 7 sp057-0089-22-022 1.00 EA 595.00 595.00 STR# 175 17X30(MOD R13)INLET 8 sp057-0089-22-027 1.00 EA 495.00 495.00 STR# 126 24X36(J10)INLET 9 sp057-0089-22-033 1.00 EA 495.00 495.00 STR# 154 24X36(J10)INLET 10 sp057-0089-22-034 1.00 EA 495.00 495.00 STR#159 24X36(J10)INLET 11 78173006RIN 2.00 EA 0.00 0.00 INLET RISER 17"X 30" 6"TALL 12 78243606RIN 2.00 EA 0.00 0.00 INLET RISER 24"X 36"6"TALL 13 700250 4.00 ROLL 0.00 0.00 JT SEAL 3/4"X 14.5'(8/CASE) Total 5525.00 Invoice Total 1„5_525.0n ob DocuSign Envelope ID:04372EEB-5867-4A05-9261-64610CF6A961 INVOICE 9 COUNTY.(800)289-2569 Fax:(715)443-3768 - P.O.BOX 100 SHIPPED INVOICE DATE ORDER NO. MATERIALS CORPORATION MARATHON,WI 54448-0100 10/14/22 10/14/22 3832788-00 P.O.NO. PAGE# 57 JHOL 2563-5 1 of 1 CUST#: 150010 106TH ST&COLLEGE AVE RAB R I� r.L"`SHIP TO: *0089-22*CHRIS 765-748-1328 �V` NEAR 10602 E 106TH ST CARMEL IN 46280 3D COMPANY INC 7240 NORTH STATE RD 3 BILL TO: MUNCIE IN 47303 Allio 6117 LINE PRODUCT QTY. QTY. UNIT AMOUNT NO. AND DESCRIPTION SHIPPED UM PRICE (NET) 1 sp057-0089-22-035 1.00 EA 495.00 495.00 STR#163 24X36(J10) INLET 2 sp057-0089-22-036 1.00 EA 495.00 495.00 OTii// 170 21)(30 (JIID)IPPLIiT 3 sp057-0089-22-037 1.00 EA 495.00 495.00 STR# 176 24X36(J10) INLET ..,007 0003 EC 041..; - I.uu to gcu.0 450.00 STR# 155 24X36(M10)INLET 5 sp057-0089-22-046 1.00 EA 450.00 450.00 STR# 156 24X36(M10)INLET 6 sp057-0089-22-047 1.00 EA 450.00 450.00 STR# 157 24X36(M10) INLET 7 sp057-0089-22-049 1.00 EA 450.00 450.00 STR#172 24X36(M10) INLET 8 sp057-0089-22-054 1.00 EA 575.00 575.00 STR#160 24X36(MOD M10)INLET 9 sp057-0089-22-055 1.00 EA 575.00 575.00 STR# 164 24X36(MOD M10)INLET 10 78243606RIN 9.00 EA 0.00 0.00 INLET RISER 24"X 36"6"TALL 11 700250 9.00 ROLL 0.00 0.00 JT SEAL 3/4"X 14.5'(8/CASE) Total 4!�35.00 Invoice Total 4435.00j