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Con-Quest Contractors - 2014 Agreement - Change Order No. 3Catp of Offrop Public Works Department - Engineering Division 7351 Rosanna St., Gilroy, CA 95020 Phone (408) 846 -0451; Fax (408) 846 -0429 CHANGE ORDER NO. 3 To contract for: Eigleberry Water Service and Water Main Replacem City Project No.: 15 -PW -215 Contractor: Con -Quest Contractors, Inc. Contract Date: Oct. 22, 2014 This order shall become effective when it has been signed by the City Administrator, City Engineer, Project Engineer, and Contractor. All copies forwarded to Contractor for signature shall be returned to the City of Gilroy properly filled out. Upon acceptance by the City, the Contractor's copy will be returned to him as his authority to proceed with the work. Description of Work Full and complete reimbursement for all costs including allowable profits and markups on bonds and insurance for the installation of approximately 790 If of new 8" Ductile Iron potable water pipe including water services and appurtanances on Eigleberry Street from connection point at 7th Street to connection point at 8th Street. Price includes all credits due the City of Gilroy for work included in the original project scope but not required due to existing system conditions. Addition Work $191,942.00. Decrease Bid Items: Bid Item 4 - Abandon Water Valve, 1 each - <$1,000.00 >, Bid Item 6 - 8" DIP Water Main, 118 LF @ $119.00 - <$14,042.00 >, Bid Item 7 - Water Main Tie -in, 3 each @ $5,000.00 - <$15,000.00 >. Total Net for This Change Order - $161,900.00 All requirements of the original Contract Documents shall apply to the above work except as specifically modified by this Change Order. The contract time shall not extend unless expressly provided for in this Change Order. By signing this Change Order, Contractor acknowledges and agrees that the adjustments to cost and time contained herein are in full satisfaction and accord, and are accepted as payment in full, for any and all costs and expenses associated with this Change Order, (the "Extra Work "), including but not limited to labor, materials, overhead and profit, delay, disruption, loss of efficiency and any and all other direct and /or indirect costs or expenses associated with the Extra Work and hereby waives any right to claim any further cost and time impacts at any time during and after completion of the Contract associated with the Extra Work. ► All Extra Work authorized under this Change Order must be billed separately from the original contract. All bills for work done under this Change Order shall reference this Change Order No. 3. I (We) agree to make the above change subject to the terms of this Change Order for a NET INCREASE not to exceed $161,900.00. - Q ucAt By: 7 Original Contract Price Previous Change Orders Total to Date This Change Order Total Change Orders to C Revised Contract Price Cost Percentage Initial $509,230.00 $73,994.94 14.53% $583,224.94 $161,900.00 )atE $235,894.94 46.32 %K $745,124.94 Date: Z/ ( f// 5— RECOMMENDED BY: r Z ( 9% (� S ACCEPTED BY: Construction Mana4r Date City Ad EIGLESERRY STREET WATER MAIN PROJECT 15 -PW -3S CHANGE ORDER 3 CONTRACT PAY ITEMS ITEM ESTIMATED UNIT ORIGINAL THIS .ESTIMAT THIS ESTIMATE TOTAL .ESTIMATE_ - .TOTAL ESTIMATE NO DESCRIPTION UNIT QUANTITY PRICE AUTH. AMT QUANTITY S AMOUNT QUANTITY S AMOUNT 1 Mobilization 80.00. 50.00 .0.00 $0.00. 1a Mobilization Submitle1, Start Up Meeting LS 1 $20000.00 $20,000.00 $0.00 0.00 $0.00 lb Derrobilaation LS 1 $20000.00 520000.00 $0.00 0.00 50.00 2 Trench Safety LS 1 S10,000.00 $10,000.00 $0.00 0.00 5070 3 Traffic Control & Safety LS 1 $5,000.00 $5,000.00 $0.00 0.00 50.00 4 Abandon Water Volvo EA 6 $1000.00 $6,000.00 $0.00 0.00 $0.00 S Cut &DPW Water Main EA 6 S1.000.00 .$6000.00 50.00. 0.00 $0.00 8 _ 8" DIP. Water Main LF 1300 $103.00' $133,900.00- _ $0.00 - -0.00' 50.00 6A Pressure Testing and Disinfection LS 1 $20,800.00 520,800.00 50.00 0.00 $0.00 7 Water Main Tie -in EA 7 S5,000:00 $35000.00 $0.00 0.00' 50.00 8 Cut & Cam Existin ' Water Main. EA 2 $2,500.00 S5,000.110 $0.00 -0.00 $070 .9 . Fire Hydrant Installation EA 9 $10,000-00 590'000.00 $0.00 0.00 $0.00 10 8" Gate Valve and Box EA 8 $1,625.00 $13,000.00 $0.00 0.00 $0.00 11 1" Copper Service Lon EA 45 S2,086:00 $93870.00 $0.00 0.00 $0.00 12 1" Copper Service Short EA 16 $1,700:00 1 $30;600.00 $0.00 0.00 $0:00 13 2" Co er Service EA 3 $3,020.00 $9,060.00 $0.00 0.00 1 1 $0.00 14 Connect. Exist.. Service to New Main. EA. - 5 $1100.00 $5,500.00. $0.00 0.00. $0.00 ..15: 4'. Service w/Manifoldl Multiple Meters EA 1'. $5,500.00 $5,500.00 $0.00. - 0.00 $0.00 1& Add riddles and &leaves maxistin - CO 1 LS 1 $39,095.00 $39,095.00 $0.00 17 _ Add Force Account Work 1.22 - CO 2 LS 1 $34,899.94 $34,899.94 $0.00 18 Add 8" Water Une & Accessories LS 1 $161900.00 $181900.00 $0.00 TOTAL BID ITEMS =. $745,124.94 $0.00. Si1.00 - 1 A ° CERTIFICATE OF LIABILITY INSURANCE 03/0 M/2015 Y) 03/04/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER LIC #OB29370 1- 415- 356 -3989 Edgewood Partners Insurance Center (EPIC) CONTACT NAME: Teri L. Koehler 415- 356 -3965 FAX 4 PHONE A/ C No ADDRESS: teri.koehler @epicbrokers.com 135 Main Street, 21st Floor INSURERS AFFORDING COVERAGE NAIC # San. Francisco, CA 94105 INSURERA: NATIONAL UNION FIRB INS CO OF PITTS 19445 requests@epicbrokers.com INSURED INSURER B: GRANITE STATE INS CO 23809 INSURERC: AG1C3 MARINE INS CO 22837 Con -Quest Contractors, Inc. INSURER D: 290 Toland Street INSURER E: MED EXP (Any one person) San Francisco, CA 94124 CLAIMS -MADE FK OCCUR 4701 INSURER F CAVFRAGFS CERTIFICATE NUMBER- 43209263 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS S_ HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADOL SUBR POLICY NUMBER MP�DCCY EFF POLICY LIMITS A GENERAL LIABILITY X X GL5388331 07/01/1 07/01/15 EACH OCCURRENCE $1,000,000 MERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea ocoulrence $300,000 MED EXP (Any one person) $5,000 CLAIMS -MADE FK OCCUR 4701 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 $ POLICY Fi PRO- LOC B' AUTOMOBILE LIABILITY X CA5101698 07/01/1 07/01/15 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person), $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Per acciden $ A UMBRELLA LIAO X OCCUR BE015157281 07/01/1 07/01/15 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ - A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE X WC034157337 07/01/1 07/01/15 % WCSLIMIT OTH - -', E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 OFFICERIMEMBER EXCLUDED? 7 (Mandatory in NH) N /A E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 K es, describe under DESCRIPTION OF OPERATIONS below C Bu er's Risk MXI930635 5 L m t: 509,230 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, iT more space is required) Re: Job No. 58, Project No. 15 -PW -215 - EIGLEBERRY WATER SERVICE AND WATER MAIN REPLACEMENT City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers are included as additional insured as respects to General Liability on a primary and non - contributory basis, and Automobile Liability per the attached endorsements. General Liability and Workers' Compensation waiver of subrogation applies in favor of the additional insured(s) above, per the attached endorsements. 30 Days Written Notice of Cancellation for Non - Renewal and 10 Days Notice of Cancellation for Non - Payment of Premiums CFRTIFICATF Hnl_nFR CANCELLATION ACORD 25 (2010/05) dorat 43209263 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Public Works Division AUTHORIZED REPRESENTATIVE 7351 Rosanna Street Gilroy, CA 95020 1� IISA ACORD 25 (2010/05) dorat 43209263 ©1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY #: cAsiol698 COMMERCIAL AUTO CA 20 48 02 99 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORM MOTOR CARRIER COVERAGE FORM TRUCKERS COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds" under the Who Is An Insured Provi- sion of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement Effective: 07/01/14 Countersigned By: Named Insured: Con -Quest Contractors, Inc. Authorized Representative) SCHEDULE Name of Person(s) or Organization(s): City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers 7351 Rosanna Street Gilroy CA 95020 USA (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) Each person or organization shown in the Schedule is an "insured" for Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured Provision contained in Section II of the Coverage Form. CA 20 48 02 99 Copyright, Insurance Services Office, Inc., 1998 ENDORSEMENT No. This endorsement, effective 12:01 AM: 07/01/2014 Forms a part of policy no: BE015157281 Issued to: Con -Quest Contractors, Inc. 8y: National Union Fire Insurance Company of Pittsburgh Prime Expresssm Additional Insured Endorsement -- Primary and Non - Contributory This policy is amended as follows: Section VII. DEFINITIONS, Paragraph N. is amended to include the following additional provision: Insured means: City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers Any person or organization for whom you are performing operations when you and such person or organization have agreed in writing in a contract or agreement that such person or organization is an additional insured on your policy, but only if such person or organization is included under the coverage provided by Scheduled Underlying Insurance. Such person or organization is an additional insured only with respect to liability arising out of Your Work at the location(s) designated in such contract or agreement. This provision does not apply to liability arising out of the sole negligence of such person or organization for its own acts or omissions or those of its employees or anyone else acting on its behalf. Coverage afforded to these additional insured parties will be primary to, and non - contributory with, any other insurance available to that person or organization. All other terms, definitions, conditions, and exclusions of this policy remain unchanged. 105514 (5110) AH 2894 ENDORSEMENT This endorsement, effective 12:01 A.M. 07/01/14 forms a part of policy No. GL5388331 issued to Con -Quest Contractors, fne. by National Union Fire Insurance Co. FA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS - COMPLETED OPERATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE NAME OF ADDITIONAL INSURED PERSON OR ORGANIZATION: City of Gilroy, its officers, elected or appointed officials, employees and volunteers LOCATION AND DESCRIPTION OF COMPLETED OPERATIONS: Project No. 15-PW -215 - Eigleberry Water Service and Water Main Replacement ADDITIONAL PREMIUM: (if No entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) SECTION It - WHO IS AN INSURED is amended to include as an insured; The person or organization shown in the Schedule, but only with respect to liability arising out of "your work" at the location designated and described in the schedule of this endorsement performed for that additional insured and included in the °pioducts- completed operations hazard ". All other terms and conditions remain unchanged. uthorized RepreserYtative =or Countersigynature RH States Where Applicable) 97837 f 4/08j Includes copyrighted material p Page 1 of 1 ;surance Services Dirice, Inc., wit)ti its permission. 9 INDORSEMENT This endorsement, effective 12 -01 A.M. 07/01/14 forms a part of policy Nc. GL5388331 issued to Con -Quest Contractors, Inc. by National Union Fire Insurance Co of PA THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsemenr modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM SCHEDULE NAME OF PERSON OR ORGANIZATION: City of Gilroy, its officers, elected or appointed officials, employees and volunteers (if no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to the endorsement.) A. SECTION 11 -WHO 1S AN INSURED is amended to include a& an insured; The person or organization shown in the schedule, but only with respect to liability arising out of your ongoing operations performed for that additional insured. B. With respect to the insurance afforded to these additional insureds, SECTION 1 - COVERAGES, COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY, 2. - Exclusions, is amended to include the following additional exclusion; This insurance does not apply to "bodily injury" or "property damage" occurring after: 11) all work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the stte of the covered operations has been completed; or, (2) that portion of "your work" out of which the injury or damage arises has been put to its intended use by any person or organization other than another Contrectot or subcontractor engaged in performing operations for a principal as a part of the same project. All other terms and conditions remain unchanged. utt4 lzed Repreair'nal pa bt-'" ountersfggrr�ture Im Stttas Where Applicable} 97838 (4108) includes copyrighted material or Page 1 of 1 fiaurance Services Office. Inc.. WLh 0 permission Policy No. GL5388331 I. STATE OR POLITICAL SUBDIVISION - PERMITS Any State or Political Subdivision, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or political subdivision has issued a permit. 2. This insurance does not apply to: a. "Bodily injury," "property damage" or" personal and advertising injury" arising out of operations performed for the state or municipality; or b. "Bodily injury" or "property damage" included within the "products - completed operations hazard ". * * * * ** II. PRIMARY INSURANCE - ADDITIONAL INSUREDS Where persons or organizations have been added to your policy as additional insureds to comply with insurance requirements of written contracts mandating primary coverage for such additional insureds relative to: a) the performance of your ongoing operations for the additional insureds; or b) "your work" performed for the additional insureds and included in the "products - completed operations hazard, then with respect to these additional insureds as defined above in this Section only, SECTION IV - COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. - Other Insurance, a. - Primary Insurance, is deleted in its entirety and replaced with the following: This insurance is primary over any similar insurance available to any person or organization we have added to this policy as an additional insured to comply with insurance requirements of written contracts mandating primary coverage for such additional insureds relative to (a) the performance of your ongoing operations for the additional insureds, or (b) "your work" performed for the additional insureds and included in the "products- completed operations hazard. However, this insurance is primary over any other similar insurance only if the additional insured is designated as a named insured of the other similar insurance. We will not require contribution of limits from the other similar insurance if the insurance afforded is III. INCIDENTAL MEDICAL MALPRACTICE LIABILITY COVERAGE SECTION II - WHO IS AN INSURED, 2. a. (1) (d) is deleted in its entirety and replaced with the following: (d) Arising out of his or her providing or failing to provide professional health care services, except for "bodily injury" arising out of "Incidental Medical Malpractice Injury" by any physician, dentist, nurse or other medical practitioner employed or retained by you unless such "bodily injury" is covered by another primary policy. However, the insurance provided hereunder to such persons will not apply to liability arising out of services performed outside of the scope of their duties as your "employees." Any series of continuous, repeated or related acts will be treated as the occurrence of a single negligent professional healthcare service, which will be assignable to the same policy and policy year in which the originating act occurred. SECTION V - DEFINITIONS - is amended to add: "Incidental Medical Malpractice Injury" means "Bodily Injury" arising out of the rendering of or failure to render the following services: 100983 (2109) Page 3 of 7 POLICY NUMBER: GL5388331 COMMERCIAL GENERAL LIABILITY CG 24 0411 85 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART. OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: city of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers 7351 Rosanna Street Gilroy, CA 95020 USA (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) We waive any right of recovery we may have against the person or organization shown in the Schedule because of payments we make for injury or damage arising out of "your work" done under a contract with that person or organization. The waiver applies only to the person or organization shown in the Schedule. CG 24 04 11 85 Copyright, Insurance Services Office, Inc., 1984 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT - CALIFORNIA This endorsement changes the policy to which it is attached effective on inception date of the policy unless a different date is indicated below. (The following "attaching clause" need be completed only when this endorsement is issued subsequent to preparation of the policy.) This endorsement, effective 12:01 AM 07/01/14 Issued to: Con -Quest Contractors, Inc. By: NATIONAL UNION FIRS INS CO OF PITTS Premium: INCL forms a part of Policy No. NC034157337 We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us). You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 5% of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization City of Gilroy, its officers, elected or appointed officials, employees, agents and volunteers Public Works Division 7351 Rosanna Street Gilroy, CA 95020 Job Description Job No. 58, Project No. 15 -PW -215 - EIGLEBERRY WATER SERVICE AND WATER MAIN REPLACEMENT WC 04 03 06 (Ed. 4 -84) Countersigned by Authorized Representative