Con-Quest Contractors - 2014 Agreement - Change Order No. 4Cftp of OfCrop
Public Works Department - Engineering Division
7351 Rosanna St., Gilroy, CA 95020
Phone (408) 846 -0451; Fax (408) 846 -0429
CHANGE ORDER NO. 4
To contract for: EIGLEBERRY WATER SERVICE AND WATER MAIN REPLACEI City Project No.: 15 -PW -215
Contractor: CON -QUEST CONTRACTORS Contract Date: 10/22/2014
This order shall become effective when it has been signed by the City Administrator, City Engineer, Project Engineer, and
Description of Worts
To adjust current contract value to reflect base bid unit items not installed as these were not required. This is an accounting change
only to reflect the adjected contract value after the deductions of base bid items that were contemplated in the original unit price bid but
not required to be installed due to changes in the work.
All requirements of the original Contract Documents shall apply to the above work except as specifically modified by this
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.
Change in working time granted by this change order:
► 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. 4.
I (We) agree to make the above change subject to the
terms of this Change Order for a NET DECREASE of
$49,325.00.
By:
RECOMMENDED BY:
ACCEPTED BY:
IIQV
City Administrator
0 Working Days
Cost
Percentage Initial
Original Contract Price
$509,230.00
Previous Change Orders
$235,894.94
46.32 % ?�
Total to Date
$745,124.94
This Change Order
(S49 325.00)
Total Change Orders to Date
$186,569.94
36.64% y k
Revised Contract Price
$695,799.94
nager
Date:
3 %q/is-'
Date
3/Z3/ I;
2;4-11 S
Date
EIGLEBERRY STREET WATER MAIN'PROJECT 15 -PW -15
CHANGE ORDER 4
CONTRACT PAY ITEMS
ITEM
ESTIMATED
UNIT _
ORIGINAL
H_ IS ESTIMAT
THIS ESTIMATE
TOTAL ESTIMATE
TOTAL ESTIMATE
NO
DESCRIPTION
UNIT
QUANTITY
PRICE
AUTH. AMT
QUANTITY
$ AMOUNT
QUANTITY
$ AMOUNT
1
Mobilization
$0.00
$0.00
0,00
$0.00
1a
Mobilization, Submittal, Start Up Meeting
LS
1
$201000.00
$20,000.00
$0.00
0.00
$0.00
1b
Demobilization
LS
1
$20;000:00
$20,000.00
$0.60
0.00
$0.00
2
Trench Safety
LS
1
$10;000.00
$10,000.00
$0.00
0.00
$0.00
3
Traffic Control & Safety
LS
1
$5,00.0_.00
$5,000.00
$0.00
0.00
$0.00
4
Abandon Water Valve
EA
6
$1,000.00
$6,000.00
$0.00
0:00
$0.00
5
Cut &Plug Water Main
EA
6
$1;000.00
$6,000.00
$0.00
0.00
$0.00
6
8" DIP Water Main
LF
1300
$103.00
$133,900.00
$0.00
0.00
$0.00
6A
JPressure Testing and Disinfection
LS
1
$20,800.00
$20,800.00
$0.00
0.00
$0.00
7
lWater Main Tie -in
EA
7
$5,000.00
$35;000.00
$0.00
0.00
$0.00
8
Cut & Cap Existing Water Main
EA
2
$2,500.00
$5,000.00
$0.00
0.00
$0.00
9
Fire Hydrant Installation
EA
9
$10,000.00
$90,000-0.0
$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 (Long)
EA
45
$2,086.00
$93,870.00
$0.00
0.00
$0.00
12
1" Copper Service (Short)
EA
18
$1,700.00
$30,600.00
$0.00
0.00
$0.00
13
2" Copper Service
EA
3
$3,020.00
$9,060:00
$0.00
0:00
$0.00
14
Connect Exist. Service to New Main
EA
5
$1,100.00
$5,500.00
$0.00
0.00
$0.00
15
4" Service w /Manifold / Multiple Meters
EA
1
$5,500.00
$5,500.00
$0.00
0.00-
16
Add saddles and sleeves on existing - 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 Line& Accessories
LS -
1
$161,900.00
$161,900.00
$0.00
19
Adjust Contract Value for Units not
LS
1
($49,325.00)
($49,325,00)
$0.00
TOTAL BID ITEMS =
$695,799.94
$0.00
$0.00
A ° CERTIFICATE OF LIABILITY INSURANCE D2 /10 2014YIQ
12/7.0/2014
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(les)`Must be endorsed. If SUBROGATION. IS WAIVED, subject to
the terms and conditions of the policy, certain P011cles 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 '10829370 1-415 -
Edgewood Partners insurance Center (EPIC)
135 Main Street, 21st Floor
San Francisco, CA 94105
Con -Quest Contractors, Inc.
290 Toland Street
San Francisco, CA 94124
Teri L. Koehler
PHONE 415 -356 -3965 , 4
ABOReSS. teri.koehleroeaicbrokers.com
NAL UNION FIRE INS CO
TK STATE INS Co
MARINE INS CO
r_nvFaerFC reoTIarATM Id"RAoMn. a�e.,, -
THIS IS TO CERTIFY-THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN.ISSUEO 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ILTR
TYPE OF INSURANCE
R
POLICY NUMBER
POLICY EFF
07/01/1
MIDO EXP
LIMITS
A
GENERAL LIABILITY
_
X
X
GL5388331
07/01/15
EACH OCCURRENCE
$1,000,000
X _COMMERCIAL GENERAL LIABILITY
0AMAGETORENTED —
$300,_OOQ.
CLAIMS-MADE a OCCUR
MED EXP 01w me peteon
$S.000
PERSONALAADVINJURY
$1,000,600
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLES PER-
PRODUCTS - COMPJCPAGG
$2,000,000
POLICY X 'PRO LOC
$
B
AuroMbsILELU1sjuvy
X
CA5101698
07 O1 TIR
07/01/15
=SINGLE U?Tr
1 000 000
X
ANYAUTO
BODILY INJURY (Per pamon)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
X
HIRED AUTOS X NON -OWNED
PROPERTY DAMAGE
A
UMBRELLALIAB
X
OCCUR
X
BE015157281
07/01/1
07/01/15
EACH OCCURRENCE
$ 101000,000
.AGGREGATE
$ 10,000,,000
X
EXCE58 LWB
CLAIMS-MADE
DED I I RETENTION
$
A
WORKERS COMPENSATION
AND EMPLOYERS LIABILITY
X
WC034157337
07/01/1
07/01/15
X WCSTATU= oTH-
YIN
ANY PROPRIETORIPARTNEIVEXECUTNE
OFFICERNeASEREXCLUDED? El
NIA
E.L. EACH ACCIDENT
$ _
E.L. DISEASE -EA EMPLOY
$ 1,000,000
(NlendatoryInNH)
��s dIPTION under
E.L. DISEASE • POLICY LIMB $ 1-000,000
DESCRIPTION OF OPERATIONS below
C
Ru er'a R s
I 5 5
509,230
DESCRIPTION of OPERATIONS! LOCATIONS f VEHICLES (Attach ACORD 101, Addidanal Remarks Schedule, Nnwe space te mqulmd)
Res 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 insureds) 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
City of Gilroy, its officers, elected or
appointed officials, employees, agents and volunteers
Public works Division
7351 Rosanna Street
Gilroy, CA 95020
( USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION- DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
m 1988.2010 ACORD CORPORATION. All rlehfs mmarvarl_
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
cmaclure
42282840
ENDORSEMENT
This endorsement, effective 12:01 A.M. 07/61/14 forms a part of
policy No. GL5368331 issued to Con -Quest Contractors, fna.
by National onion Fire insurance Co. PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS - COMPLETED
OPERATIONS
This endorsement rnodi /ids insurance provided under the loftowing:
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 1S AN INSURED is amended to include as an Insured;
The person or organization shown in the Schedule, but only with redpect to liability arisloo out of
"your work" at the i0datidrl designated and described in the schedule of this endorsement
performed for that additional insured and included in the "products- completed operations hazard%
All otter terms and conditions remain unchanged.
uthor rid Repress tive or
Countersiggnature (s+f Staten Where
Includes copyrighted material otApplicabia)
97837 14108) murance Services office, Inc., Wth its permission. Page 1 of 1
ENDORSEMENT
This endorsement, effective 12 -01 A.M. 07/01/14 forms a part of
policy No. GL5368331 'issued to Con -Quest Contractors, Inc.
by Natianal Union rti.za Inourance Co of PA
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED- OWNERS, LESSEES, OR CONTRACTORS -
. SCHEDULED PERSON OR 0RGANiZA1IOK
This endorsement modifies lnsufaace pfovlded under the fotlowfap:
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
SCHEDULE
NAME OF PERSON OR ORGANIZATION:
City of Gilroy, its officers, elected or appointed officials, employees and volunteers
itf no entry gppears above, lnforrnatwn required to complete this endorsement wn11 be shorn in the
Declarations as applicable to the endorsement.)
A. SECTION 11 WHO IS AN INSURED is amended to include a6 an Insured;
The person or organization shown In the schedule, but ordy with respect to IlabNrcy 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 DAMAsE LIABILITY, 2. -
Exciusions, Is amended to include the follovdng additional exclusion;
This insurance does not apply to "bodily injury" or "property damage* occurring after:
Its all work, including materiels, parts or equipment furnished in conndetlon watts Swell
work, on the project (other than service, maintenance of repairs) to be performed by or
on behalf of the additional htsuredfal at the Otte of the covered operations has been
completed; ar,
(2) that portion of 'your worst" out of which the injury or damage arises has been put to its
intended use by any person or organization other than another adntrgotor or
subcontractor engaged in performing, operations for a principal as a pert of the same
project.
All other terms and conditions remain unchanged.
utt(arized Repress at ^ or'
ountersi nature fin St as Where
AppRaahlel �,,
87838 (4108) +nctudes copVnghted material of Page 1 of 1
' fiaUrenre services office. ?no.. wift its 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 ".
* * * * ** 11. 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 1V - 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
Ill. 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 perforated 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 (2/09) Page 3 of 7
POLICY NUMBER: GL5388331
COMMERCIAL GENERAL LIABILITY
CG 24 04 11 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
POLICY #: CA51o1699
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 Hosanna Street
Gilroy, CA 95020 VSA
(If no entry appears above, Information required to complete this endorsementwill 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.
By: National Union Fire Insurance Company of Pittsburgh
Prime Expressam
Additional Insured Endorsement -- Primary and Mon- Contributory
This policy is amended as follows:
Section 'Al. DEFINITIONS, Paragraph N- is amended to include the following additional provision:
Insured means: City of Gllroy, 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 orgenization 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 (5/10)
AH2894
. 4
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 FIRE INS CO OF PITTS
Premium: INCL
forms apart of Policy No. WC0 3 41573 37
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 agreementapplies
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- PPP -215 - EIGLEBERRY WATER SERVICE AND WATER MAIN REPL&cwmxT
WC 04 03 06
(Ed. 4 -84)
Countersigned by
Authorized Representative