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2018-819-E Planning - J W Wilkerson contract amendment Phase 2 Extension
DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 hicDl; ENGINEERS JOINT CONTRACT DOCUMENTS COMMITTEE Change Order No. 001 Date of Issuance: December 13, 2018 Effective Date: December 20, 2018 Owner: Orange County,North Carolina Owner's Contract No.: 30044 Contractor:J.F. Wilkerson Contracting Co., Inc. Contractor's Project No.: Engineer: McGill Associates,P.A. Engineer's Project No.: 16.01904 Project: Efland Sewer to Mebane, Phase 2 Extension Contract Name: Efland Sewer to Mebane Phase 2 Extension The Contract is modified as follows upon execution of this Change Order: Description: Please see attached Change Order 001 Tracking Spreadsheet Attachments: Summary spreadsheet with supporting information; COR 001 with summary and invoice; CPRs 001 through 016; WCD 001 and 002 CHANGE IN CONTRACT PRICE CHANGE IN CONTRACT TIMES [note changes in Milestones if applicable] Original Contract Price: Original Contract Times: Substantial Completion: 330 days $3,586,121.00 Ready for Final Payment: 360days days [Increase] [Decrease] from previously approved Change [Increase] [Decrease] from previously approved Change Orders No. N/A to No. N A : Orders No. N/A to No. N/A : Substantial Completion: 0 $3,586,121.00 Ready for Final Payment: 0 days Contract Price prior to this Change Order: Contract Times prior to this Change Order: Substantial Completion: 330 $3,586,121.00 Ready for Final Payment: 360 days or dates Increase of this Change Order: Increase of this Change Order: Substantial Completion: 121 $ 149,449.09 Ready for Final Payment: 121 days or dates Contract Price incorporating this Change Order: Contract Times with all approved Change Orders: Substantial Completion: 451 $3,735,570.09 Ready for Final Payment: 481 days RECOMMENDED: ACCEPTED: ACCEPTED: By: 11 . .,1.kxse By: J fx rkcnr By Contractor(Authorized Signature) Engineer(AuthorizedSignature) Owner(Authorized Signature) Title: Vice President Title Office Manager Title CountX Manager Date: 12 14 2018 Date Date Approved by Funding Agency (if applicable) By: Date: Title: EJCDC®C-941,Change Order. Prepared and published 2013 by the Engineers Joint Contract Documents Committee. Page 1 of 1 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Efland Sewer to Mebane, Phase 2 Extension Change Order#1 Tracking Summary ID Number Item Description Days Days Cost Requested Approved 1 COR 001 Deletion of 2-10"and 1-12"gate valve from Sheet 25. 0 0 $ (8,200.00) The addition of a reverse tap and lowering of the bore under US Highway 70 to provide 2 CPR 001 2 2 $ 6,484.43 clearance of a gas line. CPR 002 The extension of Line C approximately 107 L.F.and the addition of a 4"service lateral. 3 Revised Milling and resurfacing of open cut across Turner Street,as required by NCDOT. 16 16 $ 16,043.00 4 WCD 001 Line B Plan Revision: Changing invert depth of SSMH#30 to allow for possible future 5 5 $ 953.00 CPR 003 extension of Line B and the addition of a 4"service lateral. 5 CPR 004 Deletion of SSMH#1 and 19 L.F.of 12"DIP gravity sewer line. 0 0 $ (18,890.00) 6 CPR 005 Relocation of bypass pump connection at City of Mebane's request. 5 5 $ 4,978.68 7 WCD 002 Proceed with construction of revised Line B,Plan Sheet 6 0 0 $ (16,254.00) CPR 006 Value engineered cost adjustment of Line A revisions from SSMH#10 to#14. Removal of Bid Items 57,58 and 59 after contaminated ground water was not 8 CPR 007 0 0 $ (42,400.00) encountered. Added cost for increased depth required for manholes due to survey-related deficiencies found in Hobbs/Upchurch plans. 23 days passed from the"Notice to Stop Work and 9 CPR 008 Proceed at Own Risk"to the issuance of the table with revised locations and depths that 38 23 $ 6,883.00 allowed construction to continue Added cost for increased depth required for gravity sewer due to survey-related 10 CPR 009 deficiencies found in Hobbs/Upchurch plans. 22 7 $ 12,636.00 11 CPR 010 Additional force main not included in the bid quantity. 18 18 $ 43,452.00 12 CPR 011 Rock quantity overrun of bid estimate. 69 35 $ 212,160.00 13 CPR 012 Base Bid-Quantities Revised per Field Conditions,Items 41,43,49 and 50 0 0 $ 7,027.00 14 CPR 013 Quantities that will not be required to complete the project: Rock Excavation, 0 0 $ (77,978.44) Surface Restoration,Misc Piping,Erosion Control. 15 CPR 014 Paving of pump station driveway. 1 1 $ 2,554.42 16 CPR 015 1 NTP vs Execution of Contract 9 3 $ 17 1 CPR 016 lAdditional weather delay days 6 6 Totals 191 121 $ 149,449.09 Contract Dates Change Order Dates Substantial July 24,2018 November 22,2018 Final August 23,2018 December 22,2018 i DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 I CHANGE ORDER Request Form Number 001 PROJECT: Efiand Sewer to Mebane Phase 2 DATE OF ISSUANCE: Extension OWNER'S PROJECT NO.: OWNER: Orange County, North Carolina ENGINEER: McGill Associates, P.A, 1240 19t"St. Ln.NW CONTRACTOR: J �- l4f J /A- 'f P 3 4A-7 /-00 �, CO, Hickory, NC 28601 i CONTRACT FOR: ENGINEER'S PROJECT NO.: 16.01904 You are directed to make the following changes in the Contract Documents. Description: 'V e 12 fe z r/rs, fit°�� 1 t �' Ur l ve Purpose of Change Order: 0 w j4 e p-S �{'�u e Attachments(List documents supporting change): � 1� �� !�Q• � �eS � Z�7 ��'� 6,10 CHANGE IN CONTRACT PRICE: CHANGE IN CONTRACT TIME: Original Contract Price Original Contract Time 365 Days Previous Change Order No._to No._ Net Change From Previous Change Orders $ Days Contract Price Prior to This Change Order Contract Time Prior to This•Change Order $ 33�,V� 1 z 1, G 0 3G 5T Days Net Increase(Decrease)of This Change Order Net Increase(Decrease)of This Change Order �r- $ Days Contract Price With All Approved Change Orders Contract Time With All Approved Change Orders $ 3�77 q�Z 1, 00 3�5~Days nnri,Ainnd hy: RECOMMENDED: APPROVED: APPROVED: At, A l wsov' n,ri,P.i�nnd hy: by'UocuSlgneO By.-Z� "CRtlli1/YL'31]OdL 1�C 1:CMC FC1C2.. Im't m Associates Orange County (Engineer) (Owner) (Contractor) 12/14/2018 12/17/2018 12/14/2018 EJCDC No.1910$-8(1983 Edition) ICOR 001 Prepared by the Engineers'Joint Contract Documents committee and endorsed by The Associated General Contractors of America_ DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 CHANGE PROPOSAL FORM Project: Efland to Mebane$S Contract: Contractor: JF Wilkerson Contracting Inc. Utility Construction Proposal# Project# C IP 300" Contractor C077 Description of Change: install a Reverse Tap and lower bore pit 3 vertical feet due to Conflict with gas line Materials are for additional raterials. All other items will be paid by unit pricing in the contract. Materials SUBTOTALS 1. Total Dire;:Cost of Materials S 974.52 See Attached Sheet 2. Overrhead&Profit on Item 1 15 °/, S 146.1a 3_ Sales Tax 7.25 % 5 70,55 4. Shipping&Transportation S S 1,191.35 Labor 5. Total Man-hours: 0 MH @ s0.40 Ihr S See Attached Sheet 6. Overhead&Profit on item 5 15 % 5 247.68 7. Payrolt Taxes&Insurance 31.2 % 5 515.17 S 2.414.05 Equipment Rental 8. Equipment Rental ."nS See Attached Sheet 9. Overhead&Prord on Item 6 15 % S 857.15 S 2.814.83 Subcontractors 10. Subcontractors S C.00 See Attached Sheet 11. Overhead&Profit on Item 10 5 % S 0.00 S 0.00 SUBTOTAL OF PROPOSAL S ,3,420.23 12. Bonds(%or subtotal of proposal) 54.20 5 54.20 TOTAL OF CHANGE PROPOSAL ,q� / S 5,484.43 T'me extension request ✓ - days. Schedule Actvity+Affected� ST�i77-.'s�G�O./7��i0� The Contractor agrees to perform the work o neo this ch a proposal for amount specified above and in accordance with the Contract documents if the work is authofip6 b e Own ooGus ianea by: Contractor's Signature: +�e , 2: A? _/Z—/712/14/2018 ... Approval Recommended ,sign Consultant: ?Yy �r=7=,rzCzA423 Date: 12/14/2018 �-H V' 12/17/2018 Owner's Representative Approval:�L GIs. ` Date: CPR 001 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Summary Equipment Qtv Unit Unit Pride Extension Wheel loader 16 Hr $ 4617 $ 738 72 330 Excavator 8 Hr $ 9315 $ 74520 Mini Excavator 16 Hr $ 4376 $ 70016 Tool and Supply Truck 20 Hr $ 1318 $ 26360 Sub Total Equipment $ 2,447 68 Labor Qty Unit Unit Price Extension Superintenden 4 Hr $ 5500 $ 22000 Working Foreman 16 Hr $ 2823 $ 45168 Operator 16 Hr $ 2438 $ 39008 Pipe laver/La or 32 Hr $ 1842 $ 58944 $ 1966120 Materials Qtv Unit Unit Pride Extension Ferauson Invoice 1 Is $ 97452 $ 97452 $ 974 52 Subcontractors 15ty Unit Unit Pride Extension $ CPR 001 pg 2/3 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 . FEI-RALEIGH, NC WW#1856 DeliverTo: U17-387 FERGUSON WATERWORKS I INTERNATIONAL DRIVE ®rom: Robert Malpass MORRISVILLE, NC 27560-8411 Comments: Phone: 919-465-7446 1 Fax: 919-465-7483 15:05:27 DEC 11 2017 Page 1 of 1 FERGUSON WATERWORKS#1856 Price Quotation Phone: 919-465-7446 Fax: 919-465-7483 Bid No: 8579960 Cust Phone: 919-467-1829 Bid Date: 12/11/17 Terms: NET 10TH PROX Quoted By: BM Customer: J F WILKERSON CONTRACT CO I Ship To: J F WILKERSON CONTRACT CO I EFLAND SEWER MEBANE EFLAND SEWER MEBANE PO BOX 183 PO BOX 183 MORRISVILLE, NC 27560 MORRISVILLE, NC 27560 Cust PO#: REVERSE TAP Job Name: EFLAND SEWER MEBANE Item Description Quantity Net Price Lim Total MJ9P4LA10 10 MJ C153 P-401 90 BEND UA 2 261.330 EA 522.66 SSLDE10 10 DI W WOO REST GLND-ONE LOK 4 39.720 EA 158.88 IMJBGPIO 10 MJ C153 BLTGSKT PK UGLAND 4 18.120 EA 72.48 GDATRF10 3/4X10 HDG ATR 50 2.850 FT 142.50 PSPLEBF 314 PW EYE BLT 20 2.850 EA 57.00 GHNF 314 GALV HVY HEX NUT 20 0.550 EA 11.00 GFSWF 34 GALV FLT STL WSHR 20 0.500 EA 10.00 Net Total: $974.52 Tax: $70.65 Freight: $0.00 Total: $1045.17 Quoted prices are based upon receipt of the total quantity for immediate shipment (48 hours). SHIPMENTS BEYOND 48 HOURS SHALL BE AT THE PRICE N EFFECT AT TIME OF SHIPMENT UNLESS NOTED OTHERWISE. QUOTES FOR PRODUCTS SHIPPED FOR RESALE ARE NOT FIRM UNLESS NOTED OTHERWISE. CONTACT YOUR SALES REPRESENTATIVE IMMEDIATELY FOR ASSISTANCE WITH DBEIMBENVBE/SMALL BUSINESS REQUIREMENTS. Seller not responsible for delays, lads of product or increase of pricing due to causes beyond our control. and/or based upon Local, State and Federal laws goveming type of products that can be sold or put into commerce. This Quote is offered contingent upon the Buyers acceptance of Seller's terms and conditions, which are incorporated by reference and found either following this document, or on the web at http://wolseleyna.com/terms_conditionsSale.html. Govt Buyers: All items are open market unless noted otherwise. LEAD LAW WARNING: It is illegal to install pr uc� that are not'lead free" in accordance with US Federal or other applicable JaN inpotable water systems anticippated for human consumption. Products with "NP n the description are NOT lead free and can only be installed n non-potable applications. B yer is solely responsible for product selection. CPR 001 pg 3/3 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 CHANGE PROPOSAL FORM P,oj cct: Ef*nd SS to Mebane to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting Inc. Utility Construction Proposal# FaN. '. d' Project# CIP300" Contractor# cm Description of Chang*: Edens! Alternate 2 per Line C Extension Plan and Profile Sheet C-2 as prepared by McGill Associates Items will be paid by unit pricing in the contract. Mobilization 1 I.S. $ 390.00 $ 390.00 a• DIPGS6-8 107 I.F. $ 59.00 S 6,313.00 Asphalt Road Cut 30 LF. $ 110.00 $ 3,300.00 Additional Traffic Control IE.A. $ 1.000.00 $ 1,000.00 4•Sewer Service IE.A. S 3,500.00 3,500.00 Total Line C Extension $ 14.503.00 Time Extension Request 15 days The Contractor agrees 1)perlonn the vn1<ouU,ned n Ih,s change proposal far 11e ah04I specified above and In accordance Wh 11e Conlracl documents *the vo1<is aulhoal2ed by Iht-ONner Contractor's Signature:.___ - __ _ _________ _ Date: Approval Reavrnmended by Design Consu f ' Date: Qwrrer's Representative Approval: Date:r1la 715) rn1 CPR 002 (superseded, See CPR 002 Revised) DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 C:MANUt t ROPOSAL FORM Efland SS to Mebane to Mebane Phase 2 Project: 16.01904 Contract: Contractor: Gentneiing'Fie. Utility Construction Proposal# 002 Revised Project# C I P 30044 Contractor# C077 Description of Change: Extend Alternate 2 per Line C Extension Plan and Profile Sheet C-2 as prepared by McGill Associates Items will be paid by unit pricing in the contract. Mobilization 1 L.S. $ 390.00 $ 390.00 8"DIP GS 6-8 107 L.F. $ 59.00 $ 6,313.00 Asphalt Road Cut 30 L.F. $ 110.00 $ 3,300.00 Additional Traffic Control 1 E.A. $ 1,000.00 $ 1,000.00 4"Sewer Service 1 E.A. $ 3,500,00 $ 3,500.00 __.. Mill and Resurface Turner St. 55 SY g28 0D $ 1,540.00 Total Line C Extension $ 16,043.00 Time Extension Request 16 days The Contractor agrees to perform the work outlined in this change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. 12/14/2018 o Slune by. Contractor's Signature: ��� Date- o swnetl nr� �..i..nrs,.i�iew�.� � _ t�.ur6A 12/14/2018 Approval Recommended by Design Consultant:f— Date: Dacu3lpnetl Ay' gHit Fiiv ni�� — Owner's Representative Approval: [Y'cur� 1e]t-Int�.tt{ Date: 12/1772018 Approval Recommended: F.—L 6 Date: 12/14/2018 At the County's request plans for the extension of Line C were created for review by the County and the Engineer as well as pricing by the Contractor.The extension would move Manhole#32 to the north side of Turner Street,approximately 107 feet from its original location allowing Line C to serve more properties along Mt.Willing Road.The Contractor agreed to do the additional work at the unit price rate price from the Contract.The Engineer reviewed the Contractor's proposal and believing that it was reasonable forwarded it to the County for approval.The potential$16,043.00 cost and 16-day extension were captured by this Change Proposal Request CPR 002 Revised DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Mork Change Directive No. 001 Date of issuance: 12-20-2017 Effective Date: 12-20-2017 Owner: orange County Owner's Contract No.: C1P 30044 Contractor: J.F.Wilkerson Contracting Co.,Inc. Contractor's Project No.. Engineer: McGill Associates Engineer's Project No_: 16,01904 Project: Hand Sewer to Mebane Phase 2 Contract Name: Line".B"Design Revision Extension Contractor is directed to proceed promptly with the following change(s): Description: Contractor is to install"Line B"to SSMH#30.Section from SSMH#15 to SSMH#29 is to be installed as shown in the construction documents.Section from SSMH#29 to SSMH##30 is to be installed at a revised slope of .47/.The location for SSMH#30 does not change however,SSMH30 invert out is now 628.70'.Additionally,a 4" sewer service to the right of way with cleanout and cap to grade is to be installed at station 4+60 to serve 301 Center Street, PIN 9844960792. Attachments:Norse. Purpose for Fork Change Directive: Directive to proceed promptly with the Work described herein,prior to agreeing to changes on Contract Price and Contract Time,is issued due to:[check one or both of the following] ❑Non-agreement on pricing of proposed change. EK Necessity to proceed for schedule or other Project reasons. Estimated Change in Contract Price and Contract Times(non-binding,preliminary): Contract Price $ To Be Determined [increase] [decrease]. Contract Time To Be Determined (increase] [decrease]. Basis of estimated change in Contract Price: Lump Sum ® Unit Price � ❑ Cost of the Mork ❑ Other RECOMMENDED: AUTHORIZED BY: o sC O RECEIVED: 0o usgned av •- ocu �b�+ osinn By• Ll. ea�oav'� � Y Authorized Signature) Owner(Author ature y _ ..-.___-.. , __.torized Signature) Title: i2/14/2018 Title.�� f Title: gate: r�� 20,t7 Date: /• �// 2/14/2018 Date: 12/14/2018 Approved b m s�etl By: �+�+►� ate: �� s. 12/17/2018 Title: FJCDC C-W,Work Change Directive. Prepared and published 2013 by the Engineers Joint Contract Documents Committee. JWCD 001 Page 1 of 1 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. Utility Construction Proposal No. 3 Project No. CIP 30044 Contractor No. C077 Description of Change: Line B Revision Items will be paid by unit pricing in the contract Item Qty Unit Unit Price Extended Price 8" DIP 8-10 99 LF $ 62.00 $ 6,138.00 8" DIP 10-12 126 LF $ 65.00 $ 8,190.00 8" DIPO 12-14 50 LF $ 83.00 $ 4,150.00 4' MH 12-14 1 EA $ 5,300.00 $ 5,300.00 4"Sewer Serivice 1 EA $ 3,500.00 $ 3,500.00 Total Cost per Revision $ 27,278.00 Less Line B Plan Quantities(Bid Alternate#1) $ 26,325.00 Difference-Total Price Adjustment for CPR 5 $ 953.00 Time Extension Request 5 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: a,a9 Date 12/14/2018 (`Riau U�i��w rApproval Recommended by En I Icc Date - Owner Representative: o m ..�"'�"" ' Date Approval Recommended: �`°`°"' Date 12/14/2018 At the County's request plans for the possible future extension of Line B were created for review by the County and Engineer as well as pricing by the Contractor.To facilitate this potential future extension there would be an increase in the depth of the portion of Line B included in this project.The Contractor agreed to do this additional work at the unit price rate from the Contract, which after reviewing the Engineer believed to be reasonable and appropriate. At the County's direction McGill staff issued Work Change Directive 001 instructing the Contractor to install Manholes#29, #30 and associated sewer lines as shown on the revised plans with increased depths to allow for possible future expansion.The net increase of this change was $953.00. CPR 003 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting,Inc. Utility Construction Proposal No. 004 Project No. CIP 30044 Contractor No. C077 Description of Change: Delete MH1 and Associated Piping Items will be paid by unit pricing in the contract Item Qty Unit Unit Price Extended Price Delete 5' MH 28+ 1 EA $ 13,000.00 $ (13,000.00) Delete 12" DIP 28+ 19 LF $ 310.00 $ (5,890.00) Total Cost Reduction $ (18,890.00) Time Extension Request 0 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: Date 12/14/2018 g 1=x�su, tJ�Y�cr,ew C er: :.. Date Approval Recommended by Engineer: �,t r�� C, . Owner Representative: " Date 12 17 2018 Approval Recommended: Date Elimination of Manhole#1 located just 19 feet north of Manhole#2 and having no discernible added value at this time was purposed as a cost and time saving measure.The proposal was reviewed by the Engineer,County and City of Mebane all agreeing that the elimination of Manhole#1 and associated sewer line would be appropriate at this time.The$18,890.00 cost savings of this cut is captured by this Change Proposal Request. CPR 004 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting,Inc. Utility Construction Proposal No. 005 Project No. CIP 30044 Contractor No. C077 Description of Change: Relocate By-Pass Connection at Pump Station Item Qty Unit Unit Price Extended Price Material 1 LS $ 2,079.29 $ 2,079.29 Labor and Equipment 1 LS $ 2,250.00 $ 2,250.00 O&P @ 15% 1 LS $ 649.39 $ 649.39 Total Cost By-Pass Relocation $ 4,978.68 Time Extension Request 5 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: �1eL +�Y�,,w Date 12/14/2018 12/14/2018 Approval Recommended by Engineer: Date �l r!ur� Owner Representative: _' C "-- Date 12/17/2018 Approval Recommended: Date 12/14/2018 At the request of the City of Mebane,a detail was created to show the possible relocation of the by pass pumping connections from inside the valve vault to an area immediately next the valve vault and above grade. This detail was then given to the Contractor to price,once the price was received and reviewed by the Engineer, County and City it was found to be reasonable and appropriate.The$4,978.68 cost and 5-day extension were captured by this Change Proposal Request. CPR 005 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 ray L;I k t EVOINEE3S JO'K-C)NTQAC- COf,L ME N T 5 CC hS%I ITT EE Work Change Directive No. 002 Date of Issuance: 5-23-2018 Effective Date: 5-23-2018 Owner: Orange County Owner's Contract No.: CIP 30044 Contractor: J.F. Wilkerson Contracting Co., Inc. Contractor's Project No.: Engineer: McGill Associates Engineer's Project No.: 16.01904 Project: Efland Sewer to Mebane Phase 2 Contract Name: Extension Contractor is directed to proceed promptly with the following change(s): Description: As discussed and agreed to during the quarterly project meeting, proceed with construction following the attached revised drawing.Altering the location and or depths of manholes 11, 12, and 13 as well as slope and or material of associated sewer lines. Attachments: Revised Sheet 6. Purpose for Work Change Directive: Directive to proceed promptly with the Work described herein, prior to agreeing to changes on Contract Price and Contract Time, is issued due to: [check one or both of the following] ❑Non-agreement on pricing of proposed change. ❑ Necessity to proceed for schedule or other Project reasons. Estimated Change in Contract Price and Contract Times(non-binding, preliminary): Contract Price $ No Change [increase] [decrease]. Contract Time No Change [increase] [decrease]. Basis of estimated change in Contract Price: ❑ Lump Sum ® Unit Price ❑ Cost of the Work ❑ Other RECOMMENDED: AUTHORIZED BY: RECEIVED: By: By:By• L nla fuu u i By: fni Ili �ry L engineer(Authorized Signature) Uwher(Authorized Signature) �cinuacrUr (Authorized Signature) Title: Title: Title: Date: 12/14/2018 Date: 12/17/2018 Date: 12/14/2018 Approved by Funding Agency(if applicable) By: Date: Title: EJCDC®C-940,Work Change Directive. Prepared and published 2013 by the Engineers Joint Contract Documents Committee. Page 1 of 1 mNFj � P--aR F N IN G BE A..1 Al T.=, GSflQITinm- S 'Am,TAM TO NOT A ORIGINALD=M T BUT 041Y NS NY MIO TO THE B.GG——24.I=7 REY— ? B N I ASSOCIATES Er"".—Y. =MR M W 27-. UC. I DOCUMENT . Byxxr sUiTEOFRILK M. 038% J.on — I"In —A TO TG M...D.— 1,,12 11 To 7� 4—72-—72 Al --=T MAW! j I ItiL 7z� X7 26-oo 28+oo 27+00 20+DD 29-00 33-Do 31+0o 32-00 33+00 3"oo 38-00 -00 37+00 35+W DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting,Inc. Utility/ Construction Proposal No. 006 Project No. CIP 30044 Contractor No. C077 Description of Change: Revised Line A, Plan Sheet 6 Adjust Depth per Owner Request. Value Engineered Cost Determination for Adjusted Depth as shown Item Unit Qty Bid Qty Revised Unit Price Bid Cost Revised Cost Difference 12"PVC Gravity Sewer 6-8 Ft Depth LF 24 101 $ 49.00 $ 1,176.00 $ 4,949.00 $ 3,773.00 12"PVC Gravity Sewer 8-10 Ft Depth LF 64 209 $ 56.00 $ 3,584.00 $ 11,704.00 $ 8,120.00 12"PVC Gravity Sewer 10-12 Ft Depth LF 76 0 $ 59.00 $ 4,484.00 $ - $ (4,484.00) 12"PVC Gravity Sewer 12-14 Ft Depth LF 88 0 $ 74.00 $ 6,512.00 $ $ (6,512.00) 12"PVC Gravity Sewer 14-16 Ft Depth LF 121 0 $ 80.00 $ 9,680.00 $ $ (9,680.00) 12"DIP Gravity Sewer 6-8 Ft Depth LF 0 15 $ 85.00 $ - $ 1,275.00 $ 1,275.00 12"DIP Gravity Sewer 8-10 Ft Depth LF 0 35 $ 88.00 $ - $ 3,080.00 $ 3,080.00 12"DIP Gravity Sewer 10-12 Ft Depth LF 6 90 $ 91.00 $ 546.00 $ 8,190.00 $ 7,644.00 12"DIP Gravity Sewer 12-14 Ft Depth LF 25 70 $ 98.00 $ 2,450.00 $ 6,860.00 $ 4,410.00 12"DIP Gravity Sewer 14-16 Ft Depth LF 40 75 $ 100.00 $ 4,000.00 $ 7,500.00 $ 3,500.00 12"DIP Gravity Sewer 16-18 Ft Depth LF 62 285 $ 120.00 $ 7,440.00 $ 34,200.00 $ 26,760.00 12"DIP Gravity Sewer 18-20 Ft Depth LF 131 52 $ 130.00 $ 17,030.00 $ 6,760.00 $ (10,270.00) 12"DIP Gravity Sewer 20-22 Ft Depth LF 179 0 $ 150.00 $ 26,850.00 $ - $ (26,850.00) 12"DIP Gravity Sewer 22-24 Ft Depth LF 60 0 $ 180.00 $ 10,800.00 $ - $ (10,800.00) 4'Manhole 8-10 Ft EA 0 1 $ 4,600.00 $ - $ 4,600.00 $ 4,600.00 4'Manhole 10-12 Ft EA 0 1 $ 5,000.00 $ - $ 5,000.00 $ 5,000.00 5'Manhole 16-18 Ft EA 2 0 $ 7,800.00 $ 15,600.00 $ - $ (15,600.00) 5'Manhole 20-22 Ft EA 0 1 $ 8,700.00 $ - $ 8,700.00 $ 8,700.00 5'Manhole 24-26 Ft EA 1 0 $ 30,000.00 $ 10,000.00 $ - $ (10,000.00) Directional Drill LF 56 60 $ 270.00 $ - $ 1,080.00 $ 1,080.00 Total Costs per Revised Plan Sheet 6 $ 120,152.00 $ 103,898.00 $ (16,254.00) Time Extension Request 0 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: Gicrmw Date 12/14/2018 e. y Approval Recommended by Engineer: �� �,,,,� Date Date �8 Owner Representative: ��sci 12/'-L4/'2 0 19 Approval Recommended: Date CPR 006 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. Utility Construction Proposal No. 007 Project No. CIP 30044 Contractor No. C077 Description of Change: Remove bid Items 57, 58 and 59-Contaminated Groundwater Items will be paid by unit pricing in the contract Item Qty Unit Unit Price Extended Price Pump Haul Contam Grd Wtr 5,000 Gal $ 1.00 $ (5,000.00) Remove Replace Contam Soil 500 CY $ 68.00 $ (34,000.00) Mob/Demob Frac Tank 1 LS $ 3,400.00 $ (3,400.00) Total Deduct: Contam Grd Wtr Removal $ (42,400.00) Time Extension Request 0 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: Date 12/14/2018 12/14/2018 Approval Recommended by Engineer: Date 12 17 2018 Owner Representative: �.�� �,L�;;1 .. x'. ' Date Approval Recommended: Date 12/14/2018 �.:•��,-,: CPR 007 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. Utility Construction Proposal No. 008 Project No. CIP 30044 Contractor No. C077 Description of Change: Survey Horizontal Error: Depth Adjustments Required for MI-Is and Main Installation Item Qty Unit Unit Price Extended Price Revised Depths due to error 1 LS $ 6,883.00 $ 6,883.00 Total Material and Labor for Depth Adjustments $ 6,883.00 Time Extension Request 38 Days Time Extension Approved 23 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: Date 12/14/2018 12/14/2018 Approval Recommended by Engineer: Date 12/17/2018Owner Representative: Date Approval Recommended: ,,_., Date 12/14/2018 During the early stages of construction JF Wilkerson questioned the correctness of the plans,as elevations did not seem to match field conditions.After further investigation by McGill staff it was determined that the Hobbs Upchurch plans were slightly skewed resulting in a shift horizontally.The horizontal shift although relatively minor resulted in numerous changes in depth along the gravity sewer portion of the project.McGill then issued a corrective table with proper locations and depths for all manholes associated with the gravity section.A total of 23 days elapsed from Wilkerson's notification of an issue to McGill's issuance of the corrective table.The total cost for the change in depth resulting from horizontal survey error of the manholes was estimated to be $6,883.00. Additionally,Wilkerson requested a 38-day extension,the request was reviewed by the Engineer who recommended a 23-day extension would be more appropriate as the issue did not prevent work from taking place on other portions of the project. CPR 008 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. Utility Construction Proposal No. 009 Project No. CIP 30044 Contractor No. C077 Description of Change: Survey Additional Errors: Depth Adjustments Required for MHs and Main Installation Item Qty Unit Unit Price Extended Price Revised Depths due to error 1 LS $ 12,636.00 $ 12,636.00 Total Material and Labor for Depth Adjustments $ 12,636.00 Time Extension Request 22 Days Time Extension Approved 7 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: y� Date 12/14/2018 �Ji I-" 12/14/2018 Approval Recommended by Engineer: Date 17 2 018 •,'.=::'w:. Owner Representative: �,�;�I`.w,1�i5' Date Approval Recommended: ��,^,. Date 12/14/2018 Additional Survey errors were also discovered in the Hobbs Upchurch information,which further impacted the depth of the gravity sewer lines shown in the plans. The errors resulted in a significant change in the depth of many lines,making many deeper while shallowing others.The net cost due to the errors is$12,636.00.Wilkerson also requested 22 additional days.The Engineer reviewed this claim and recommends a 7-day extension as reasonable and appropriate due to days for the additional construction effort are also included with other requests. CPR 009 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. Utility Construction Proposal No. 010 Project No. CIP 30044 Contractor No. C077 Description of Change: Additional Force Main not included in Bid Quantity Item Qty Unit Unit Price Extended Price 12" Dia PVC Force Main 1,278 LF $ 34.00 $ 43,452.00 Total Material and Labor for Depth Adjustments $ 43,452.00 Time Extension Request 18 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: Date 12/14/2018 12/14/2018 Approval Recommended by Engineer: Y+" Date Owner Representative: x'. Date 18 ,��t`�.L�i 12/14/2018 C�..,a,,�:, Date Approval Recommended: ��,�,-.," Due to a stationing error on the Hobbs Upchurch plan set and a station equation error the bid quantity did not accurately reflect the length of the 12-inch force main required for the project.An additional 1,278 linear feet of force main was required at a unit price of$34.00 per linear foot resulting in a net increase of$43,452.00.JF Wilkerson also requested 18 additional days to install the additional force main.The Engineer reviewed this request and believed it to be reasonable and appropriate,likewise length of additional force main as well as the total length of force main have been measured and appear to be accurate. CPR 010 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. Utility Construction Proposal No. 011 Project No. CIP 30044 Contractor No. C077 Description of Change: Additional Rock Excavation not included in Bid Quantity Item Qty Unit Unit Price Extended Price Rock Excavaion 4,080 CY $ 52.00 $ 212,160.00 Total Additional Rock Excavation $ 212,160.00 Time Extension Request 69 Days Time Extension Approved 35 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: Date 12/14/2018 �M1'H��I��!-YS�4L Approval Recommended by Engineer:-''- Y+" Date 12/14/2018 Owner Representative: f nr�'�v �i; x'. Date 12/17/2018 Approval Recommended: . - .: Date 12/14/2018 Over the course of the project significantly more rock was encountered than originally anticipated.Rock was not expected to be present along the force main however several hundred cubic yards were encountered,likewise quantities greatly exceeding expectations were found to be present at the pump station site and along the gravity section.The bid quantity included for this project allowed for 1,000 cubic yards of rock(Bid Item 48),approximately 5,080 cubic yards of rock has been or is expected to be encountered during construction.This quantity has been measured by the Contractor and verified by the Engineer to be both reasonable and accurate.The total projected cost increase of the rock overrun is estimated to be$212,160.00.To contend with this unforeseen rock quantity the Contractor has requested an additional 69-days,after reviewing this request the Engineer recommended a 35- day extension as the rock did not prevent work from progressing in other areas of the project as well as overlap with other requested days. CPR O11 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. Utility Construction Proposal No. 012 Project No. CIP 30044 Contractor No. C077 Description of Change: Quantities Revised per Field Conditions Item Qty Unit Unit Price Extended Price 41.Tie to Existing MH -1 EA $ 2,200.00 $ (2,200.00) 43.4"Sewer Service Conn Ext 1 LF $ 3,500.00 $ 3,500.00 49.Gravel Drive Repair 164 EA $ 14.00 $ 2,296.00 50.Asphalt Drive Repair 73 LF $ 47.00 $ 3,431.00 Total Additional Cost per Field Conditions $ 7,027.00 Time Extension Request 0 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: � 11 �Cklwa Date 12/14/2018 Cx.. ..-. Approval Recommended by Engineer: �F Date :.Owner Representative: G,�g'fw.e�i�' Date 12 17 2018 Approval Recommended: :" :; Date 12/14/2018 The following bid quantities required for several items did not reflect actual conditions in the field. Bid Item 41;only one connection to an existing manhole was required not the two allowed for in Bid resulting in a $2,200.00 savings. Bid Item 43;calls for eight 4-inch sewer services however,the plans show a total of 9 sewer services on Line A:3 south of West Ten Road,1 on the north side of West Ten Road,4 in the area of Missy's Grill serving and 1 serving the Minnis property.The unit price increase for this additional service was$3,500.00. Bid Item 49;Gravel Driveway Repair provided for 800 linear feet of repair at the unit price of$14.00 per linear foot.Throughout the project several driveways were wider than indicated on the plans,likewise significantly more stone was required at the Fowler property PIN 9844965134 and the gravel lot at the intersection of Buckhorn and West Ten Roads than anticipated.An additional 164 linear feet was required to complete the project resulting in an increase of$2296.00. Bid Item 50;Asphalt driveway repair allotted 100 linear feet at a unit price of$47.00 per linear foot.Ultimately an additional 73 linear feet were required to pave 3 additional driveways that were not shown or mislabeled on the Hobbs Upchurch plans including the driveways of the Efland Ruritan Club and additional paving at Missy's Grill. This additional paving lead to an additional$3431.00 of cost to the project. The Engineer has reviewed these items and has found them to be reasonable and appropriate,the net increase of these items totals$7,027.00. CPR 012 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting,Inc. utility Construction Proposal No. 013 Project No. CIP 30044 Contractor No. C077 Description of Change: Bid Alternate 1-Quantities that will not be required to complete the project Rock Excavation,Surface Restoration, Erosion Control Items Item Qty Unit Unit Price Extended Price Fittings with Thrust Blocking -745 LB $ 16.00 $ (11,920.00) Silt Fence -205 LF $ 3.00 $ (615.00) Double Row Silt Fence -225 LF $ 6.00 $ (1,350.00) Coir Wattle -78 EA $ 180.00 $ (14,040.00) Rock Excavation,Lines B&C -40 CY $ 190.00 $ (7,600.00) Gravel Drive Repair -50 LF $ 20.00 $ (1,000.00) Asphalt Mill and Repair -223 SY $ 28.00 $ (6,244.00) Rem/Repl Unsuitable Soil -744.67 CY $ 32.00 $ (23,829.44) Inlet/Outlet Protection -30 EA $ 320.00 $ (9,600.00) Inlet/Outlet Protection -3 EA $ 360.00 $ (1,080.00) Inlet/Outlet Protection -2 EA $ 350.00 $ (700.00) Total Additional Cost per Field Conditions $ (77,978.44) Time Extension Request 0 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: y- ��� Date 12/14/2018 O )sjlR—«�IL�LYY LL 2018 Approval Recommended by Engineer: r}+. ,,, Date / / e..Hs.,^.y: Date Owner Representative: L a u,L 12/17/2018 Con L° 12/14/2018 Approval Recommended: �,�f_: Date CPR 013 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting,Inc. Utility Construction Proposal No. 014 Project No. CIP 30044 Contractor No. C077 Description of Change: Pave Entrance to Pump Station Items will be paid by unit pricing in the contract Item Qty Unit Unit Price Extended Price Pave Entrance to Pump Stn 116.11 SY $ 22.00 $ 2,554.42 Total Cost $ 2,554.42 Time Extension Request 1 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: Date 12/14/2018 �Y_r�t��w C Approval Recommended by Engineer: Date 12/14/2018, r�, .Owner Representative: """ Date 12/17/2018 Approval Recommended: '" Date 12/14/2018 To meet the requirements laid out by the North Carolina Department of Transportation's Policy on Street and Driveway Access paving of the pump station driveway from the edge of West Ten Road to the edge of the NCDOT right of way was required.The pavement of the driveway is intended to protect the highway from damage as well as prevent tracking of mud or gravel onto the road surface.The total cost associated with this additional paving totaled$2,554.42 captured by this Change Proposal Request. CPR 014 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting,Inc. Utility Construction Proposal No. 015 Project No. CIP 30044 Contractor No. C077 Description of Change: Time Extension Notice to Proceed Issued 9 days after Contract Execution Item Date Contract Execution Date August 28,2017 Notice to Proceed Rec'd by Contractor August 31,2017 Time Delay 3 Days Time Extension Request 9 Days Time Extension Approved 3 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: C'� Date 12/14/2018 Approval Recommended by Engineer: �,�r,�,� Date 1211412018Owner Representative: ,p Date 12/17/2018 C 12/14/2018 Approval Recommended: Date This item captures the time lapsed from the signing of the Notice to Proceed to when the Contractor received an executed copy of the Contract.There was a 3-day delay in Contractor receiving an executed Contract once the Notice to proceed had been signed,delaying the Contractor beginning work.This claim of time has been reviewed by the Engineer and is believed to be reasonable and appropriate. CPR 015 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 Change Proposal Form Project: Efland SS to Mebane Phase 2 Contract: 16.01904 Contractor: JF Wilkerson Contracting, Inc. utility Construction Proposal No. 016 Project No. CIP 30044 Contractor No. C077 Description of Change: Time Extension: Weather Related Delay January 2018: In addition to 8 days allowed in contract,6 additional days requested Item Days Total Delay Days per Paragraph 12.03.C. 14 January Monthly Contract Allowanace 8 Time Extension Request 6 Days The contractor agrees to perform the work outlined in thes change proposal for the amount specified above and in accordance with the Contract documents if the work is authorized by the Owner. Contractor Signature: �vnH Ili �rvL Date 12/14/2018 12/14/2018 Approval Recommended by Engineer: + Date Owner Representative: { n;aLfuA ui """ Date 1211112018 14 2 Approval Recommended: ��F_; Date 12/ / 018 This item captures 6 additional days of abnormal weather conditions,beyond the Standard Baseline 8 days as defined in Modified Standard General Conditions Paragraph 12.03.C. McGill verified a total of 14 days in January 2018 where precipitation in the form of snow and ice occurred in abnormal amounts as defined in subparagraph 3 and dry-out days were required under subparagraph 4. This claim of time has been reviewed by the Engineer and believed to be reasonable and appropriate. CPR 016 DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 JFWILKE-01 CLUCAS '4C0/Za CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/05/2018 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 INSUREII AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms 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 CONTACT Cathleen Lucas NAME: Summers Thompson Lowry, Inc. PHONE FAX 100 Europa Drive (AIC,No,Ext):(919)969-5311 (Arc,No):(919)9424221 IL Suite 571 AI DARESS:cathy@stlinsure.com Chapel Hill, NC 27517-2393 INSURER(S)AFFORDING COVERAGE NAIL# INSURERA:The Charter Oak Fire Insurance Corn pany 25615 INSURED INSURERB:The Travelers Indemnity Company 25658 J.F.Wilkerson Contracting Co. Inc. INSURERC:The Travelers Property Casualty Insurance Company of America 25674 P.O. Box 183 INSURERD:The Phoenix Insurance Company25623 Morrisville, NC 27560 INSURERE:St Paul Surplus Lines Insurance Company INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS IINSD WVD MMIDDNYYY MMIDDNYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR C06B354615 04/01/2018 04/01/2019 DAMAGE TO RENTED 300,000 X PREMISES Ea occurrence $ MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PEP GENERAL AGGREGATE $ 2,000,000 POLICY T JjECT LOC PRODUCTS-COMPIOPAGO $ 2,000,000 OTHER $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO BA613354615 04/01/2018 04/01/2019 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Peraccident) $ C X UMBRELLA N OCCUR EACH OCCURRENCE $ 6,000,000 EXCESS CLAIMS-MADE CUP613354615 04/01/2018 04/01/2019 AGGREGATE $ 6,000,000 DIED I X I RETENTION$ 10,000 $ D WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN UB2J614794 04/01/2018 04/01/2019 500,000 ANY PROPRIRf RfEXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICERfMEMBMBER EXCLUDED? NfA (Mandatory in I E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Installation Floater 660613715799 04/01/2018 04/01/2019 Pump Houses 2,000,000 E Comm Pollution CC41M94021 04/01/2018 04/01/2019 Each Poll Condition 1,000,000 DESCRIPTION OF OPERATIONS r LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Blanket additional insured endorsement applies to general liability,to include completed operations, as regarded by written contract. Project: Efland Sewer to Mebane Phase 2 Extension,Orange County,NC Owners's Contract No.: CIP 30044 Engineer's Project No.: 16.01904 hfleming@orangecountync.gov,dale.schepers@mcgillengineers.com CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County, NC(owner)&McGill&Associates(Eng) ACCORDANCE WITH THE POLICY PROVISIONS. 131 West Margaret Lane Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD