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Home My WebLink About2019-279-E AMS - Riley Surveying Northern Campus additional services DocuSign Envelope ID:43FC2FFB-67E2-4FBC-A5DF-06C16A5500B6 ORANGE COUNTY CHANGE ORDER REQUE NORTH CAROLINA Date: 05/17/2019 Project: Northern Campus- Detention Center Change Order No. 003 AMS Department Address: Orange County, PO Box 8181 Hillsborough, NC 27278 Project: 10071 Contrac Surveying, P.A. Contractor Address: 3326 Durham Chapel Hill Blvd, Ste B-100, Durham, NC 27707 Effective date of contract: 05/21/2018 This change order® increases❑ decreases the contract time by N/A days. Check here if no impact to contract time [ Will this change order impact the date of substantial completion? ❑ Yes❑ No. If yes,the amended date of sub< completion is: Full Description of Change: additional survey mapping and field survey Reason for Change: To prepare three exhibits, one for Orange County parcel,to be depicted as Holloway on advice form one for Orange County parcel west of future Holloway parcel; and one for the Lisa Hall parcel to be entitled Town of Hills Permanent 20' Sanitary Sewer Easement.The Temporary construction Easement 10' each side as show on plance prepar( Consultants, Inc. shall also be shown on the exhibits.At minimum, set monmuentation (iron stake) along the centerline o Easement where it corsses each property line.The Survery/mapping shall conform in all respects with 21 NCAC 56, as per agreement. Original contract sum: $ 28,700 Contract sum prior to this change order: $ 36,100 Amount of this change order: $ 2,800 Total sum of the contract including this change order: $ 38,900 This change order is executed to amend the contract time and/or contract sum. It shall not be construed to impact the o project, services, or work in any other manner. Approved and executed this 17th day of May, 2019. Riley Surveying, P.A. Orange County NC Contractor Owner Architect (when retainer DocuSignedby: DocuSigned by: B / . PU �� By: FAAA, V6MaJA, By: B1D3297FKL4A6... 21EF373ACD454EF... Revised 10/17 DocuSign Envelope ID:43FC2FFB-67E2-4FBC-A5DF-06C16A5500B6 Riley Surveying, P.A. 3326 Durham Chapel Hill Blvd. Suite B-100 Durham, North Carolina 27707 THIRD ADDENDUM TO AGREEMENT FORTH PROVISION OF LIMITED PROFESSIONAL SERVICES DATE: May 9, 2019 CLI ENT: County of Orange 131 West Margaret Lane, Suite300 Hillsborough, NC 27278 Attention: Alan Dorman, Interim Di r. Asset Management Services PROJECT NAM E/LOCATION: Highway 70 Tracts Development Surveys Hillsborough, NC SCOPE AND EXTENT OF SERVICES: This Third Addendum to Agreement dated 9 May, 2019 is to provide additional survey mapping and field survey to prepare three exhibits (one for the Orange County parcel(to be depicted as Holloway on advice from Brian Ferrell), one for the Orange County parcel west of future Holloway parcel, and one for the Lisa Hall parcel) to be entitled "Town of Hillsborough Permanent 20' Sanitary Sewer Easement" . The Temporary Construction Easement 10' each side as shown on plans prepared by Civil Consultants, Inc. shall also be shown on the exhibits. At a minimum, set monumentation(iron stake) along the centerline of the 20' Easement where it crosses each property line. Third Addendum Fixed Fee: $2,800.00 Special Provisions 1) The survey/mappi ng shal I conform i n al I respects with 21 NCAC 56. 2) As per original Agreement. The Terms and Conditions in the Original Contract dated 21 M ay, 2018 are a part of thisAgreement. ThisAgreement entered into asof the day and year first written above. CLIENT SURVEYOR Authorized Signature Phillip W. Riley, PLS President Phone—(919)667-0742 Fax—(919)402-0234 NC Firm LicenseC-1281 DocuSign Envelope ID:43FC2FFB-67E2-4FBC-A5DF-06C16A5500B6 ACC} 4JrrC�Mx as ryyY} ' CERTIFICATE F LIABILITYINSURANCE 031i r2019 THIS CERTIHCATE IS ISSUE❑ AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CiER71FICATE DOMES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERArE AFFORDED BY THE POLICIES BELOW- THis CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETywEF!N THE ISSUING INSURERN, AUTHORI.ED REPRESENTATIVE OR PRODUCED, AND THE CERTIFICATE HOLDER- IMPORTANT` If the certifloate holder is an ADDITIONAL INSURI=d,the policy(Ies}must be endowed- It SUBROGATION LS WAIVED, subject to the terms and cbnditlorts of the policy, cerjain Poligies may require a4 Ortdorsemont- A si:atenrerd on this coYdficate dw4 riot confer fights to rhL, Certificate hald6T In lieu of such endorsr=monl(s)- PRp[)UCCFr Greg Lopeman, CPCU °r*,a°M - crea Laaan-lan StMFarm [n6urance Pr14NE Eet1�919- 33-7T1D {NC NoI:919=9r33-7713 Lar qIL 1{134 hd HYw.y 541N AaDo ss-Greg, art-PfYSE Ia Iam.C4m_ _ aurora, N 27510 IF 11 "WDIIIGCOy�gE weJetl NS;JRER+4:Sloe FwmFIreapitcasuahvCria ny _ #3 IH3�IRF,p RILEY SURVEYING PA Iws,3RFR 5: a Farm i�9lrtµ�l 14Ldornohile JrrsurarTna Corrm�rn� r8 TE 100B IwauR�xc 3326 DURHAM CHAPEL HILL BLVD 1MSldi[aro DURHAM NC 27707-2695 IN�LMiERE: INSURER F COVEPAGES CERTIFICATE NUMBER: REVISiON NUMBER: THIS IS TO CERTIFY THAT IHL POLICJE$ OF 11%13Ur"L4NOF LISTED}SELOWV HAVE BEEN FSSUED TO THE INSURED NAMED ABOVE FOR THE POE.I Y PERIOD INDICATED- NC(rWFFHSTANDIFJG AfkY RFOLIIREMENT, TERM OR CCRUITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VMICH THIS CERTJFIr,ATF MAY BF ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDF0 BY THE POLICIES DESCRQED NEF.EJN I$ SUBJECT TO ALI, THE TERMS. EXCLUSIONS AND rONDITIONS OF uUal POLICIES,LIMITS SLIp{I N MAY HAVE BEEN REDUC;I"Q Sy PAID MAIMS, NSR TYPEDF1NSURAIpE AD6LSU6R Tfr'YEFF POLICY P64eev NUMB S.i11f8 A EGLNeiznLLIA➢ILITY ,f ❑I 43 t}- � $-$ 0=W241$ 0?.I�UJ'2020 EACHOWA)RRENCE $ 9,Od0•pP4 CG2WNIF.RL-IAL GENERAL Llp$IUTY TGRENTED SES iEAmpLimm $ W0,000 µ CLAIMS-NE,4QE OCCUR _t�RekA+EQIXP(,aycnePevecn�i 5 5,000 PERSONA{b ADV INJURY _ $ 1'0f 0.000 �- GENERALAGOR LATE L 2,00 .Wo G€HL AGGRE$'ATE LN{IT APPLIFfi PER: P#i4�91 1;,CONplOP AG6 .000- 000 } POLICY Y F� 66C B nuOalLtuaelLm i 4719744�f33D-33 iD130J201B 134d19 13sil Leulnrr $ AHY AtJ7O 60113rY,h7,ILIRY{Per pure $ 500,000 lJTC)15 E1} ALrr dMJLEd 4GOrt.'r1NARY{Peromedern} +S.IJTOti ALrf03 S SOIJ,OD4 HIRED AUTOS rx NON-Uyb%F.p I — AUTOS S f00,0y0 S A U115REL I-A r raa ocCMR F+rw OCCI�pPE}1CC S 1.000,044 93•Gi4f-1117-1 t]8f70f2b1$ 08t70f2029 FxGEs3 LUSB ,ClAIxS-HRQE AfiiGREG4TE # 1,000-400 oFr+ X Q.E IIUNS 10,OOQ - A I WQRKERSCOMPENSAMN wCSrn,u- oTH A IQ EMPLUTEMX L"UTY T I Fi AWY FRpPRTT0RPP4R1NCR+EKEG1UTIVE - E!. 1,0gG,gpO CFnCFnMEM5EREXCLUOEW I11A 93•CV-R463-3 020200201$ 02170I2020 111114ENr $ {Man�6ory N wlrF E.L.Qh—#-EA EMPLOYEE S 1,009,t31id a SBe,deseritg prQgr E.L QIS€A$f-r1(%_ICw IIdIT S 1,00¢,q(IO I 6EWRIPTIGNOFOPERATIONS;LOCATIONs.'VEHICLESIAMn h ACORD 101.AddltaalReim.kaSchedula.itrk)W&Spam ismgWryq CERTIFICATE BOLDER CANCELLATION Orange COuTIty 514OULD THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE UPI�4T N DATA THEREOF, NOTICE WILL BE DELIVERED JN PO Box 8181 ACCORDAI1 1.CE MITH THE POLICY PROVIS IONS_ Hillsborough, NC 27278 % ALI I iDm1zED Ewan 019SO-2010 ACORD CORPCOAT N. All rights reserved. ACORD 25 (2010ffi5) The AC0FZD name and logo are registered marks of ACORD ]001466 I32849.6 11-1 rs 01p