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Home My WebLink About2019-556-E AMS - Riley Surveying Northern Campus addendum 5 DocuSign Envelope ID: BCD73544-6839-4F10-91D7-06F26CCC9F02 ORANGE COUNTY CHANGE ORDER REQUE NORTH CAROLINA Date: 8/19/2019 Project: Northern Campus Change Order No. 005 Department: AN Department Address: Orange County, PO Box 8181 Hillsborough, NC 27278 Project: 10051 Contras Surving, P.A. Contractor Address: 3326 Durham Capel Hill Blvd, Ste b_100, Durham, NC 27707 Effective date of contract: 8/21/2018 This change order❑ increases❑ decreases the contract time by 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: Removal of lot lines from properties being developed for the Northern Campus Reason for Change: unforseen work at the time of the orginal contract Original contract sum: $ 28,700 Contract sum prior to this change order: $ 39,650 Amount of this change order: $ 1,250 Total sum of the contract including this change order: $ 40,900 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. Ep DacuSigned by: OocuSigned by: r xecuted this 19th day of Augus u i I0637994B755E477 6in�An , RA*AA YS� 6103297F87ANA6 . Contractor uwner Architect (when retainei By: President By: County Manager By: Revised 12/18 DocuSign Envelope ID: BCD73544-6839-4F10-91D7-06F26CCC9F02 Riley Surveying, P.A. 3326 Durham Chapel Hill Blvd. Suite B-100 Durham, North Carolina 27707 FIFTH ADDENDUM TO AGREEMENT FORTH PROVISION OF LIMITED PROFESSIONAL SERVICES DATE: August 5, 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 Fifth Addendum to Agreement dated 21 May, 2018 is to provide additional survey mapping of three parcels. Additional Survey Mapping Preparation of a recombination plat to abandon all interior lot lines and create one parcel from the existing three parcels of land. Obtain Hillsborough Planning department approval for plat recordation. Fifth Addendum Fixed Fee: $1,250.00 Special Provisions 1) No f i el dwork/new boundary survey to be performed. Mapping shall be based on previously recorded plats by this Firm. 2) As per original Agreement. TheTermsand Conditions fol lowi ng this for m area part of this Agreement. This Agreement entered into as of the day and year first written above. CLIENT SURVEYOR P"M Authorized Signature Phillip W. Riley, PLS President Phone—(919)667-0742 Fax—(919)402-0234 NC Firm LicenseC-1281 DocuSign Envelope ID: BCD73544-6839-4F10-91D7-06F26CCC9FO2 . ►rr (MlmaWwyyy[E TiFf TE = LI4BILIT II JR V EFi�DATE- 03l!)Z019 THIS CERTIFICATE IS ISSUED AS A IVAT7ER OF INFORMATION ONLY ANO CONFERS NO RrGHTS UPON THE CERTIFFCATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMAT)VELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AF'FORI]EI} BY THE POLICIES BELOIM_ THIS CERTTFICATE OF INSURANCE DOES NOT CONS-"TUTE A CONTRACT BETWEFN THE ISSUING INSURER(S), AUTHORILED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICA HOLDER_ IMPORTANT- IF ttva certlt3oafe holder is an ADDITIONAL.INSURED,the P64Y(ies)must be endorsed_ 4i S USRDGATION IS WAIVED, subject to the terms and condltlarxs of the Policy, certaln polFpies may require an andorsernent A statement an this certificate flocs not confer rights to the, certificate holder In lieu of Such end!Wsan erd(s}. f-RCOUGER Greg Loperman, CPGU cw°r. - area LooEmlan tM Farm Insurance I14ME 91 -T7 Nr,r:919-9s3- t €MAIL -w 104-B NC Hwy 54 W � C�10[emari-WSL talefafm,corn arrboro. NC 27510 nruolt RISURER+4:S4ie Farm Fire and GaSua Com rn _ 43 IH3�IRF,p RILEY SURVEYING PA hlsulz�lx B: e Farm t<auhrsl Autornabile lnsurar�ca co!,m�rny � TE 10OB Iaaulm7c 3326 DURHAM CHAPEL HILL BLVD ,rlsulx�xo DURHAM NC 27707- 695 IMSUY�E M19LIREk F: - COVERAGES CUMFICATE NUMBER: REWSION NIJMBER: THIS IS TO CERTIFY THAT �HfE POLICIES [;IF 1N5URANIGE LISTED SELOW HAVE BEIEN ISSIJEO TO THE INSURED N MED ABOVE FOR THE POLICY PIERrOD INOICATEp_ NCTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY MISITRACT OR OTHER OCM-.UMETIT WITH RESPECT TO "ICH THIS CERTIFICATE MAY BE I$uED OR MAy PERTAIN, THE IN60RANCE AFFCFU)F p BY THE POLICIES IDESCREEO HEREIN I$ SU113JECT TO ALL THE TERMS, EXCLIU$IOHS ANq CONOFTIONS QF$UCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED Sy PAID CLAIMS, ! NSR TYPEflFtliSlR2A{NCE L5U6i# QORICTEFF 2POB-yP NL9S92 1�FA6BIFAAL L1ABrAY ,� g3 R_ � - 471u 020 E+ MOW-�RENCE $ 1,Od0,ppl;l + COMMERCIALGE➢IERALLIA�$ILITY Ih4$Ig5E3 ooagrm # G40,040 CLAIMS-WDE F OCC{R2 MEdE3f15(rvycnePer�ar�i _5 ffS 5.000 FER90Fw{b ADV INJURY T QETJERhL}X3GRF,GATE 5 '�,¢QQ,� GEr1L AGGREGATE LIk1FT APPiIEfi PER! FROUMM_0OMPY01"AGG S 2.1)00.000 rx{ POLkly Y 6 .AUTISMpgIL><LL4&LISY 0719714-C#3 33 1DJ3p 018 10130,1'20tg C h1 ti I -LE LIMIT $ AHYAUTO BODLYIH,IL1Ry(Ref pur p 3 5GO.OQ4 �LTOa a AUTtM Eo r3QM'YW.R.Rr;P�Ma:2dwTo S 541J,OD4 HIRED AUTOS }( NON-U%%F.4 ALTOS S 100,0w f >; f{ Us1BRELLA UAR x OCCUR Fif`.w OCCURP.E7ICC EAQE5SLIAB B3�GM-1911-1 U819p 0118 OIVIO12019 S 1,004,440 .. CLAIMS-1I4�E AGGREGATE S 1,000.000 oFn X gCM"I1UN5 10,00Q I A 1WORKERSCOMFENSATION WCSYn7u OTH AND EMF-LUTE"L�fsBILFTy T N Mr AWY FRVPRMT0RPPRTn01 {ECUTIVE EL.EhCH,+ OI4ENT OFnCknWEMBEREXCLUDED1 114 93-CV-FZ463-3 0202012011 02r�t202e - IMenaatory b MHt If 5'Be,descriGta E.L.DI' ASE-Ea EMPLOYE 4M9f S 1,009,4dd E.LOIS€ASC-POLICY LIMIT I tx3CRwTION OF OPGRATIgrIS+LOCATIONS f VEHICLES Oetbdfi ACOND 101.AA*09 #q R4rri* a S[hcdula.it mofo toam is mquirwdp CERTIFICATE BOLDER CANCELLATION Orange County SHOULD AI 4{TH A13OV'E DESCRIBED POLICIES SE CANCELLED BEFORE THE EXPI Tp�H f7A'E THEREOF, N#ti7CE VWLL BE DIWV'ER D IN PO BOX 8181 ACCORDA E 4 H THE POLDGY PROVISIONS_ HillsborOugh, NC 27278 AUTHOMMn EHTA 01988-2010 ACORO COR? N. All rights reserved. ACORD 25 (21MOM5) The AC0FZD name and iogo are registered marks of#CORD T661486 132849.E 11-15 Ot4 DocuSign Envelope ID: BCD73544-6839-4F10-91D7-06F26CCC9F02 A ��0 CERTIFICATE OF LIABILITY INSURANCE DATE(M 10/01//2018 Y) 018 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 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 Trish Clark NAME: Trustpoint Insurance aCONN. Ext: (540)389-0261 ac,No): (888)872-5496 16 East Church Ave E-MAIL tclark@trustpointins.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Roanoke VA 24010 INSURERA: AXIS Insurance Company INSURED INSURER B: Riley Surveying,P.A. INSURER C: 3326 Durham Chapel Hill Blvd INSURER D: INSURER E: Ste B-100 Dur NC 27707 INSURER F: COVERAGES CERTIFICATE NUMBER: 18-19 Master 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLSUBR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE To CLAIMS-MADE OCCUR PREMISES Ea occurrence)l $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) r $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Per Claim $1,000,000 A Professional Liability LHR882546206 08/10/2018 08/10/2020 Aggregate $2,000,000 Deductible $2,500 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) certificate provided as evidence of insurance CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County Asset Management Services ACCORDANCE WITH THE POLICY PROVISIONS. 131 West Market Lane AUTHORIZED REPRESENTATIVE Hillsborough NC 27278 '-/ @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD