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HomeMy WebLinkAbout2021-466-E-AMS-ASJ Wilson Construction LLC-Board of Elections – Provide additional brick pavers to complete entrance walkway.Revised 07/20 NORTH CAROLINA CONTRACT AMENDMENT ORANGE COUNTY THIS CONTRACT AMENDMENT (“Amendment”) is made and entered into this 20th day of August, 2021 by and between ORANGE COUNTY (hereinafter referred to as “County”) and ASJ Wilson Construction, LLC. (hereinafter referred to as “Provider”). WITNESSETH: THAT WHEREAS, the County and Provider entered into a contract dated January 18, 2021, (hereinafter the “Original Agreement”), for the provision of services for Stormwater Improvements and Waterproofing Services at the Orange County Board of Elections; and WHEREAS, the County and Provider desire to amend the Original Agreement while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: 1. In order to ensure the completion of the Services identified in the term of the Original Agreement is amended to reflect an end date by which all Services shall be completed of September 30, 2021. 2. Exhibit A to the Original Agreement is amended by adding the following tasks and services to the Services to be provided by the Contractor: Provide labor and materials perform porch masonry repairs per proposal dated July 26, 2021, and to extend the existing roof leaders per proposal dated July 23, 2021.- . 3. Article 5 Payment & Taxes, Section “a” is amended to reflect a maximum payable not-to-exceed amount of One Hundred Forty One Thousand, Four Hundred Thirty Eight Dollars and Fifteen Cents ($141,437.15) 4. Except for the changes made herein, the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event there is a conflict between the terms of the Original Agreement and the terms of this Amendment, this Amendment shall control. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. ORANGE COUNTY PROVIDER ______________________________ __________________________________ Bonnie Hammersley Joe Wilson, Manager County Manager ASJ Wilson Construction, LLC. DocuSign Envelope ID: CA949BE9-C4E1-4240-9F98-AFB8F9A022BC 8/23/20218/24/2021 Revised 07/20 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Party/Vendor Name: ASJ Wilson Construction LLC. Party/Vendor Contact Person: Michael R. Phillips (asj1michael@gmail.com) Contact Phone: 336.272.7122 Party/Vendor Address: 415 Pisgah Church Road, PMB 128 City: Greensboro State: NC Zip: 27455 Department: AMS Amount: Increase contract from $134,184 to $141,437.15 by adding $7253.15 to existing contract Purpose: Board of Elections – Provide additional brick pavers to complete entrance walkway. Budget Code(s): 61370035-880000- 10008 Vendor # 66963 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 8/20/2021 Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: NA Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer ___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All DocuSign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for DocuSign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: CA949BE9-C4E1-4240-9F98-AFB8F9A022BC 8/23/2021 8/23/2021 8/24/2021 8/24/2021 Orange County - Board of Elections PM Initials DOC Initials Project Name Reference: (RFI, RFP, ASI, BD) Proposal 2 CONTRACT: Board of Elections - Site Improvements CONTRACTOR:ASJ Wilson Construction CONTRACTOR #: DESCRIPTION OF CHANGE:SE Downspout - add roof liter & tie into 12" HDPE pipe; SW Downspout - add roof liter & run to existing yard inlet; Materials -- Install paver flume and infill masonry vent opening Materials (Attach list with qty, item, unit mh, total mh, OT mh, Total $) 1 Total direct cost of materials -$ 2 Sales Tax 6.75%-$ 3 Shipping and transportation -$ 4 Overhead and Profit on Items 1-3 -$ (10% maximum). (Includes small tools & consumables) Materials Subtotal -$ Labor (include time sheets if requested) 5 Total man-hours:13 @ 75 975.00$ 6 Payroll taxes and insurance@.34%331.50$ (40% maximum) 7 Overhead and Profit on Items 5 & 6 130.65$ Labor Subtotal 1,437.15$ Equipment Rental (includes quotes and pick-up / delivery tickets) 8 Equipment Rental (crew truck+fuel)(2 day)-$ 9 Overhead and Profit on Item 8 -$ (10%maximum) Equipment Rental Subtotal -$ Subcontractors (includes quotes with material and equipment backup) 10 Subcontractors 4,600.00$ 11 Overhead and Profit on Item 10 230.00$ (5% maximum) Subcontractor Subtotal 4,830.00$ Subtotal of Proposal 6,267.15$ 12 Bonds (___%of subtotal proposal)0%-$ (2% maximum) TOTAL OF CHANGE PROPOSAL 6,267.15$ Rounded Down to $6267 Time Extension Request 0 days Schedule Activity # Affected Schedule Date: 7/26/21-7/27/21 Contractor's Signature: Michael R. Phillips Date:7/23/2021 Architect's Signature:Date: Owner's Signature: Date: Note:Subcontractors must also fill out this form for all requested change orders. Change Order Request Form Section 00 63 57 DATE: __7/23/2021 (10% maximum). (O&P includes supervisor's time). 1 DocuSign Envelope ID: CA949BE9-C4E1-4240-9F98-AFB8F9A022BC 415 Pisgah Church Road PMB 128 Greensboro, NC 27455 Bus: (336) 272-7722 MBE, DBE, HUB, VOSB July 26, 2021 RE: Orange County Board of Elections Site Improvements CO# 4 To Whom lt May Concern: ASJ Wilson Construction LLC is a change order request for labor, materials and equipment for porch masonry repair. Total - $986.00 If you should have any questions regarding the above quote, please do not hesitate to contact me at (336) 272-7722. Very truly yours, Joe Wilson / Manager DocuSign Envelope ID: CA949BE9-C4E1-4240-9F98-AFB8F9A022BC 01/06/2021 Pelnik Insurance 100 Ridgeview Drive Suite 100 Cary NC 27511 Jen Shon (919) 459-8000 (866) 714-3576 Jen.Shon@pelnik.com ASJ Wilson Construction LLC 415 Pisgah Church Rd PMB 128 Greensboro NC 27455 West Bend Mutual Ins Co 15350 CL211620837 A A826708 01/06/2021 01/06/2022 1,000,000 300,000 5,000 1,000,000 2,000,000 2,000,000 A A826708 01/06/2021 01/06/2022 1,000,000 Uninsured motorist combined single limit 1,000,000 A 0 A826708 01/06/2021 01/06/2022 4,000,000 4,000,000 A N Y A823975 01/06/2021 01/06/2022 1,000,000 1,000,000 1,000,000 A Waiver of Subrogation applies in favor of the Certificate Holder with respects to Workers' Compensation & Employer's Liability policy when required by written contract, executed prior to loss. Orange County PO Box 8181 Hillsborough NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY DocuSign Envelope ID: CA949BE9-C4E1-4240-9F98-AFB8F9A022BC WC 00 03 13 (04 84) Copyright 1983, National Council on Compensation Insurance, Inc. Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 04 84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule “Organizations for which the Named Insured has agreed to by written contract executed prior to the loss to furnish waiver” This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement No. Premium $ Endorsement Effective 1/6/2021 Policy No. A823975 Insured ASJ Wilson Construction, LLC Insurance Company West Bend Mutual Insurance Countersigned by ____________________________________________ DocuSign Envelope ID: CA949BE9-C4E1-4240-9F98-AFB8F9A022BC