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Home My WebLink AboutUntitled City of Jeffersonville Government Contract Coversheet Please note: All information MUST be completely filled out and submitted to Clerk's Office within 48 hrs of execution. Date Submitted to Clerk: 8/2/2023 Department: Motor Vehicle (Street) Vendor Name: Libs Paving, LLC Sign Date: 8/2/2023 Ending Date: 6/22/2022 Amount of Original Contract: $62,402.00 Is this an amendment or change order to original contract? Yes or No Amended Contract Amount: $8,247.45 Purpose: Change Order#1 for 2022-2 Community Crossings Grant Funded Street Paving Project For Clerk's Office to fill out Date uploaded to Gateway: City of Jeffersonville 2022-2 Community Crossings Grant Funded street Paving Project Change Order Change Order No. 1 Date of Issuance: Effective Date: Owner: City of Jeffersonville Owner's Contract No.: N/A Contractor: Libs Paving Contractor's Project No.: N/A Engineer: Jacobi Toombs& Lanz Engineer's Project No.: 22051 Project: 2022-2 Community Crossings Grant Funded street Contract Name: 2022-2 Community Paving Project Crossings Grant Funded street Paving Project The Contract is modified as follows upon execution of this Change Order: Description:This Change order is for the following: Division A:Wall St(From 7th St to 8th St) Item Description Quant Unit Unit Price Total Cost ity A3 Asphalt Milling -45.00 SYD $1.22 $ (54.90) A4 HMA Base,Type B(For Patching) -30.00 $1.00 $ (Assume 605 LB/SY) (5.5 Inch) TON (30.00) A5 HMA Surface,Type B(Assume -20.44 $78.00 $ 165 LB/SY)(1.5 Inch) TON (1,594.32) A6 Stop Bars,Thermo -6.00 LF $13.00 $ (78.00) A7 Thermo Painted Lines -71.00 LF $1.55 $ (110.05) A8 Sidewalk,Concrete,4 Inch -7.37 SYD $95.00 $ (700.15) Subtotal: $ (2,567.42) 006363-1 City of Jeffersonville 2022-2 Community Crossings Grant Funded street Paving Project Change Order Division B: E 9th St(From Spring St to Wall St ) Item Description Quant Unit Unit Price Total Cost ity B3 $ Asphalt Milling 73 SYD $1.22 89.06 B4 HMA Base, Type B (For Patching) $ (Assume 605 LB/SY) (5.5 Inch) -70 TON $1.00 (70.00) _ 65 HMA Surface,Type B (Assume $ 165 LB/SY) (1.5 Inch) 35 TON $78.00 2,743.26 B6 $ Stop Bars -5 LF $13.00 (65.00) B7 $ Concrete Curb 46 LF $55.00 2,543.75 B8 $ Structure 1 EA $3,500.00 3,500.00 B9 $ Pipe,Type 1, Circular, 15 In. 36 LF $75.00 2,700.00 B10 $ Striping Thermoplastic Lines 4in -404 LF $1.55 (626.20) Subtotal: 10,814.87 CHANGE IN CONTRACT PRICE CHANGE IN CONTRACT TIMES [note changes in Milestones if applicable] Current Contract Price: Original Contract Times: Substantial Completion: July 31 ,2023 $62,402.00 Substantial Completion: July 31 ,2023 $ Increase of this Change Order: [Increase] of this Change Order: Substantial Completion: 0 Working Days $8,247.45 Ready for Final Payment: 0 Working Days Contract Price incorporating this Change Order: C nt act Times with all approved Change Orders: S bs antial Completion: July 31,2023 $70,649.45 Ilea y for Final Payment: July 31,2023 RECpMMENDED: C T : ACCEP ED: By: By: By: e) /frj gir eer(if required) Owner(Aut orized Signature) Con nature) Title: Project En i e r Title Nk cci ;c Title Date: 7-31-2023 ate -' . ) Date 7-31-2023 Approved by Fun ng ncy(if applicable) By: Date: Title: 006363-2 APPLICATION AND CERTIFICATE FOR PAYMENT PAGE I of 2 [O OWNER. CITY OF JEFFERSONVILLE PROJECT: APPLICATION NUMBER: 1 Distribution to: 500 QUARTERMASTER COURT 2022-2 CCMG CITY OF JEFFERSONVILL PERIOD FROM: 2t21/2023 OWNER JEFFERSONVILLE,IN 47130 PERIOD TO:6/1/2023 ARCHITECT VIA ENGINEER: CONTRACTOR FROM CONTRACTOR: LIBS PAVING COMPANY,INC. JACOBI,TOOMZ,AND LANZ CONTRACT DATE: 3/1/2023 CONSTRUCTION 6931 ATKINS ROAD 1829 EAST SPRING STREET MANAGER FLOYDS KNOBS,[N 47119 NEW ALBANY,IN 47150 ARCHITECT JOB NO 22051 CONTRACT FOR: CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, Application is made for payment,as shown below,in accordance with the Contract. information and belief,the Work covered by this Application for Payment has been Continuation Sheet,Document G703,is attached. completed in accordance with the Contract Documents,that all amounts have been I. ORIGINAL CONTRACT SUM $ 62,402.00 paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner,and that current payment shown herein is now due. 2. Net Change By Change Orders $ - CONTRACTOR1,,3(..7.1 3. CONTRACT SUM TO DATE (Line 1 9-2!. $ 62,402.00 BY: V DATE -7-.3,- Z3 4. TOTAL COMPLETED&STORED TO DATE $ 70,649.45 . (Column G on G703) State of: n cA,X v1J/\f}� County _11�4' � of: -c-i-.6\A 5. RETAINAGE: a. 5%of Completed Work $ - Subscribed and sworn before me this 31 day of 4) i 3.,Qy►,,, (Columns D&Eon G703) Notary Public: O ,� ��a°`^PRl E BFT'.�� My Commission Expires: �� _ �, �� Yoiresn 0 ''3 b. 5%%of Stored Material $ - J �� NOTARY ,��Z a CERTIFICATE FOR PAYMENT (Column F on G703) (1...:-.CC* �g � :::� � .Total Retainage(Line 5a+5b or . SAL 'Total m Column 1 of G703) $ - In accordance with the Contract Documents,based on on-site observations ',. PUBLIChand the data comprising the above application,the Construction Manager '.�o� �,<P�% at, TOTAL EARNED LESS RETAINAGE $ 70,649.45 certifies that to the best of his knowledge,information and belief the Work %,Sj.`.�,Comm -'��41' (Line 4 less Line 5 Total) has progressed as indicated,the quality of the Work is in accordance with ,',,,��tC OF ENO\P•,`." the Contract Documents,and the Contractor is entitled to payment of the '''a',,,,,''1114 p+'`` 7 LESS PREVIOUS CERTIFICATES FOR PAYMENT AMOUNT CERTIFIED. (Line 6 from prior Certificate) - AMOUNT CERTIFIED $ 70,649.45 CURRENT PAYMENT DUE $ 70,649.45 (Attach explanation([amount certified differs from the amount applied for.Initial all figures on this Application and on.the Continuation Sheet that changed to conform to the amount certified.). 9 BALANCE TO FINISH,INCLUDING RETAINAGE CONSTIItt C N MGR: -31 2023 (Line 3 less Line 6) $ (8,247.45) By: Date: CHANGE ORDER SUMMARY ADDI l IONS DEDUCTIONS A HIT CT: Total changes approved in By: Date: previous months by Owner $ - $ - This certificate is not negotiable.The AMOUNT CERTIFIED is payable only Total Approved this Month to the Contractor named herein.Issuance,payment and acceptance of TOTALS $ - $ - payment are without prejudice to any rights of the Owner or Contractor under NET CHANGES by Change Order $ - this Contract. City ofleffersonville,Indiana 2022-2 Community Crossings Grant Funded Street Paving Project lob No.22051 Division A:Wall St(From 7th St to 8th St) Item 8 Description Quantity Unit Unit Price Total Cost Al Mobilization/Demobilization 1 LS $2,364.00 $2,364.00 A2 Maintenance of Traffic 1 LS 5500.00 $500.00 A3 Asphalt Milling 1,955 SYD $1.22 $2,385.10 A4 HMA Base,Type B(For Patching)(Assume 605 LB/SY)(5.5 Inch) 0 TON $1.00 $0.00 A5 HMA Surface,Type B(Assume 165 LB/SY)(1.5 Inch) 161.56 TON $78.00 $12,601.68 A6 Stop Bars,Thermo 19 LF $13.00 $247.00 A7 Thermo Painted Lines 829 LF $1.55 $1,284.95 A8 Sidewalk,Concrete,4 Inch 12.63 SYD $95.00 $1,199.85 Subtotal: $20,582.58 Division B:E 9th St(From Spring St to Wall St) Item 6 Description Quantity Unit Unit Price Total Cost B1 Mobilization/Demobilization 1 LS $5,515.00 $5,515.00 B2 Maintenance of Traffic 1 LS $500.00 $500.00 B3 Asphalt Milling 1023 SYD $1.22 $1,248.06 B4 HMA Base,Type B(For Patching)(Assume 605 LB/SY)(5.5 Inch) 0 TON $1.00 $0.00 B5 HMA Surface,Type B(Assume 165 LB/SY)(1.5 Inch) 121.17, TON $78.00 $9,451.26 B6 Stop Bars 20 LF $13.00 $260.00 B7 Concrete Curb 86.25 LF $55.00 $4,743.75 B8 Structure 3 EA $3,500.00 $10,500.00 89 Pipe,Type 1,Circular,15 In. 236 LF $75.00 $17,700.00 B10 Striping Thermoplastic Lines 4in 96 LF $1.55 $148.80 Subtotal: $50,066.87 TOTAL BID PRICE=Total of Division A thru Division B= $70,649.45 Contractor LIBS PAVING CO.,INC.