Okaloosa County BOCC — July 1, 2014 — Change Order and Final Close-out checklist with documents for Airport Police Station — reading text

CONTRACT/LEASE PAYMENT APPROVAL FORM COMPLETE AND FORWARD TO THE NEXT DEPARTMENT IE = =] COMPLETED BY DEPARTMENT DATE: 6/10/2014 VENDOR NAME: Lord & Son Construction, Inc. VENDOR #: 004002 CONTRACT/LEASE#: C14-2151-AP Police Station TASK COUNTY/FEMA VENDOR BUDGET INVOICE # ORDER # PROJECT # DEPARTMENT #| “CCOUNT# AMOUNTS (If Applicable) (If Applicable) Pay App 3-Fin Pay App 3-Fin 421 2051100 8,256.34 TOTAL $ 8,256.34 APPROVED FOR PROGRESS PAYMENT (please sien, as applicable and date) CONTRACTOR'S ENGINEER/ARCHITECT/PROJECT MANAGER: DATE: COUNTY SUPERVISOR/PROJECT MANAGER; Sf, / 7S. DATE: £-/6-/4 Vi racy Stage, A.A.E. DEPARTMENT DIRECTOR: DATE: 6/48/41 AE Vi F 7 Sunil Harman, A.A.E., IAP Gyo CONTRACTS & GRANT MANAGER: DATE: COUNTY ADMINISTRATOR: DATE: (Payments > $25,000.) «qYIYV|N)__OHS——= — 1 FINAL PAYMENT FINAL PAYMENT YES x NO__ (If "Yes", forward to Purchasing Services Coordinator for Close-Out) DATE: of (Pid PURCHASING DIRECTOR: “4 yee obs ak (Aa ledvrak | (Per Initial Agreement) pate. 6 -ZY-/f CONTRACTS & GRANTS MANAGER: (All Contracts) DATE: b)r JS) COUNTY ADMINISTRATOR APPROVAL: (Per Initial Agreement) 7 Oe DATE: BOARD APPROVAL: (Per Initial Agreement) COMPLETED BY FINANCE - ACCOUNTS PAYABLE ONLY FISCAL YEAR: DATE RECEIVED: REVIEWED BY: Contract Amount: Interior Mod for Police Station at VPS $82,563.41 Less Gross 10% % Payee Date Pay Apps Amount Retainage Net Paid Balance _|{ Complete Lord & Son 4/112014|Pay App#1 45,501.95 4,550.20 40,951.75 0.00 [Lord & Son Pay App#2 37,061.46 3,706.14 33,355.32 -286.59 Lord & Son Pay App #3 Final 0.00 0.00 82,563.41 8,256.34 74,307.07 -286.59} 100.0% Contract Amount - Gross Amount Contract Amount - Net Paid Balance to Finish $0.00 Balance to Finish $8,256.34 1 Original Contract Sum 2 Net Change By Change Orders 3 Contract Sum to Date 4 Total completed and Stored to Date (cotumn G on G703) 5 Retainage a. 10% of completed Work (column D + E on G703) b. % of Stored Material (column F on G703) Total in Column | of G707 6 Total Earned Less Retainage 7 Less Previous Certificates for Payment 8 Current Payment Due 9 Balance to Finish, Including Retainage 82,850.00 286.59 82,563.41 82,563.41 0.00 82,563.41 74,307.07 0.00 8,256.34 0.00 CONTRACT CLOSE-OUT CHECKLIST (To Be Prepared by the Contracts and Lease Coordinator) DATE: 6-18-14 TO: Contracts & Grants Manager, Finance Department Contracts & Grants Office SUBJECT: Contract No. C14-2151-AP MANAGING DEPARTMENT: AIRPORT CONTRACTOR'S NAME: LORD & SON CONSTRUCTION PROJECT TITLE: INTERIOR TERMINAL MODIFICATIONS FOR POLICE STATION The attached has met the final payment contract requirement in subject contract. Yes No 1. Final Invoice x | 2. Completed Contract/Lease Payment Approval Form x] LC] 3. Close-Out Documents Yes No N/A a. Signed Release of Lien Xx] [| C] b. Proof of Completion Advertisement [| C] c. Certificate of Insurance i C] d. Consent of Surety to Final Payment | LC] e. Proof of Performance/Payment Bond x [] C Continuation 12 Months Following Final Payment Yes No 4. Agenda Request x] LC] 5. Remarks Project Title: Interior Terminal Modifications for Police Station at NWFRA Project Number: AP 12-14 Lord & Son Construction Purchasing Contract No.: C14-2151-AP Expires: 60 Days from NTP TOTAL 4207- 421-2051100 562431 COST 10% Amount Inv# Cost to date Withheld Paid 1 45,501.95 45,501.95 (4,550.20) 40,951.75 2 37,061.46 37,061.46 (3,706.14) 33,355.32 3 - 8,256.34 8,256.34 4 - - - 5 - - - 6 - - - 7 - - - 8 - - - 9 - - - 10 - - - 11 - - - 82,563.41 82,563.41 (0.00) 82,563.41 Contract Total 82,850.00 Change Order #1 (286.59) Change Order #2 Change Order #3 Change Order #4 New Contract Total 82,563.41 Balance to finish w/o retainage 0.00 Date Check Paid Number 04/24/14 V1404966 06/05/14 V1406102 LPA Group Inc. A Unit of Michael Baker jaa) 4503 Woodland Corporate Blvd. SS Suite 400 Tampa, Florida 33614 (813) 889-3892 June 9, 2014 Tracy Stage, A.A.E. Deputy Director Okaloosa County Airports 1701 State Rd 85 N Eglin AFB, FL 32542-1498 Re: Interior Terminal Modifications for Police Station/ Northwest Florida Regional Airport Contract #C14-2151-AP; Bid # AP 12-14 Lord and Son Pay Application #3 (Final), Closeout Documents Dear Mr. Stage: Enclosed please find five (5) originals of the Northwest Florida Regional Airport Interior Terminal Modifications for Police Station project pay application number #3 (Final) as submitted by Lord and Son Construction, Inc. This pay request represents work installed and verified by LPA or our on-site representative, fully completed to in accordance with the contract requirements. All work was completed prior to the contract expiration date of April 27,2014. All retainage has been released. Based on the above, we recommend payment to Lord and Son Construction, Inc. in the amount of $8,256.34. Closeout documents enclosed include the following: Final Pay Request Final Inspection Punch List Substantial Completion Letter Contractor Warranty Form Affidavit of Payment Affidavit of Release of Lien Final Waiver of Lien Contractor’s Release of Liens Change Order #1 1 Advertisement of Completion Extended Insurance Coverage Letter Consent of Surety for Final Payment Extended P&P Bonds Letter DBE Expenditure Report As-Built Drawings (Hard Copy and CD) Please contact me if you have any questions. Sincerely, The LPA Group Incorporated A Unit of Michael Baker Corporation Project Manager ce: John Klumpp — Lord and Son Construction Project Title: Police Station Inside Terminal VPS The LPA Group-C09-1736-AP County Airport Project Number vpso1o TOR: Date: Airport Reserves Contract i: Total Funding * $95,000.00 $95,000.00 Pay Application No.: 10% Bid #: Date: Retainage Construction Award Construction Start: County County Construction Complete: Check Date } Check # Invoice # Invoice Date | invoice Amount | _4207/562434 421-2051100 | Check Total Lord & Son Construction $82,850.00 4/23/14 _|v1404966 Pay App 1 4/1/14 $ 45,501.95 | $ 45,501.95 | $ (4,550.20)]$ 40,951.75 [Change Order #1 Deduct $286.59 6/5/14 _|v1406102 Pay App 2 5/6/14 $ 37,061.46 | $ 37,061.46 | $ (3,706.14)| $ 33,355.32 $82,563.41 Pay App 3 Fin 6/9/14 § 8,256.341$ 8,256.34 Complete 100.00% § ~ $ : $ : {LPA--TO 14] Design, Bidding, and Construction Services 11/7/13 _| 1400962 859842 $ 880.00 | $ 380.00 $ 880.00 $18,975.00 4/2/14 v1401995 863649 $ 6,010.00 | $ 6,010.00 $ 6,010.00 Percentage Complete 4/9/2014 | v1402145 865661 12/16/2013 | $ 984,59 | $ 984,59 $ 984,59 90.35% 3/13/2024 | v1403905 868407 1/21/2013 $ 3,127.82 | $ 3,127.82 $ 3,127.82 3/27/2013 | vi404342 870893 2/20/2014 $ 517.59 | $ 517.59 $ 517,59 4/23/2014 | v1405008 874672 4/9/2014 $ 1,683.79 | $ 1,683.79 $ 1,683.79 6/5/2014 | v1406139 877053 5/11/2014 $ 3,939.71 1 $ 3,939.71 $ 3,939.71, $ Misc Charges : : : Bonding 5/8/2014 | v1405466 § 44,00 | $ 44.00 $ 44.00 $ - s - $ : $ : Total Funding of Program Cost § 99,750.91 | $ 99,750.91 | $ - |$ 99,750.91 $101,825.00 Totat Amount| § 599,750.91 | | Balance -$4,750.91| a Lord & Son Construction $82,563.41 TO # 14 Total to Date $17,143.50 TO # T8D Total to Date Mise Charges $ 44.00 6/10/2014 ] Total § 99,750.91 APPLICATION AND CERTIFICATE FOR PAYMENT AIA DOCUMENT G702 PAGE 1 OF 2 TO OWNER: PROJECT: APPLICATION NO.: 3 Okaloosa County Northwest Florida Regional Airport DATE: 27-May?14 G2 602 N. Pearl Street Interior Modifciation for Police Station Bid No. AP 12-14, Contract #6414-2151-AP PERIOD TO: 27-May-14 Crestview, FL 32536 1701 State Road 85 North Contractor PROJECT NO.: MPR 1494 Eglin AFB, FL 32542 CONTRACT NO.: AP 12-14 CONTRACT DATE: 18-Jan-14 FROM CONTRACTOR: VIA ENGINEER: 4503 Woodland Corporate Blvd. Suite 400 Tampa, Florida 33614 CONTRACT FOR: Northwest Florida Regional Airport- Police Station The undersigned Contractor certifies that to the best of the Contractor's knowledge, information and CONTRACTOR'S APPLICATION FOR PAYMENT belief the Work covered by this Application for Payment has been completed in accordance with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Application is made for payment as shown below, in connection with the Certificates for Payment were issued and payments received from the Owner, and that current payment Contract Continuation Sheet is attached. shown hereipisndw due. 1. ORIGINAL CONTRACT SUM 00.0... ccc ea eae $82,850,00 2, NET CHANGE BY CHANGE ORDERS.............. ($286.59) ~ a 7 , { <| 3, CONTRACT SUM TO DATE (Line 1 + 2) $82,563.41 . Date: Lb ‘ 4a, TOTAL COMPLETED TO DATE (Cal. F on Recap Sheeet) $82,563.41 Leven D. Lord il C_--7 5/27/2014 = 4b, TOTAL STORED MATERIALS CURRENT (Col. G on Recap Sheet) $0.00 State of: Florida County of: Okaloosa 5.RETAINAGE a. 10 % of Applicable Work 30,00 Subscribed and sworn to before me this _27th day of May 2014 (Column F x16% on Recap Sheet} by _ Leven D. Lord Il_, personaily known b. 10 % of Stored Material $0.00 Notary Public: (Column G x10% on Recap Sheet) My Commission expires: 5. TOTAL RETAINAGE (a. +b.) $0.00 ENGINEER'S CERTIFICATE FOR PAYMENT: 6, TOTAL EARNED LESS RETAINAGE...............005 In accordance with the Contract Documents, based on on-site observation and the data comprising this (Line 4 less Line 5 Total) $82,563.41 application, the Construction Coordinator and Owners Representative certify to the Owner that to the best of their knowledge, information and belief the Work has p as ji isin 8 7. LESS PREVIOUS PAYMENTS. .................. $74,307.07 with the Contract D and the Ci ris entitled to of the AMOUNT CERTIFIED. AMOUNT CERTIFIED 00... ec i cc cece cece ceeeeesece | $8,256.34 | 8. CURRENT PAYMENT DUE $8,256.34 | (Aitach explanation if amount certified differs from the amount applied for. Initial all figures on this Application and on the Cont Sheet that are changed to conform to the amount certified) 9. BALANCE TO FINISH, PLUS RETAINAGE............. $0.00 (Line 3 less Line 6) Date: 6-6: +4 [CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS Total changes approved in previous months by Owner | — $286.59 aw $0.00 $286.59 a \ Date: G+rb-s ta AIRPORT DEPUTY BIRECT NET CHANGES by Change Order __($286.59) fall ite: SOM Warman, AIRPORT DIRECTO) Date: 2 LLP) [14 crap So Rentanshe Sa Fed Crea 2/12 E CONTINUATION SHEET PAGE 2 OF 2 APPLICATION AND CERTIFICATE FOR PAYMENT, APPLICATION NO.: 3 containing Contractor's signed Certification is attached. APPLICATION DATE: 27-May-14 In tabulations below, amounts are stated to the nearest dollar. PERIOD TO: 27-May-14 Use Column ! on Contracts where variable retainage for line items may apply. BID NO.: AP 12-14 A B c D | E EF G H I ITEM DESCRIPTION OF WORK SCHEDULED WORK COMPLETED MATERIALS TOTAL BALANCE RETAINAGE NO. VALUE PREVIOUS PRESENTLY | COMPLETED % TO (IF VARIABLE 0 APPLICATIONS THIS STORED AND STORED (G/C) FINISH RATE) (D+E) PERIOD (Not in D or E) TO DATE (C - G) (D+E+F) 01 _|GENERAL CONDITIONS A___|Mobilization $7,500.00 $7,500.00 $7,500.00 100.0% $0.00 $0.00 B___|Bonds, Permit & Insurance $2,446.00 $2,446.00 $2,446.00 100.0% $0.00 $0.00 C__|Supervision & Job Overhead $16,181.00 $16,181.00 $16,181.00 100.0% $0.00 $0.00 D__|[Allowance - Office Furniture $5,000.00 $4,941.01 $58.99 $5,000.00 100.0% $0.00 $0.00 E___|Allowance - Police Sign $800.00 $572.40 $227.60 $800.00 100.0% $0.00 $0.00 02 |WOOD & PLASTICS Blocking and Headers $1,161.00 $1,161.00 $1,161.00 100.0% $0.00 $0.00 B__{Informational Counter & Desk $7,520.00 $7,520,00 $7,520.00 100.0% $0.00 $0.00 03 [DOORS & GLASS A___|Doors, Frames & Hardware $4,323.00 $4,323.00 $4,323.00 100.0% $0.00 $0.00 B__IAIl Ent, Storefront & Glass $22,373.00 $22,373.00 $22,373.00 100.0% $0.00 $0.00 04 {FINISHES A__|Metal Studs, Gyp. Bd., Act. Ceil. $4,799.00 $4,799.00 $4,799.00 100.0% $0.00 $0.00 B {Painting $3,084,00 $3,084.00 $3,084.00 100.0% $0.00 $0.00 C {Rubber Base $350,00 $350,00 $350.00 {00.0% $0.00 $0.00 05 |SPECIALTIES A__|Fire Extinguisher & Cab. $320.00 $320.00 $320.00 100.0%