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bocc.con.amended.181.2018 L
9TKIN Pitkin County CouNTt Procurement Cover Sheet Please complete the Contract Cover Sheet when the contract/task order is complete and fully executed. Return all Contract Cover Sheets and Contracts/Change Orders/Amendments/Task Orders to Procurement (procurement@pitkincounty.com). If not already completed, any contracts $50,000 and over will be routed for signatures to County Manager and Attorney's Office (if required)by Procurement. Contract Information Contract Number 181.2018L Project Name Aspen Ambulance District Facility CM/GC Contractor FCI Constructors,Inc. Budget Line Item 115.34.92834.86200 $ Additional Budget Line $ Item(s) $ (Please fully allocate New _ $ Contract Total) $ Contract Start Date 7/16/2018 Contract End Date 8/23/2019 Renewals Available? Yes E No Retainage Yes$ or 5.00% No❑ If this is a new contractor,please request they complete and submit to Finance a New Vendor Request Form. Contact Information: Department Administration County Representative Rich Englehart County Representative (970)429-6135 Phone Provide a brief description of the contract: Click here to enter text. Contract Value Summary: Original Contract Amount $6,912,873.00 Previous Change Order/Amendment Amount $341,884.00 This Change order/Amendment amount $-18,850.00 New Contract Total $7,235,907.00 Procurement Method: None ❑ Informal Formal © Sole Source ❑ Outside Agency ❑ Emergency ❑ Contract Type: Services/Maintenance ❑ Construction ❑X Goods,Equipment, Supplies ❑ Change Order/Amendment 0 Contract Renewal 0 Other,please explain 0 Click here to enter text. Contract#: 181.2018 Rev. 2018.06.13 btf Budget Line Item#: 115.34.92834.86200 1/441)1 iTKIN COUNT - CHANGE ORDER/ CONTRACT AMENDMENT Change Order Number: 181.2018L OWNER: CONTRACTOR: Pitkin County, Colorado FCI Constructors, Inc. 530 E. Main St., Suite#302 PO Box 1767 Aspen, CO 81611 Grand Junction, CO 81502 The Provision of Aspen Ambulance District Facility CM/GC (the "Contract") dated July 11, 2018 between the Board of County Commissioners of Pitkin County, Colorado (the "County") and FCI Constructors, Inc. (the "Contractor"), is hereby amended as follows: Description of Change: 1. COR-094—Contract to Actual ($18,850.00) TOTAL THIS CHANGE ORDER ($18,850.00) Reason for Change: 1. COR-094 Reconcile to final contract amount Original Contract Amount $ 6,912,873.00 Previous Change Order/Amendment Amount $ 341,884.00 This Change Order/Amendment Amount $ -18,850.00 New Contract Total $ 7,235,907.00 *Increases over$25,000 and/or 10% (single increase or accumulative)of original contract must have County Manager signature. 1 Contract#: 181.2018 Rev. 2018.06.13 btf Budget Line Item#: 115.34.92834.86200 In all other respects, the Contract is in full force and effect and remains unchanged by this Amendment. FCI CONSTRUCTORS, INC. Digitally signed by Brian Young orn Brian Young C 20 0 01 c 2700'tors,C 80 Young Date Date PITKIN COUNTY,COLORADO RECOMMENDED FOR APPROVAL: C DocuSigned by:rGU. tkijI ._' Jan-09-2020 7C4400 724F1 Ricy3 Eng enart Date Deputy County Manager MANAGER APPROVAL: [DocuSigned b Jan-16-2020 950370Bn01z n.t5 Ton PeacockDate County Manager *Increases over$25,000 and/or 10% (single increase or accumulative)of original contract must have County Manager signature. 2 F C I Constructors,Inc. CONTRACTOR LIEN WAIVER AND RELEASE OF CLAIMS Contractor: FCI Constructors, Inc. Project: Aspen Ambulance District Facility (NAME OF FIRM GIVING RELEASE) (PROJECT NAME) PO Box 1767 (BUSINESS ADDRESS) (PROJECT ADDRESS) Grand Junction, CO 81502 Aspen, CO 81611 (CITY,STATE,ZIP CODE) (CITY,STATE,ZIP CODE) Contact Person: Brian Young Owner: Pitkin County Contact Telephone: 970-434-9093 Contact Fax: 970-434-7583 Project Manager: Brian Young Contract Number: Project Telephone: Conditional Release Unconditional Release (Current Progress Payment) (Prior Progress Payments) The undersigned does hereby acknowledge that upon receipt by the The undersigned does hereby acknowledge that the undersigned has undersigned of a check from Pitkin r:ounty in the sum of received progress payments in the sum of$ 7 213 192.00 for $22.715.00 and when the check has been properly endorsed and labor,service,equipment or materials furnished to the above referenced has been paid by the bank upon which it was drawn,this document shall job and does hereby release any and all claims and rights,including, become effective to release any and all claims and rights,including,without without limitation,mechanics'lien rights,which the undersigned has on the limitation,mechanics'lien rights,which the undersigned has on the above- above referenced job.This release covers all payment for labor,services, referenced job.This release covers a progress payment for labor,services, equipment,materials furnished,as well as delays,impacts,disruptions equipment,materials fumished and/or claims through(date) and/or claims through(date) October 31.2019 only and does not cover December 31,2019 only and does not cover any retention items fumished any retention or items furnished after that date. after that date. The undersigned warrants its work to be of good and workmanlike quality. The undersigned warrants its work to be of good and workmanlike quality.The The undersigned certifies that all of its laborers,materials,suppliers and undersigned certifies that all of its laborers,materials,suppliers and subcontractors have been paid in full. subcontractors have been paid in accordance with the requirements of the In consideration of the payments described herein,the undersigned Contract Documents. releases and forever discharges the Owner,Contractor,and any of their In consideration of the payments described herein,the undersigned releases affiliates,sureties,successors,and assigns from any claim,demand,or and forever discharges the Owner and any of its affiliates,sureties,successors, causes of action at law and equity of whatsoever kind attributable to this and assigns from any claim,demand,or causes of action at law and equity of Project arising out of or by reason of having furnished labor,materials whatsoever kind attributable to this Project arising out of or by reason of having and/or supplies pursuant to a contract with the Owner or its affiliates or furnished labor,materials and/or supplies pursuant to a contract with the Owner agents. or its affiliates or agents. NOTICE:THIS DOCUMENT WAIVES RIGHTS UNCONDITIONALLY AND STATES THAT YOU HAVE BEEN PAID FOR GIVING UP THOSE RIGHTS.THIS IS A LEGAL INSTRUMENT AND MUST BE EXECUTED ACCORDINGLY.IF YOU HAVE NOT BEEN I CERTIFY UNDER PENALTY OR PERJURY UNDER LAWS OF THE STATE PAID,USE A CONDITIONAL RELEASE FORM. OF COLORADO THAT THE ABOVE IS A TRUE AND CORRECT STATEMENT. I CERTIFY UNDER PENALTY OR PERJURY UNDER LAWS OF THE STATE OF COLORADO THAT THE ABOVE IS A TRUE AND CORRECT Signature: __ Signature: Dated this 8th ' day of January ,2019 Dated this 8th day of January , 2019 At: Grand Junction, fiesa County, CO At: Grand Junction, Mesa County, CO Subscri and sworn br r the fret mitten: Subscr nd;?9oom before m d and year first above written: BYd(,� t_OI IN TARY PUBLIC By: /�(� =�„-- STATE OF COLOt Aug EVELIN J. HI AL Notary Public for: State o C4�tjtRY ID#20134022018� Notary Public for: State o COIoraPTARY PUBLIC M ommission Expires F.pni 4,nee 3TATF ��� ` My Commission Expires: My Commission Expires: (,� 1 t' /�, ,_,, lio ® ' Document G702TM - 1992 Application and Certificate for Payment • TO OWNER: PROJECT: APPLICATION NOP Distribution to: Pitkin County Aspen Ambulance District Facility PERIOD T:2/31/2019 OWNER 0 401 Castle Creek Road,Aspen,CO 81611 530 E.Main St. CONTRACT FOR: ARCHITECT ❑ Aspep18L �I RACTOR: VIA ARCHITECT: CONTRACT DATE: 6/25/2018 CONTRACTOR 0 FCI Constructors, Inc.-GJ Chamberlin Architects, Inc. PROJECT NOS:10-17-033 P.O. Box 1767 437 Main Street ! FIELD ❑ Grand Junction,CO 81502 Grand Junction,CO 81501 OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT The undersigned Contractor certifies that to the best of the Contractor's knowledge, information Application is made for payment,as shown below,in connection with the Contract. and belief the Work covered by this Application for Payment has been completed in accordance AIA Document for Continuation Sheet,is attached. with the Contract Documents, that all amounts have been paid by the Contractor for Work for which previous Certificates for Payment were issued and payments received from the Owner, and 1.ORIGINAL CONTRACT SUM $ 1112 873 00 that current payment shown herein's now due. 2.NET CHANGE BY CHANGE ORDERS $ 393 n34 on CONT • 3.CONTRACT SUM TO DATE(Line l±2) $ 7.235.907.00 By: Date: ' -8 - zo 4.TOTAL COMPLETED&STORED TO DATE(Column G on G703) $ 7,235,907.00 State of: £g(Q v 5.RETAINAGE: County of: 0414 u- a. %of completed Work Subscribed and sworn to fore EVELIN J. HOAL (Columns D+Eon G703) $ 00 me this ��,{� a �j� UBLIC b. %of Stored Material 0 y of`,�STATEOFCOLORADO (Column F on G703) $ 1VOTARY ID#20134022018 0.00 Notary Public: MyCommission My commission expires: (�/,` o Expires April 4,2021 Total Retainage(Lines 5a+5b, or Total in Column I of G703) $ n on [` Z l� 6.TOTAL EARNED LESS RETAINAGE $ 7,235 907.00 ARCHITECT'S CERTIFICATE FOR PAYMENT (Line 4 minus Line 5 Total) In accordance with the Contract Documents,based on on-site observations and the data comprising 7.LESS PREVIOUS CERTIFICATES FOR PAYMENT $ 7 21'192 00 this application,the Architect certifies to the Owner that to the best of the Architect's knowledge, (Line 6from prior Certificate) information and belief the Work has progressed as indicated, the quality of the Work is in accordance with the Contract Documents, and the Contractor is entitled to payment of the 8.CURRENT PAYMENT DUE $ 22.715.00_ I AMOUNT CERTIFIED. 9.BALANCE TO FINISH,INCLUDING RETAINAGE AMOUNT CERTIFIED $ (Line 3 minus Line 6) $ 1 0.00 (Attach explanation if amount certified differs front the amount applied.Initial all figures on this Application and on the Continuation Sheet that are changed to conform with the amount certified.) CHANGE ORDER SUMMARY ADDITIONS DEDUCTIONS ARCHITECT: Total changes approved in.previous months by Owner 71,307 on .$ 24 423.00 By: Date: Total approved this month $ 0 00 $ 18,$50.00 This Certificate is not'negotiable.The AMOUNT CERTIFIED is payable only to the Contractor TOTAL 371,307 00 $ 48.273.00 named herein.Issuance,payment and acceptance of payment are without prejudice to any rights of ,NET CHANGES by Change Order 29 �4 o0 the Owner or Contractor under this Contract. 3 �- CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G702TM—1992.Copyright ©1953,1963,1965,1971,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Una. --Auction or distribution of this Able Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 010711AC044 AI ,,,,,, %.4....... A Document G703TM - 1992 Continuation Sheet 1 9 AIA Document G702ml-1992,Application and Certificate for Payment,or G732T 2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 018 containing Contractor's signed certification is attached. 12/31/2019 In tabulations below,amounts are in US dollars. PERIOD TO: 12/31/2019 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS FINISH NO. VALUE STORED STORED TO DATE (G_C) (if variable rate) APPLICATION THIS PERIOD (C-G) (D+E) (Not inDorE) (D+E+F) Wool CONSTRUCTION PHASE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00002 DIVISION 1 GENERAL CONDITIONS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00003 Subsistence 14,393.00 40,900.00 0.00 0.00 40,900.00 284.17 (26,507.00) 0.00 0I0004 Home&Office Travel 4,278.00 6,095.00 0.00 0.00 6,095.00 142.47 (1,817.00) 0.00 Opooe Apartment Rent 46,367.00 49,807.00 (117.00) 0.00 49,690.00 107.17 (3,323.00) 0.00 I1006 Superintendent 180,582.00 158,710.00 0.00 0.00 158,710.00 87.89 21,872.00 0.00 abo07 Project Manager 56,000.00 57,955.00 0.00 0.00 57,955.00 103.49 (1,955.00) 0.00 I2008 Temp Electric 4,878.00 2,480.00 0.00 0:00 2,480.00 50.84 2,398.00 0.00 009 Internet 2,746.00 3,869.00 0.00 0.00 3,869.00 140.90 (1,123.00) 0.00 010 Cell Phone 2,139.00 4,843.00 0.00 0.00 4,843.00 226.41 (2,704.00) 0.00 011 Construction Water 2,746.00 0.00 0.00 0.00 0.00 0.00 2,746.00 0.00 0 012 Drinking Water 662.00 417.00 0.00 0.00 417.00 62.99 245.00 0.00 013 Field Office Trailer 14,418.00 9,846.00 792.00 0.00 10,638.00 73.78 3,780.00 0.00 014 Storage Facility Offsite 12,000.00 7,675.00 0.00 0.00 7,675.00 63.96 4,325.00 0.00 0 015 First Aid ,600.00 579.00 0.00 0.00 579.00 22.27 2,021.00 0.00 016 Temp Toilets 5,299.00 8,230.00 0.00 0.00 8,230.00 155.31 (2,931.00) 0.00 0 017 Office Supplies 1,783.00 750.00 0.00 0.00 750.00 42.06 1,033.00 0.00 18 Office Equipment Rent 11,367.00 6,936.00 0.00 0.00 6,936.00 61.02 4,431.00 0.00 019 rbostage&Delivery 713.00 140.00 0.00 0.00 140.00 19.64 573.00 0.00 020 plan Reproduction 7,490.00 4,765.00 769.00 0.00 5,534,00 73.89 1,956.00 0.00 09021 snow Removal 7,092.00 5,567.00 0.00 0.00 5.56700 78.50 1,525.00 0.00 0p022 Safety 2,700.00 4,074.00 0.00 0.00 4,074.00 150.89 (1,374.00) 0.00 0 023 Fire Extinguishers 725.00 0.00 0.00 0.00 0.00 0.00 725.00 0.00 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703TM-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlAe Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. ,o,z,wco<. P4 .--,-'101IA Document G7O3TM - 1992 Continuation Sheet 2 9 AIA Document G702T"L1992,_Application and Certificate for Payment,or G732T"_2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 018 containing Contractor's signed certification is attached. 12/31/2019 In tabulations below,amounts are in US dollars. PERIOD TO: 12/31/2019 Use ColunM I ou Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE NO. DESCRIPTION OF WORK VALUE FROM PREVIOUS STORED STORED TO DATE (G-C) APPLICATION THIS PERIOD FINISH (If variable rate) (D+E) (Not inDorE) (D+E+F) C0024 Pick-Up Rent 13,579.00 12,304.00 0.00 0.00 12,304.00 90.61 1,275.00 0.00 00025 Gas&Oil 8,557.00 6,455.00 0.00 0.00 6,455.00 75.44 2,102.00 0.00 00026 Temporary Fence 16,060.00 11,731.00 0.00 0.00 11,731.00 73.04 4,329.00 0.00 00027 Project Sign 350.00 335.00 0.00 0.00 335.00 95.71 15.00 0.00 00028 General Layout 20,000.00 26,780.00 0.00 0.00 26,780.00 t33.90 (6,780.00) 0.00 00029 Surveying 40,000.00 43,172.00 0.00 0.00 43,172.00 107;93 (3,172.00) 0.00 00030 Weekly Cleaning 13,804.00 17,539.00 0.00 0.00 17,539.00 127.06 (3,735.00) 0.00 90031 Dump Fees&Dumpsters 26,000.00 39,989.00 0.00_ 0.00 39,989.00 153.80 (13,989.00) 0.00 t110032 Final Cleaning 6,000.00 4,837.00 0.00 0.00 4,837.00 80.62 1,163.00 0.00 0033 D. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 034 DIVISION 3 CONCRETE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0035 Concrete-ASHLEY 608,502.00 608,502.00 (500.00) 0.00 608,002.00 99.92 500.00 0.00 0036 Misc.Concrete 67,646.00 54,464.00 0.00 0.00 54,464.00 80.51 13,182.00 0.00 0037 Housekeeping Pads 7,600.00 461.00 0.00 0.00 461.00 6.07 7,139.00 0.00 0038 Polish/Stain Concrete-ALL WEST 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0039 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 004o DIVISION 4 MASONRY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0041 Masonry-BSM WALL 213,184.00 213,184.00 0.00 0.00 213,184.00 100.00 0.00 0.00 II0181 Masonry Misc 7,372.00 6,122.00 0.00 0.00 6,122.00 83.04 1,250.00 0.00 doo42 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00043 DIVISION 5 METALS 0.00 0.00 0.00 0.00 000 0.00 0.00 0.00 (0044 Structural Steel-MIDWEST 577,775.00 577,775.00 0.00 0.00 577,775.00 100.00 0.00 0.00 C0045 Misc.Metals . 5,393.00 3,805.00 0.00 0.00 3,805.00 70.55 1.588.00 0.00 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703w-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 101210ACD44 , ,l1� = -ATA µ Document G703" - 1992 Continuation Sheet 3 9 AIA Document G702TM_l9.92,Application and Certificate for Payment,or G732T 2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, 018 APPLICATION DATE: containing Contractor's signed certification is attached. 12/31/2019 In tabulations below,amounts are in US dollars. PERIOD TO: 12/31/2019 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D I E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE NO. DESCRIPTION OF WORK VALUE FROM PREVIOUS STORED STORED TO DATE (G-C FINISH variable rate) THIS PERIOD ) (C-G) (If (D+E) (Not in D or E) (D+E+F) I 60046 Steel Primer Touch-Up 5,132.00 96.00 0.00 0.00 96.00 1.87 5,036.00 0.00 00047 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00048 DIVISION 6 WOODS&PLASTICS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0049 Architectural Woodwork-OSBURN 136,745.00 133,860.00 2,885.00 0.00 136,745.00 100.00 0.00 0.00 0050051 DIVISION 7 THERMAL.&MOISTURE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0052 Roofing-SKYLINE 288,139.00 288,139.000.00 0.00 288,139.00 100.00 0.00 0.00 0184 Roofing Misc 1,592.00 1,913.00 0.00 0.00 1,913.00 120.16 (321.00) 0.00 0053 Insulation-ACCURATE INSULATION 74,204.00 74,506.00 (302.00) 0.00 74,204.00 100.00 0.00 0.00 0054 Foundation Insulation 2,920.00 461.00 0.000.00 461.00 15.79 2,459.00 0.00 0055 Rigid Insulation 17,013.00 0.00 0,00 0.00 0.00 0.00 17,013.00 0.00 0183 Weather Barrier 256.00 0.00 0.00 0.00 0.00 0.00 256.00 0.00 oo56 Interior Rigid Insulation 5,146.00 704.00 0.00 0.00 704.00 13.68 4,442.00 0.00 057 Sheet Metal Flashings&Trims 4,463.00 8,047.00 0.00 0.00 8,047.00 180.30 (3,584.00) 0.00 110058 Firestopping 1,049.00 0.00 0.00 0.00 0.00 0.00 1,049.00 0.00 00059 Joint Sealants-SUMMIT SEALANTS 38,615.00 38,615.00 0.00 0.00 38,615.00 100.00 0.00 0.00 00060 Misc.Caulking 16,681.00 37,346.00 0.00 0.00 37,346.00 223.88 (20,665.00) 0.00 00061 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00062 DIVISION 8 OPENINGS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00063 Overhead Doors-OHDGJ 36,530.00 36,530.00 0.00 0.00 36,530.00 100.00 0.00 0.00 00064 Aluminum Storefront-EAGLE VALLE 130,115.00 128,303.00 1,812.00 0.00 130.115.00 100.00 0.00 0.00 00065 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00066 DIVISION 9'FINISHES 0.00 0.00 0.00 0.00': 0.00 0.00 0.00 0.00 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703Tm-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties_unautho►Izpd renmduetign or distribution of this Alen^^"iment,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 01210noo44 I1 . ® a Document G703Tm - 1992 Continuation Sheet 4 9 AIA Document G702T"_1992,Application and Certificate for Payment,or G732T"-2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 018 containing Contractor's signed certification is attached. 12/31/2019 In tabulations below,,amounts are in US dollars. PERIOD TO: 12/31/2019 Use Coles I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE NO. DESCRIPTION OF WORK VALUE FROM PREVIOUS FINISH APPLICATION THIS PERIOD STORED STORED TO DATE (G+C) (C-G) (If variable rate) (D+E) (Not inDorE) (D+E+F) 00067 Metal Studs&Drywall-PEAK INTER - 347,232.00 34-,232.00 0.00 0.00 347,232.00 100.00 0.00 0.00 00068 Metal Stud Engineering 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00069 Flooring-PH&Moisture Test 672.00 0.00 0.00 0.00 0.00 0.00 672.00 0.00 0070 Flooring-CEDAREDGE INTERIORS 88,899.00 88,899.00 0.00 0.00 88,899.00 100.00 0.00 0.00 0071 Floor Prep&Leveling 12,157.00 10,313.00 0.00 0.00 10,313.00 84.83 1,844.00 0.00 0.00 0072 Painting IPS 120,087.00 120,087.00 0.00 0.00 120,087.00 100.00 0.00 0073 Painting Touch-Ups (8,715.00) 0.00 0.00 0.00 0.00 0.00 (8,715.00) 0.00 0074 . 0.00 0.00 0.00 0.00; 0.00 0.00 0.00 0.00 0075 DIVISION 10 SPECIALTIES 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0076 Specialties-SPECALTIES CONTRA( 59,381.00 59,381.00 0.00 0.00 59,381.00 100.00 0.00 0.00 00077 Visual Display Boards 2,500.00 0.00 0.00 0.00 0.00 0.00 2,500.00 0.00 00078 Signage-ASI 9,086.00 9,086.00 0.00 0.00 9,086.00 100.00 0.00 0.00 00079 ExteriorSignage 5,927.00 4,690.00 0.00 0.00 4,690.00 79.13 1,237.00 0.00 Ooo8o 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 Qom DIVISION 12 FURNISHINGS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 D0o82 Window Treatments-GOTCHA COVI 18,441.00 18,441.00 0.00 0.00 18,441.00 100.00 0.00 0.00 00083 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00186 DIVISION 11 EQUIPMENT 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 60187 Appliances 26,808.00 26,808.00 0.00 0.00 26,808.00 100.00 0.00 0.00 00188 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00084 DIVISION 14 CONVEYING EQUIPME 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00085 Elevator-TKE 89,963.00 89,963.00 0.00 0.00 89,963.00 100.00 0.00 0.00 00086 0.00 0.00 0.00 0.00. 0.00 0.00 0.00 0.00 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G7031M-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 101210ACD44 st4 AI:::::_1.): A Document G7O3TM - 1992 Continuation Sheet 5 9 ALA Document G702T 1992,Application and Certificate for Payment,or G732Tm-2009, APPLICATION:NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 018 containing Contractor's signed certification is attached. 12/31/2019 In tabulations below,amounts are in US dollars. PERIOD TO: 12/31/2019 Use Column,I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % RETAINAGE NO. DESCRIPTION OF WORK VALUE FROM PREVIOUS FINI STORED STORED TO DATE - APPLICATION THIS PERIOD (G C) (C-G) (If variable rate) (D+E) (Not in D or E) (D+E+F) 00087 DIVISION 21 FIRE SUPPRESSION 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00088 Fire Protection-FLAME-OUT 61,254.00 61,254.00 0.00 0.00 61,254.00 100.00 0.00 0.00 0089 Fire Main Calcs 0.00 500.00 0.00 0.00 500.00 0.00 (500.00) 0.00 0090 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10091 DIVISION 22 PLUMBING. 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0092 Plumbing-GARRETT HANSEN 253,916.00 253,916.00 0.00 0.00 253,916.00 100.00 0.00 0.00 '0182 Plumbing Misc 3,160.00 3,160.00 0.00 0.00 3,160.00 100.00 0.00 0.00 0093 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10094 DIVISION 23 HVAC/MECHANICAL 0.00 0.00 0.00 0,00 0.00 0.00 0.00 0.00 '0095 Mechanical-CLIMATE CONTROL 403,421.00 399,282.00 4,139.00 0.00 403,421.00 100.00 0.00 0.00 0096 Mechanical Coordination 16,284.00 13,010.00 0.00 0.00 13,010.00 79.89 3,274.00 0.00 i 0097 Radon Mitigation ALLOWANCE 8,396.00 8,396.00 0.00 0.00 8,396.00 100.00 0.00 0.00 00098 Mechanical Core Drill (438.00) 0.00 0.00 0.00 0.00 0.00 (438.00) 0.00 00099 Blower Door Test ALLOWANCE 10,000.00 10,988.00 0.00 0.00 10,988.00 109.88 (988.00) 0.00 'moo . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 iot01 DIVISION 26 ELECTRICAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10102 Electrical-LASSITER 462,949.00 458,114.00 4,835.00 0.00 462,949.00 100.00 0.00 0.00 10103 Electrical Misc. (1,027.00) 925.00 0.00 0.00 925.00 -90.07 (1,952.00) 0.00 0104 Heat Trace ALLOWANCE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 '0105 Door Power 31.00 0.00 0.00 0.00 0.00 0.00 31.00 0.00 10106 Electrical Coordination 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0185 Potovltc Svs.-ASPEN SOLAR 79,548.00 79,548.00 0.00 0.00 79,548.00 100.00 0.00 0.00 ,0107 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G7O3TM-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AlA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. o,z,nnco„ ,t =';.:!-FAIA Document G703 - 1992 Continuation Sheet _ ' 6 9 MA Document G702TM1992,Application and Certificate for Payment,or G732T'-2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, 018 APPLICATION DATE: containingContractor's signed certification is attached. 12/31/2019 $n In tabulations below,amounts are in US dollars. PERIOD TO: 12/31/2019 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C 11 I E F G _ H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % FINISH RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS NO. VALUE STORED STORED TO DATE (G=C) (C_G) (If variable rare) APPLICATION THIS PERIOD (D+E) (Not in D or E) (D+E+F) 00108 DIVISION 27 COMMUNICATION 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00109 Data/TelecommALLOWANCE 35,979.00 36,279.00 (300.001 0.00 35,979.00 100.00 0.00 0.00 00110 AV Systems ALLOWANCE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00111 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00112 DIVISION 28 ELECTRONIC SAFETY 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 90113 Access Control ALLOWANCE 39,444.00 39,444.00 0.00 0.00 39,444 00 100.00 0.00 0.00 00114 Security ALLOWANCE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00115 Alerting System-LVI 93,090.00 91,700.00 1,390.00 0.00, 93,090.00 100.00 0.00 0.00 00116 , 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00117 DIVISION 31 EARTHWORK 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0118 Sitework-ASPEN DIGGER 877,254.00 877,254.00 0.00 0.00 877,254.00 100.00 0.00 0.00 0119 Traffic Control 59,430.00 84,683.00 0.00 0.00 84,683.00 142.49 (25,253.00) 0.00 0120 Skidsteer Rent 7,251.00 15,461.00 0.00 0.00 15,461.00 213.23 (8,210.00) 0.00 121 Dewatering 3,305.00 0.00 0.00 0.00 0.00 0.00 3,305.00 0.00 0122 Foundation Exc.Misc. 7,112.00 567.00 3.00 0.00 570.00 8.01 6,542.00 0.00 0123 Rock Removal 15,444.00 724.00 0.00 0.00 724.00 4.69 14,720.00 0.00 0124 Crane Pad 3,980.00 0.00 0.00 0.00 0.00 0.00 3,980.00 0.00 00125 Backfill Misc. 1,555.00 0.00 0.00 0.00 0.00 0.00 1,555.00 0.00 00126 Erosion Control 746.00 525.00 0.00 0.00 525.00 70.38 221.00 0.00 00127 Earth Retention Design/Engineering 37,032.00 23,830.00 0.00 0.00 23,83000 64.35 13,202.00 0.00 0128 Soil Stabilization-B&Y DRILLING 62,717.00 62,717.00 0.00 0.00 62,717.00 100.00 0.00 0.00 0129 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00130 DIVISION 32 EXT.IMPROVEMENTS 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 GRAND TOTAL I CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703n,-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AIA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 101210noD44 a1 ��: Document G7031M - 1992 Continuation Sheet 7 9 ALA Document G702T1992,Application and Certificate for Payment,or G732T"_2009, APPLICATION:NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, 018 containingContractor's signed ed certification is attached. APPLICATION DATE: PERIOD TO: 12/31/2019 In tabulations below,.amounts are in US dollars. 12/31/2019 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D E I+ G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLETED AND % FINISH RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS NO. VALUE STORED STORED TO APPLICATION THIS PERIOD DATE (G+C) (C_G) (If variable rate) (D+E) (Not inDorE), (D+E+F) .)0131 Asphalt Paving-FRONTIER 145,438.00 145,438.00 0.00 0.00 145,438.00 " 100.00 0.00 0.00 00132 Asphalt Escalation 1,539.00 88.00 0.00 0.00 88.00 5.72 1,451.00 0.00 00133 Wheel Stops 2,184.00 1,920.00 0.00 0.00 1,920.00 87.91 : 264.00 0.00 00134 Trench Drains 12,627.00 12,627.00 0.00 0.00 12,627.00 100.00 0.00 0.00 '0135 Misc.Site Concrete 9,810.00 0.00 0.00 0.00 0.00 0.00 9,810.00 0.00 '0136 Pavement Markings 8,024.00 5,123.00 0.00 0.00 5,123.00 63,85 2,901.00 0.00 .0137 Site Benches 3,648.00 12,659.00 0.00 0.00 12,659.00 347.01 (9,011.00) 0.00 '0138 Landscaping&Irrigation-DEEP CRE 128,830.00 124,096.00 0.00 0.00 124,096.00 96.33 4,734.00 0.00 '0139 Landscape Patch&Repair 8,000.00 9,853.00 0.00 0.00 9,853.00 123.16 (1,853.00) 0.00 '0140 Top Soil 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 00141 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 '0142 DIVISION 33 UTILITIES 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10143 i Pothole for Utilities 1,835.00 600.00 0.00 0.00 600.00 32.70 1,235.00 0.00 ,0144 Light Pole Bases 519.00 0.00 0.00 0.00 0.00 0.00 519.00 0.00 '145 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0146 DIVISION 50 SELF PERFORM WOR 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 "147 Temp Barricades 31,774.00 28,001.00 0.00 0.00 28,001.00 88.13 3,773.00 0.00 1.148 Dust Control 7,768.00 7,645.00 0.00 0.00 7,645.00 98.42 123.00 0.00 001.49 Sound Fence 19,578.00 21,886.00 0.00 0.00 21,886.00 111.79 (2,308.00) 0.00 p0150 Snow Removal 9,019.00 12,636.00 0.00 0.00 12,636.00 140.10 (3.617.00) 0.00 0151 Protect Trees 3,571.00 2,430.00 0.00 0.00 2,430.00 68.05 1,141.00 0.00 0152 Grout 2,183.00 1,582.00 0.00 0.00 1,582.00 72.47 601.00 0.00 00153 Concrete Weather Protection 35,231.00 35,144.00 0.00 0.00.' 35.144.00 99.75 87.00 0.00 • GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703",-1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the Iavr Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org 101210nco,. ,, , ,:....--./fAIA Document G7O3TM - 1992 Continuation Sheet 8 9 AIA Document G702T"1-1992,Application and Certificate for Payment,or G732TM_2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, APPLICATION DATE: 018 containing Contractor's signed certification is attached. 12/31/2019 In tabulations below,amounts are in US dollars. PERIOD TO: 12/31/2019 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D E F G H - I WORK COMPLETED MATERIALS TOTAL ITEM SCHEDULED PRESENTLY COMPLETED AND % BALANCE TO RETAINAGE NO. DESCRIPTION OF WORK FROM PREVIOUS STORED STORED TO DATE (G_C) FINISH VALUE APPLICATION THIS PERIOD (C_G) (If variable rate) (D+E) (Not inDorE) (D+E+F) C0154 Masonry Weather Protection 15,218.00 15,016.00 0.00 0.00 15,016.00 98.67 202.00 0.00 d0155 Scaffolding&Stairs(Temp) 7,540.00 7,395.00 0.00 0.00 7,395.00 98.08 145.00 0.00 160156 Structural Safety Railings(Temp) ,027.00 4,953.00 0.00 0.00 4,953.00 82.18 1,074.00 0.00 157 Rough Carpentry 27,138.00 29,835.00 5,550.00 0.00 35,385.00 130.39 (8,247.00) 0.00 0158 Roof Fascia/Blocking 13,339.00 21,592.00 0.00 0.00 21,592.00 161.87 (8,253.00) 0.00 0159 interior Wall Blocking 13,165.00 16,408.00 0.00 0.00 16,408,00 124.63 (3,243.00) 0.00 0160 Misc.Finish Carpentry 6,342.00 18,755.00 0.00 0.00 18,755.00 295.73 (12,413.00) 0.00 0161 Roofy Safety 2,964.00 2,682.00 0.00 0.00 2,682.00 90.49 282.00 0.00 o162 Weather Protection Misc. 5,214.00 10,321.00 0.00 0:00 10,321.00 197.95 (5,107.00) 0.00 r 00163 Fireproofing 4,223.00 1,698.00 0.00 0.00 1,698.00 40.21 2,525.00 0.00 0164 Openings Weather Protection 7,411.00 20,375.00 0.00 0.00 20,375.00 274.93 (12,964.00) 0.00 0165 Doors&Hardware Install 16,924.00 20,138.00 0.00 0.00 0.00 20,138.00 118.99 (3,214.00) 0.00 0166 Doors&Hardware Materials 52,225.00 53,192.00 (270.00) 52,922.00 101.33 (697.00) 0.00 0.00 0ts7 Access Doors 2,802.00 0.00 0.00 0.00 0.00 0.00 2,802.00 0168 �FloorProtection 16,512.00 21,952.00 0.00 0.00 21,952.00 132.95 (5,440.00) 0.00 0109 'Floor Grates 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0170 Misc.Specialties/Fire Extinguishers 3,636.00 3,703.00 0.00 0.00 3,703.0D 101.84 (67.00) 0.00 0171 Appliances (4,197.00) 662.00 0.00 0.00 662.00 -15.77 (4,859.00) 0.00 0172 Self-Perform Work Fee 41,709.00 45,326.00 (34.00) 0.00 45,292.00 108.59 (3,583.00) 0.00 0173 . 0.00 0.00 0.00 0.00 0,00 0.00 0.00 0.00 174 DIVISIONS 90,95,99 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 175 Builders Risk Insurance 5,292.00 4,286.00 0.00 0.00 4,286.00 80.99 1,006.00 0.00 0176 General Liability Insurance 43,548.00 43,509.00 20.00 0.00 43,529.00 99.96 19.00 0.00 GRAND TOTAL CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G703" -1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This AIA®Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this AlA®Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 101210Aco44 tAIA Document G703TM - 1992 Continuation Sheet 9 9 AIA Document G702TM-1992,_Application and Certificate for Payment,or G732TM-2009, APPLICATION NO: Application and Certificate for Payment,Construction Manager as Adviser Edition, 018 containing Contractor's signed certification is attached. APPLICATION DATE: 12/31/2019 In tabulations below„amounts are in US dollars. PERIOD TO: 12/31/2019 Use Column I on Contracts where variable retainage for line items may apply. ARCHITECT'S PROJECT NO: 10-17-033 A B C D E F G H I WORK COMPLETED MATERIALS TOTAL BALANCE TO ITEM SCHEDULED PRESENTLY COMPLEI'hD AND % RETAINAGE DESCRIPTION OF WORK FROM PREVIOUS FINISH NO. VALUE STORED STORED TO DATE (G_C) APPLICATION THIS PERIOD (C_G) (If variable rate) (D+E) (Not inDorE) (D+E+F) 00177 Bond 40,431.00 38,511.0(51 0.00 0:00 38,511.00 95.25 1,920.00 0.00 00178 Contractor Contingency 43,637.00 0.00 0.00 0.00 0.00 0.00 43,637.00 0.00 00179 Fee 354,908.00 352,865.00 2,043.00 0.00 354,908.00 1.0.0.00 0.00 0.00 00180 Preconstruction Services 11,500.00 11,500.00 0.00 0.00 11,500.00. 100.00 0.00 0.00 00189 Amendment L(Contract to Actual) (18,850.00) 0.00 0.00 0.00 0.00 0.00 (18,850.00) 0.00 GRAND TOTAL 7,235,907.00 7,213,192.00 22,715.00 0.00 7,235,907.00 100.00 0.00 0.00 CAUTION:You should sign an original AIA Contract Document,on which this text appears in RED.An original assures that changes will not be obscured. AIA Document G7O3TM'—1992.Copyright©1963,1965,1966,1967,1970,1978,1983 and 1992 by The American Institute of Architects.All rights reserved.WARNING:This Ale Document is protected by U.S.Copyright Law and International Treaties.Unauthorized reproduction or distribution of this Ale Document,or any portion of it,may result in severe civil and criminal penalties,and will be prosecuted to the maximum extent possible under the law.Purchasers are permitted to reproduce ten(10)copies of this document when completed.To report copyright violations of AIA Contract Documents,e-mail The American Institute of Architects'legal counsel,copyright@aia.org. 101210 CD„ Docu 5i ,. SECURED Certificate Of Completion Envelope Id:0CAA96EAA806446C9D3998580573FE86 Status:Completed Subject: FCI Constructors, Inc. I Pitkin County Change Order 181.2018 L for Review and Signature Source Envelope: Document Pages: 14 Signatures:2 Envelope Originator: Certificate Pages:5 Initials:0 Pitkin County Procurement AutoNav: Enabled 530 East Main Street Envelopeld Stamping: Disabled Suite 203 Time Zone: (UTC-07:00)Mountain Time(US&Canada) Aspen,CO 81611 Procurement@PitkinCounty.com IP Address:65.38.144.66 Record Tracking Status:Original Holder:Pitkin County Procurement Location: DocuSign 1/9/2020 3:23:31 PM Procurement@PitkinCounty.com Signer Events Signature Timestamp Rich Englehart ° 59 tlbyy I Sent: 1/9/2020 3:26:06 PM Rich.Englehart@PitkinCounty.com rick ftAltt'' vn� Viewed: 1/9/2020 9:32:39 PM Deputy County Manager 2783c44890724F1... Signed: 1/9/2020 9:32:54 PM Pitkin County Security Level: Email,Account Authentication Signature Adoption: Pre selected Style (None) Using IP Address: 174.209.28.187 Signed using mobile Electronic Record and Signature Disclosure: Accepted:6/13/2019 1:11:19 PM ID:9e 1 c1 f04-8bdf-4c85-aa77-fe0d5af72270 Company Name:Pitkin County,Colorado Jon Peacock c—Dausiyned b: Sent: 1/9/2020 9:32:57 PM Jon.Peacock@PitkinCounty.com Viewed: 1/16/2020 4:16:03 PM County Manager �DEE3 e°ao,aeaas Signed: 1/16/2020 4:18:05 PM Pitkin County Security Level: Email,Account Authentication Signature Adoption: Drawn on Device (None) Using IP Address:65.38.144.66 Signed using mobile Electronic Record and Signature Disclosure: Accepted:6/12/2019 9:29:00 AM ID:917e30ed-8186-40bf-b2f9-0336f129484c Company Name:Pitkin County,Colorado In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Carbon Copy Events Status Timestamp Pitkin County Procurement COPIED Sent: 1/16/2020 4:18:08 PM procurement@pitkincounty.com Resent: 1/16/2020 4:18:16 PM Procurement Viewed: 1/17/2020 10:33:24 AM Pitkin County Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Accepted:6/21/2019 11:35:47 AM ID:f4b0c7d5-e378-4bad-8806-08d16f6ff44c Company Name:Pitkin County,Colorado Accounts Payable COPIED Sent: 1/16/2020 4:18:11 PM AP@pitkincounty.com Accounts Payable Pitkin County Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Brian Young COPIED Sent: 1/16/2020 4:18:13 PM BYoung@fciol.com Project Manager FCI Constructors, Inc. Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 1/16/2020 4:18:13 PM Certified Delivered Security Checked 1/16/2020 4:18:13 PM Signing Complete Security Checked 1/16/2020 4:18:13 PM Completed Security Checked 1/16/2020 4:18:13 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on:6/11/2019 12:14:06 PM Parties agreed to:Rich Englehart,Jon Peacock,Pitkin County Procurement ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, Pitkin County(we, us or Pitkin County)may be required by law to provide to you certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically when we send you documents for electronic signature. Acknowledging your Access, Intent, and Consent to Receive and Sign Materials Electronically To confirm that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you,please verify that you were able to read this electronic disclosure and that you also were able to print on paper or electronically save this page for your future reference and access or that you were able to e-mail this disclosure and consent to an address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receive notices and disclosures exclusively in electronic format on the terms and conditions described above,please let us know by clicking the 'I agree' button below. By checking the 'I Agree' box, I confirm that: • I am establishing my intent to be bound to the transaction, and indicating that I am fully aware of the purpose for which the signature is being provided. • I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and • I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for for future reference and access; and • Until or unless I notify Pitkin County as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgements, and other documents that are required to be provided or made available to me by Pitkin County during the course of my relationship with you. Signing Documents without a Pitkin County DocuSign Account: Pitkin County may not require all document signers to be authorized users of the Pitkin County DocuSign Account. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the 'I agree'button at the bottom of this document. When you don't have a DocuSign Account, you will be provided the opportunity to agree to the Legal Disclosure each time you open an "envelope" for signing, at this time, you can download and retain this disclosure. Pitkin County will forward completed documents that you've reviewed, processed or signed via email. Should you require copies of these signed documents (e.g., if they get deleted from your email account) you should request those documents from Pitkin County under the Colorado Open Records Act by contacting the Pitkin County custodian who sent you the document for signature. Signing Documents with a Pitkin County DocuSign Account: Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions,please confirm your agreement by clicking the 'I agree'button at the bottom of this document. Getting paper or electronic copies At any time, you may request from us a paper or electronic copy of any record provided or made available electronically to you by us. For such copies, as long as you are an authorized user of the DocuSign system you will have the ability to download and print any documents we send to you through your DocuSign user account for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper or electronic copies of any such documents from our office to you, you may be charged a per-page fee. You may request delivery of such paper or electronic copies from us by following the procedure described below. Withdrawing your consent If you are an authorized DocuSign Account holder, you can decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. Described below is the process for informing us of your decision to receive future notices and disclosure in paper format and also how to withdraw your consent to receive notices and disclosures electronically. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign'Withdraw Consent' form on the signing page of your DocuSign account. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use your DocuSign user account to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through your DocuSign user account all required notices, disclosures, authorizations, acknowledgments, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process,please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. How to contact Pitkin County: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by email send messages to: susan.sullivan@pitkincounty.com To advise Pitkin County of your new e-mail address To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must send an email message to us at susan.sullivan@pitkincounty.com and in the body of such request you must state: your previous e-mail address, your new e-mail address . In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected in your DocuSign account by following the process for changing e-mail in DocuSign. To request paper or electronic copies from Pitkin County To request delivery from us of paper or electronic copies of the notices and disclosures previously provided by us to you electronically, you should request those documents from Pitkin County under the Colorado Open Records Act by contacting the Pitkin County custodian who sent you the document for signature. . To withdraw your consent with Pitkin County To inform us that you no longer want to receive future notices and disclosures in electronic format you may: i. decline to sign a document from within your DocuSign account, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an e-mail to susan.sullivan@pitkincounty.com and in the body of such request you must state your e-mail, full name, Postal Address, telephone number, and account number.