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HomeMy WebLinkAboutC2013-051 - 2/13/2013 - NACITY OF CORPUS CHRISTI RECEIVED AMENDMENT NO.4 TO CONTRACT FOR .IAN 2 9 P.M. `3 PROFESSIONAL SERVICES• The City of Corpus Christi, Texas hereinafter called "CITY', and Freese and Nichols. Inc. hereinafter called "ENGINEER," agree to the following amendment to the Contract for Professional Services for Spillway Radial Gates Repair (Project No. 8411) as authorized and amended by: Ori inal AIE Agreement February 11, 2003 Motion M2003 -055 $181,582.00 Amendment No. 1 December 14, 2004 Motion M2004445 $314,450.00 Amendment No. 2 June 5, 2006 Administrative $25,000.00 Amendment No. 3 May 29, 2007 Motion M2007 -141 65,000.00 EXHIBIT "A ", SECTION 1. SCOPE OF SERVICES shall be amended as specified in the attached Amendment No. 4 Exhibit "A ". EXHIBIT "A ", SECTION 3. FEES shall be amended as specified in the attached Amendment No. 4 Exhibit "A" Summary of Fees, for a revised fee not to exceed $47,277.00 (Forty -Seven Thousand Two Hundred Seven -Seven Dollars and Zero Cents ), for a total restated fee not to exceed $633.309.00 (Six Hundred Thirty -Three Thousand Three Hundred Nine Dollars and ,Zero Cents) Monthly invoices shall be submitted in accordance with Exhibit "B All other terms and conditions of the February 11, 2003 contract and any amendments between the City and Engineer will remain in full force and effect. CITY OF CORPUS CHRISTI Q 2a i 3. 1 — L - Oscar R. Martinez, Date Assistant City Manager RECOMMENDED Il-,-s Q=A20;��� Daniel Biles, P.E., Date Dir or f En eeri a Services T7E ND NICHOLS, INC. 1 - - 13.13 Ron Gu man, .E., Date Vice President 800 North Shoreline Boulevard Suite 160ON Corpus Christi, Texas 78401 (361) 561 -6500 Office (361) 561 -6501 Fax Operating' Departmfent ( ') Date APPRO D AS TO FORM Office of Management Date and Budget 2013 -051 2113113 ITER'0411 SPILLWAY RADIAL GATES REPAIMAMENDMENT NO. 41CONTRACT.DOCX Freese and Nichols Inc. AMEND. NO.4 Pagel of 2 wnrym ATTEST Armando Chapa, City Sec tary Project No: 8411 Fund Source No: 530000 -4010 -30210 -8411 Fund Source Name: Water Fund Encumbrance No: � �� "�13 JAN 2 3 2013 CONT UI M ANAGER AMEND. NO.4 Pa e2of2 K %ENGINEERING DATAEXCHANGEUENNIFERIWATEMB411 SPILLWAY RADIAL GATES REPAIRXAMENDMENT NO.4ICONTRACT.DOCX EXHIBIT "A" CITY OF CORPUS CHRISTI, TEXAS CHOKE CANYON DAM — SPILLWAY RADIAL GATES REPAIR PROJECT NO, 8411 1. SCOPE OF SERVICES A. Basic Services 1. PRELIMINARY DESIGN SERVICES: a. Project Management Establish schedule, coordinate information between FNI and the City of Corpus Christi (City), and other efforts in support of this project. Coordinate Quality Control (QC) /Quality Assurance (QA) by Senior Management and Technical Staff consistent with FNI's established internal quality review processes. Coordinate conference calls for internal kickoff meeting, client kickoff meeting, and progress meetings. Coordinate one (1) site visit to the dam to meet with City staff and conduct physical/visual inspections of the spillway gates. b. Document Review Review and evaluate pertinent information regarding the spillway and spillway gates associated with Choke Canyon Dam. Information not already acquired shall be provided by the City in electronic form (PDF, Word, Excel, or AutoCAD formats). Information to be reviewed includes: a) Plans for construction of the spillway and spillway gates b) Most recent Comprehensive Facility Review c) Recent Inspection Reports d) Existing records of coatings e) Current Operation and Maintenance Manual f) Current Gate Operation Plan Additional information to review, as available, specific to the gates, includes: • Original design criteria and calculations • Manufacturers shop drawings and data for fabrication and construction of the spillway gates AM 4 E"A" Pf 8 • Designer's operating criteria • Operation and maintenance manuals, records and logs • Periodic inspection reports • Design and fabrication drawings for the spillway gate stoplogs c. Spillway Gate Inspection At the start of the inspection, participate in meeting at the site with City staff familiar with the design, construction, operation and maintenance of the spillway and spillway gates and discuss any historical performance, behavior or problems with the gates and gate operations. Following the meeting, set up for and perform a climbing inspection of one of the seven spillway tainter gates, including the upstream skinplate and downstream side. It is understood that at this time, the reservoir water surface is below the bottom of the gates such that the entire upstream face of the gates can be observed from the upstream side of the ogee crest. The examination of the gates will be performed by engineers with proper climbing equipment to access downstream portions of the gate. We will perform a visual examination of the condition of structural members and connections, as well as inspect the stoplog slots. The upstream and downstream faces of the remaining six gates will be visually inspected from the bridge deck and ogee. Based on the detailed inspection of one gate, attention by means of visual observations will be given to similar areas of disrepair in the remaining gates. An examination plan, including an examination form with checklists for the gates will be prepared prior to the inspection for use in the field for the evaluation and documentation of the various structural members and components. During the field examination, primary focus will be on the condition of gate coating systems. In addition, structural members, plates, connections, and side and bottom seals will be visually examined and photographed and conditions will be recorded. The depth and extent of visible corrosion will be estimated and documented. In addition, the existing stoplog slots will be examined and conditions will be documented. Any significant deficiencies or deterioration observed during the course of the inspection will immediately be brought to the attention of City personnel. It is estimated that the inspection will take two days. E D. NO.4 BIT "A" 2of8 The following specific tasks will be performed during the examination of the spillway gates. 1. Visually evaluate the skin plate for corrosion on the upstream face and at skin plate joints, cracked or broken welds, and damage due to floating debris. 2. Evaluate cable- bearing areas by looking for excessive wear, corrosion or section loss. 3. Evaluate the cables and lifting bracket assemblies by looking for section loss and corrosion, as well as the condition of welds. 4. Evaluate gate arms and bracing members by looking for corrosion along members and at connections and any evidence of water standing on members due to missing or clogged drain holes. Visually inspect welds for cracks and corrosion. Visually inspect bolts for corrosion and tightness. If any extensive corrosion is found, ultrasonic nondestructive testing may be recommended to measure the thickness. 5. Observe the condition of side and bottom seals and check for wear, damage or weathering and loose or missing connection bolts. Check side seal plates for nicks, corrosion, pitting or wear. Visually observe sill beam and check for deterioration of grout adjacent to the sill plate, nicks, corrosion, pitting or wear of the top flange. 6. Evaluate conditions of paint and coatings based on observed conditions of member surfaces. Take paint sample and submit to certified lab for testing. 7. Observe and evaluate condition of stoplog slots. d. Inspection Report Following completion of the inspection, prepare a draft inspection documenting the examination findings and conditions of the spillway gates and stoplog slots. Specific tasks will include the following: AMEND. NO.4 EXHIBIT `°A" Page 3 of 8 1. Develop summary of field observations and data collected. 2. Identify areas or components that need maintenance, repair, adjustment or modification. 3. Identify components that need to be replaced or renewed. 4. Prepare a draft report that will include: • Executive Summary • Field inspection notes and photographs • List and summary of data collected, reviewed and evaluated • Summary and results of examination of spillway gates and stoplog slots Conclusions and recommendations • Preliminary opinions of probable project costs • Appendices (photographs and examination forms) 5. Submit five (5) copies of the draft report to the City for review and schedule a conference call to discuss the findings, conclusions and recommendations. 6. Incorporate comments from the City and prepare and submit five (5) hard copies and one (1) electronic copy in PDF format (contained on a CD or flash drive) of the final report. Deliverables will include the following: A draft and final report documenting the observations and findings from the inspections, and conclusions and recommendations for rehabilitation and maintenance with associated cost estimates. It is understood that the City's desire is to expedite these services to take advantage of the lowered lake conditions to facilitate the inspection and to obtain favorable construction pricing. We are available to perform this work as soon as the City is able to issue a notice to proceed. n O. . N4 IT "A" 4of8 City will provide the following to FNI: 1. Coordinate participation of staff for project meetings and notify all parties of the time and place of the meeting; 2. Provide access to the facilities to be inspected; 3. Provide copies of all available historic documents and drawings as requested for examination by FNI; 4. Provide copies of all available reports, appendices, and other pertinent documents; 5. Schedule conference calls and provide for notice of the time and method of connection to all parties; 6. Attend scheduled meetings; 7. Receive and review all critiques, comments, and reports submitted by FNI; 8. Operate hoists and gates for inspection of bottom seal and gate sill; 9. Distribute copies of draft documents to City staff for review and comment. 2. SCHEDULE A. A/E will provide Basic Services within two weeks of receiving Notice to Proceed. 3. FEES A. Fee for Basic Services. The City will pay the A/E a fixed fee for providing for all "Basic Services" authorized as per the table below. The fees for Basic Services will not exceed those identified and will be full and total compensation for all services outlined in Section 1.A.1 -4 above, and for all expenses incurred in performing these services. For services provided in Section 1.A.14, A/E will submit monthly statements for basic services rendered. In Section 1.A.1 -3, the statement will be based upon AIE's estimate (and City concurrence) of the proportion of the total services actually completed at the time of billing. For services provided in Section 1.A.4, the statement will be based upon the percent of completion of the construction contract. City will make prompt monthly payments in response to AIE's monthly statements. B. Fee for Additional Services. For services authorized by the Director of Engineering Services under Section 1.13. "Additional Services" the City will pay the A/E a not -to- exceed fee as per the table below. L O 4 . N. IT "A" 5of8 CHOKE CANYON DAM IMPROVEMENTS PROJECT NO. 8407, 8408, 8409, 8521, 8411, 8520 SUMMARY OF FEES M = M Z �Wv o a a , ; 0 ORIGINAL CONTRACT AMENDMENT NO.1 Part 1 Part 2 Part 3 Total Part 1 Part 2 Part 3 Total River Outlet Works Repair (Concrete Damage Chute Repair & Buoy Line) (8407) Site Imps.: Trash Rack Repair (8408) Site imps.: Alarm Level Alarm Instal (8409} Spillway Radial Gates Repalr (8411) River Outlet Works Repair (Concrete Damage Chute Repair & Buoy Line) (8407) Site Imps.: Trash Rack Repair (8408) Site Imps.: High Instal Alarm nstal {8409} Site Imps.: Conduits Protective Coating (8521) Spillway Radial Gates Repair (8411) Gate Hoist Protective Coating Replace (8520) BASIC SERVICES 1 Preliminary Phase $28,990.00 $21,039.00 $1,500.00 TBD $51,529.00 $0.00 $0.00 $0.00 $0.00 TBD $0.00 $0.00 2 Design Phase 0.00 0.00 0.00 TBD 0.00 39,300.00 18,200.00 4,200.00 14,800.00 TBD 33,400.00 109,900.00 3 Bid Phase 0,00 0.00 0.00 TBD 0.00 6,150.00 6,100.00 2,590.00 0.00 TBD 6,100.00 20,850.00 4 Constriction Phase 0.00 0.00 0.00 TBD 0.00 9,550.00 0.00 1,300.00 0.00 TBD 9,550.00 20,400.00 Subtotal Basic Services 28,990.00 21,039.00 1,500.00 TBD 51,529.00 55,000.00 24,300.00 8,000.00 14,800,00 TBD 49,050.00 151,150.00 ADDITIONAL SERVICES 1 TopographicJStruetural Survey 22,473.00 0.00 0.00 TBD 22,473.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 2 Flood Damage Assessment 17,744.00 0.00 0.00 TBD 17,744.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 3 Hydraulic Modeling 55,222.00 0.00 0.00 TBD 55,222.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 4 Corrosion Field investigation/Testing 9,184,001 12,214.00 0.00 TBD 21,398.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 5 Underwater Topographical Survey 0,001 13,216.00 0.00 TBD 13,216.00 0.00 0.00 0.00 0.00 TBD 0.01 0.00 6 Assist USBR with Field Tests, Diving Services 0.00 0.00 0.00 TBD 0.00 13,220.00 0,00 0.00 0.00 TBD 0.00 13,220.00 7 Coordinate with USBR on Deflector Design 0100 0.00 TBD 0.00 10,130.00 0.00 0.00 0.00 TBD 0.00 10,130.00 8 Construction Observation Services 0.00 0.00 0.00 TBD 0.00 17,000.00 20,590.00 0.00 0.00 TBD 16,100.00 53,600.00 9 AssembliestCommission Cathodic Protection System 0.00 0.001 0.00 TBD 0.00 0.00 11,250.00 awl 0.00 TBD 0.001 11,250.00 10 SCADA Services 0.00 0.00 0.00 TBD 0.00 0.00 0.00 8,600.00 0.00 TBD 0.00 8,600.00 11 Diving 0100 0.00 0.00 TBD 0.00 0,00 25,000.00 0.00 0.00 TBD 0.00 25,000.00 12 Lead Abatement Engineering 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 TBD 7,150.00 7,150.00 13 Coatings Inspection 0.00 0.00 0.00 TBD 0.00 0,00 0.00 0.00 0.00 TBD 19,40D.00 19,400.00 14 Pipe Lining Repair Demonstration 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 14,950.00 TBD 0,00 14,950.00 15 Trash Rack Bolts 0.001 0.00 0.00 TBD 0.00 0100 0.00 0.00 0.00 TBD 0.00 0.00 Subtotal Additional Services 104,623.001 25,430.00 0.00 TBD 130,053.00 40,350.00 56,750.00 8,600.. 01 14,950.001 TBD 1 42,(350,01)1 163,300.00 TOTAL FEE $133,613.0ol $46,469.001 $1,500.00 TBD $181,582.00 $95,350.001 $81.050,001 $16,600.001 $29,750.001 TBD 1 $91,700.014 $314,450.00 02/11103 M2003.055 12114104 M2004 -445 M = M Z �Wv o a a , ; 0 CHOKE CANYON DAM IMPROVEMENTS PROJECT NO. 8407, 8408, 8409, 8521, 8411, 8520 SUMMARY OF FEES X X Z C Fo Z 0 z C a0 �46 AMENDMENT NO.2 AMENDMENT NO.3 Part 7 Part 2 Part 3 Total Part 1 Part 2 Part 3 Total " River Outlet Works Repair (Concrete Damage Chute Repair & Buoy Line) (8407) Site Im Imps... p Trash Rack Repair (8408) Site Imps.: High Level Alarm Instal (8409) Site Imps.: Conduits Protective Coating (8521) Spillway Radial Gates Repair (8411) Gate hoist Protective Coating Replace (8520) River Outlet Works Repair (Concrete Concrete Damage Chute Repair & Buoy Line) (8407) Site Imps.: Trash Rack Repair (8406) Site Imps.: Level Alarm Instal (8408) site Imps.: Conduits Protective Coating (8521) Spillway Radial Gates Repair (8411) Gate Hoist Protective Coating Replace (8520) BASIC SERVICES 1 Prelimina Phase $0.00 $0.00 $0.00 $0.00 TBD $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TBD $0.00 $0.00 2 Design Phase 0.00 0,00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 3 Bid Phase 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 4 Construction Phase 0.00 0.00 0.00 0.00 TBb 0.00 0.00 0,00 0.00 0.00 0.00 TBD 0.00 0.00 Subtotal BasicServ[ces 0.00 0.00 0,0GI 0.00 TBD 0.00 0.00 0.00 0.00 0.001 0.00 TBD 1 0.00 0.00 ADDITIONAL SERVICES 1 TopographiGStructural Survey 0,00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 2 Flood Dama a Assessment 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 3 Hydraulic Modeling 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 4 Corrosion Field Investigationfresting 0.00 0.00 0.00 0.00 TBD 0,00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 5 Underwater Topographical Survey 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 6 Assist USER with Field Tests, Diving Services 0.00 0.00 0.00 0.00 TBD 0100 0.00 5,000.00 0.00 0.00 0.00 TBD 0.00 5,000.00 Coordinate with USER on Deflector Design 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 B lCon struction Observation Services 0.00 0.00 0.00 0.00 TBD 0.00 0.00 10,000.00 0.001 0.00 0.00 TBD 0.00 10,000.00 g A Cathodic Protection System 0.00 0.00 0.001 0.00 TBD 0.001 0.00 0.00 10,000.00 0,00 0.00 TBD 0.00 10,000.00 10 ISCADA Services 0.00 0.00 25,000.00 0.00 TBD 0.00 25,000.00 0.00 O.OD 0.00 0.00 TBD 0.00 0.00 11 Diving 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TEO 0.00 0,00 12 Lead Abatement Engineering 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.00 0.00 TBD 0.00 0.00 13 Coatings Inspection 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.00 0.001 0.00 TBD 0.00 0.00 14 Pipe Lining Repair Demonstration 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 0.0D 0.00 0.00 TBD 0.00 0.00 15 Trash Rack Bolts 0.00 0.00 0.00 0.00 TBD 0.00 0.00 0.00 40,000.00 0.00 0.00 TBD 0.00 40,000.00 Subtotal Additional Services 0.001 0.00 25,000.00 0.00 TBD 0.00 25,000.00 15,000.00 50,000.00 0.00 0.00 TBD 0.00 65,000.00 TOTAL FEE $0.001 $0,001 $25,000.001 $0.00 TBD 1 $0.001 $25,000.00 $15,000.001 $50,000.00 $0.00 $0.00 TBD $0.001 $65 ,0oo.vv 06/05/06 Administrative Approval 05/29/07 M2007 -141 X X Z C Fo Z 0 z C a0 �46 CHOKE CANYON DAM IMPROVEMENTS PROJECT NO. 8407, 8408, 8409, 8521, 8411, 8520 SUMMARY OF FEES = M Z � W 0 i '�P 00 AMENDMENT NO.4 TOTAL REVISED FEE Part 1 Part 2 Part 3 Total Part 1 Part 2 Part 3 Total River Outlet Works Repair (Concrete Damage Chute Repair & Buoy Line) (8407) Site Imps.: Trash Rack Repair (8408) Site Imps.: High Level Alarm Instal (8409) Site Imps.: Conduits Protective Coating (8521) Spillway Radial Gates Repair (8411) Gate Hoist Protective Coating Replace (8520) River Outlet Works Repair (Concrete Damage Chute Repair & Buoy Line) (8407) Site Imps.: Trash Rack Repair (8408) Site Imps.: High Level Alarm Instal (8409) Site Imps.: Conduits protective Coating (8521) Spillway Radial Gates Repair (8411) Gate Hoist Protective Coating Replace (8520) BASIC SERVICES 1 Pfelimina Phase $0.00 $0.00 $0.00 $0.00 $47,277.00 $0.00 $47,277.00 $28,990.00 $21,039.00 $1,500.00 $0.00 $47,277.00 $0.00 $98,806,00 2 Design Phase 0,00 0,00 0.00 0.00 0.00 0.00 0.00 39,300.00 18,200.00 4,200.00 14,800.00 0.00 33,400.00 109,900.00 3 Bid Phase 0.00 0.00 0.00 0.00 0.00 0.00 0.00 6,150.00 6,100.00 2,500.00 0.00 0.00 8,100.00 20,850.00 4 Construction Phase 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9,550.00 0.00 1,300m 0.00 0.00 9,550.00 20,400.00 Subtotal Basic Services 0.00 0.00 0.00 0.001 47,277.00 0.00 47.277.001 83,990.00 45,339.00 9,500.00 14,800.00 47.277,001 49,050.00 249,956.00 ADDITIONAL SERVICES 1 To DgraphiclStructural Survey 0.00 0.00 0.00 0.00 0100 0.00 0.00 22,473.00 0.00 0.00 0.00 $0.00 0.00 22,473.00 2 Flood Damage Assessment 0.00 0.00 0.00 0.00 0.00 0.00 0.00 17,744.00 0100 0.00 0.00 $0.00 0.00 17,744.00 3 Hydraulic Modelin 0.00 0.00 0.00 0.00 0.00 DAD 0.00 55,222.00 0.00 0.00 0.00 $0.00 0.00 55,222.00 4 Corrosion Field Investigation/Tesling 0.00 0.00 0.00 0.00 0.00 0.00 0.00 9,184.00 12,214.00 0.00 0.00 $0.00 0.00 21,398.00 5 Underwater Topographical Survey 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 13,2116.01) 0.00 0.00 $0.00 0.00 13,216.00 6 Assist USBR with Field Tests, Diving Services 0.00 0.00 0.00 0.00 0.00 0.00 0.00 18,220.00 0.00 4.00 0.00 $0.00 0,00 16,220.00 7 Coordinate with USBR on Deflector Design 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10,130.00 0.00 0.00 0.00 $0.00 0.00 10,130.00 8 JCGnstructlen Observation Services 0.00 0.00 0,00 0.00 0.00 0.00 0.00 27,000.00 20,500.00 0.00 0.00 $0.00 16,100.00 63,600.00 g AssemblieslCommission Cathodic Protection System 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 21,250.00 0,00 0.00 $0.00 0.00 21,250.00 10 SCADA Services 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 33,600.00 0.00 $0.00 0.00 33,600.00 11 Diving 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 25,000.00 0,00 0.00 $0.00 0.00 25,000.00 12 Lead Abatement Engineering 0.00 1).Ool 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 7,150.00 7,150.01) 13 Coatings Inspection 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 $0.00 19,40D.00 19,400.00 14 Pipe Lining Repair Demonstration 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 14,950.00 $0.00 0.00 14,950.00 15 I Trash Rack Bolts 0.00 0.00 0.00 D.00 0.00 0.00 0.00 0.00 40,000.00 0,00 0.00 $0.00 0.00 40,000.00 Subtotal Additional Services 0.00 0.00 0.00 0.00 0.00 0.00 0.00 159,973.00 132,180.00 33,600.00 14,950.00 0.00 42,650.00 383,353.00 TOTAL FEE $0.001 $0.00 $0.13DI $0.001 $47,277.00 $0.001 47,277.00 $243.1363,OGI $177,519.001 $43,100.001 $29.750.001 $47,277.001 $91,700.00 $633,308.00 Administrative Approval = M Z � W 0 i '�P 00 M =m ( �z o - �135o Basic Services: Preliminary Phase Design Phase Bid Phase Construction Phase Subtotal Basic Services Additional Services: Permitting Warranty Phase Inspection Platting Survey 0 & M Manuals SCADA Subtotal Additional Services Summary of Fees Basic Services Fees Additional Services Fees Total of Fees COMPLETE PROJECT NAME Project No. XXXX Invoice No. 12345 Invoice Date: Sample form for: Payment Request Revised 07/27/00 Total Amount Previous Total Percent Contract Amd No. 1 Amd No. 2 Contract Invoiced Invoice Invoice Complete $1,000 $0 $0 $1,000 $0 $1,000 $1,000 100% 2,000 1,000 0 3,000 1,000 500 1,500 50% 500 0 250 750 0 0 0 0% 2,500 0 1,000 3,500 0 0 0 0% $6,000 $1,000 $1,250 $8,250 $750 '$1,500 $2,500 30% $2,000 $0 $0 $2,000 $500 $0 $500 25% 0 1,120 0 1,120 0 0 0 0% 0 0 1,627 1,627 0 0 0 0% TBD TBD TBD TBD TBD TBD TBD 0% TBD TBD TBD TBD TBD TBD TBD 0% TBD TBD TBD TBD TBD TBD TBD 0% $2,000 $1,120 $1,627 $4,747 $500 $0 $500 11% $6,000 $1,000 $1,250 $8,250 $750 $1,500 $2,500 30% 2,000 1,120 1,627 4,747 500 0 500 11 % $8,000 $2,120 $2,877 $12,997 $1,250 $1,500 $3,000 23% SUPPLIER NUMBER TO BE ASSIGNED BY Crr"Y PURCHASING DIVISION CITY OF CORPUS CHRISTI Ch&ti. DISCLOSURE OF INTEREST City of Corpus Christi Ordinance 17112, as amended, requires all persons or firms seeking to do business with the City to provide the following information. Every question must be answered. If the question is not applicable, answer with "NA ". See reverse side for Filing Requirements, Certifications and definitions. COMPANY NAME: Freese and Nichols, Inc. P. O. BOX: STREET ADDRESS: 8 00 N. Shoreline Blvd., Suite 160ON CM: Corpus Christi ZIP: 78401 FIRM IS: 1. Corporation 2. Partnership 3. Sole Owner [3 4_ Association ® 5. Other DISCLOSURE QUESTIONS If additional space is necessary, please use the reverse side of this page or attach separate sheet. 1. State the names of each "employee" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of ownership in the above named "fi m. " Name Job Title and City Department (if known) N/A NIA 2. State the names of each "official" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm" Name Title NIA N/A 3. State the names of each "board member" of the City of Corpus Christi having an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name Board, Commission or Committee N/A N/A 4. State the names of each employee or officer of a "consultant" for the City of Corpus Christi who worked on any matter related to the subject of this contract and has an "ownership interest" constituting 3% or more of the ownership in the above named "firm." Name Consultant N/A N/A FILING REQUMEMENTS If a person who requests official action on a matter knows that the requested action will confer an economic benefit on any City official or employee that is distinguishable from the effect that the action will have on members of the public in general or a substantial segment thereof, you shall disclose that fact in a signed writing to the City official, employee or body that has been requested to act in the matter, unless the interest of the City official or employee in the matter is apparent. The disclosure shall also be made in a signed writing filed with the City Secretary. [Ethics Ordinance Section 2 -349 (d)] CERTIFICATION I certify that all information provided is true and correct as of the date of this statement, that I have not knowingly withheld disclosure of any information requested; and that supplemental statements will be promptly submitted to the City of Corpus Christi, Texas as changes occur. Certifying Person: Ron Guzman, P.E. Title: Principal (Type or Prig Signature of Certifying Date: Person: DEFINITIONS a. "Board member." A member of any board, commission, or committee appointed by the City Council of the City of Corpus Christi, Texas. b. "Economic benefit". An action that is likely to affect an economic interest if it is likely to have an effect on that interest that is distinguishable from its effect on members of the public in general or a substantial segment thereof. c. "Employee." Any person employed by the City of Corpus Christi, Texas either on a full or part- time basis, but not as an independent contractor. d. "Firm." Any entity operated for economic gain, whether professional, industrial or commercial, and whether established to produce or deal with a product or service, including but not limited to, entities operated in the form of sole proprietorship, as self- employed person, partnership, corporation, joint stock company, joint venture, receivership or trust, and entities which for purposes of taxation are treated as non - profit organizations. e. "Official" The Mayor, members of the City Council, City Manager, Deputy City Manager, Assistant City Managers, Department and Division Heads, and Municipal Court Judges of the City of Corpus Christi, Texas. f. "Ownership Interest" Legal or equitable interest, whether actually or constructively held, in a firm, including when such interest is held through an agent, trust, estate, or holding entity. "Constructively held" refers to holdings or control established through voting trusts, proxies, or special terms of venture or partnership agreements!' g. "Consultant." Any person or firm, such as engineers and architects, hired by the City of Corpus Christi for the purpose of professional consultation and recommendation.