please ensure distribution to all pertinent contacts · ecs-cwp-17 – rev. june 2017 page 2 of 2...

ECS-CWP-17 – Rev. June 2017 Page 2 of 2

Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Manager Name, Title Section Name Unit Name

ECS-CWP-18 – rev. June 2017 Page 1 of 2

Sample Wording

Section Subject Sample Wording

4.7 Acceptance - Study or Pre-Design Report (formerly A18)

We acknowledge receipt of your final predesign report dated _______ for the above project. We have reviewed your predesign report with staff from Toronto Water and, with their concurrence, hereby accept your final predesign report and authorize you to proceed with the detailed design work. Should you have any questions concerning the foregoing, please contact XXX at XXXXX.

6.5.2.3 Acceptance of Proposed Construction Schedule (formerly A47)

We advise that your proposed construction schedule dated XXX for the above-mentioned project, is acceptable. Please note that an updated schedule is required for all future progress meetings. The updated schedule should reflect the actual progress of the project. The differences between the original proposed schedule and the updated schedule should be clearly identified. Should you have any questions concerning foregoing, please contact me at the above number.

8.3.1 Letter to Contractor - Correcting Deficiencies Prior to Certification of Completion (formerly A72)

We are in receipt of your letter dated ………… indicating that the deficiencies listed in our letter of (DATE) have been rectified. However, our inspection shows that the following deficiencies are not corrected:

• •

Please note that we would certify the completion of this contract when all deficiencies listed above have been corrected to the City’s satisfaction. Yours truly


, P. Eng. Manager,

8.7 Letter to Contractor – Final Acceptance (formerly A79)

The warranty period for this contract expired on (date). We advise that the contract is now considered complete and the works accepted by the City as of (date)

SCHEDULE SD-FINAL

STATUTORY DECLARATION BY THE CONSULTANT SECTION 3(5): FINAL PAYMENT

PROVINCE OF ONTARIO ) IN THE MATTER OF ) the Consulting Agreement entered into ) between the City of Toronto ) and ) dated, ,(“the Agreement”) ) and an Invoice dated, (“the Invoice”) To Wit: ) I, , of the (name) (City, Town, etc.) in the (Regional Municipality etc.) do solemnly declare that: 1. I am a senior professional engineer employed by , hereinafter referred to as the (name of Consultant) Consultant. I have personal knowledge of the facts herein set forth and, as a duly authorized representative of the Consultant, have the authority to certify as follows. 2. Attached hereto and marked as Exhibit “A” to this my declaration are true copies of statements of the Consultant as part of the Invoice addressed to City of Toronto setting forth in detail the services performed and the disbursements incurred by the Consultant during the period from the day of , 20 to the day of , 20 , and for which payment is requested. I do hereby certify that such services were performed and such disbursements were properly incurred by the Consultant pursuant to and in accordance with the provisions of the Agreement. 3. The Consultant has completed all Services (as defined in the Agreement) to be performed by the Consultant. AND I make this solemn declaration conscientiously believing it to be true and knowing that it is of the same force and effect as if made under oath and by virtue of the Canada Evidence Act. DECLARED before me at the ) ) of , in the ) ) of , this ) ) day of , 20 . ) ) )

) A Commissioner etc,

1st 2nd 3rd

Unit:

From: File # (Y):

To:

PTP #: Contract #:

Streetscaping

Sewer Construction

Watermain Construction

Watercourse

SOIP/TSLIP

Category #4 (Boundary)

Category #5 (Road Resurfacing)

Category #6 (Layout)

ENGINEERING & CONSTRUCTION SERVICES

TTC Track Allowance

Example: "Please ensure survey is from streetline to streetline and includes 30m of additional

pick up in all directions at both ends and at intersections"

Date Requested:

Sidewalk Construction

Survey Category

Requested By:

Priority:

Structure (Bridge/Tunnel/Wall)

SUL (Utilities Location)

Consultant Survey

Plant & Facility Improvements

Other

Road Resurfacing

Road Reconstruction

Proposed Scope of Work:

Additional Instructions

Survey Request Form

Requested by:

Section:

Division:

Project :

Description

Laneways

Category #1 (Topo)

Category #2 (TTC)

Category #3 (Subsurface)

Category #7 (Construction Support)

Category #8 (As-Built)

Other (See Below)

ECS-CWP-20 - rev. June 2017

ECS-CWP-21 – Rev. June 2017

Use Appropriate Director's Letterhead Title, Section Name

toronto.ca Engineering & Construction Services

Metro Hall 55 John Street, 16th Floor Toronto, Ontario M5V 3C6

Refer to: Name, Title

Tel: 416-XXX-XXXX

Fax: 416-XXX-XXXX Email: [email protected]

Month, Day, Year

Name & Title Address of Utility Company Re: Public Service Works on Highways Act Official Notice of Proposed Construction Plan #: XXXX We are writing to advise you that Engineering & Construction Services – Design & Construction Transportation Infrastructure is initiating the design and construction of: insert description of the work that may affect infrastructure owned by your company located within the City’s highway: Enter street names where work may be affected The contract for this work is tentatively scheduled to be called during the month of insert month proposed for tender. Construction is tentatively scheduled to start during the month of insert month proposed for construction. We request that you review the project limits, edit and return as-built drawings indicating all your existing and abandoned plant locations by insert date for reply. Digital CADD files would be preferred, if available. As part of your review, your operational units should conduct an inspection of all existing infrastructure to assess the condition and possible need for repairs, relocation or upgrades. The following information is required, as part of the above inspection and condition assessment of your infrastructure, no later than insert date for reply.

• Depth of cover, including horizontal and vertical alignment;

• Existing elevations of utility plant, size of duct bank;

• A determination whether maintenance holes and/or any below grade structures owned by your company will require alterations/relocations as a result of our proposed construction;

• A cost estimate of any required plant alterations/relocations;

• Existing utilities within and approximately 30 m outside of our proposed construction limits; and

• Program scheduling conflicts. If the above information is not provided by the specified date, the City will proceed with the planning and design of the project on the basis that there are no conflicts with your


infrastructure. If any conflicts are discovered during the construction stage of the project, which require the repair and/or relocation of your infrastructure, then all costs associated with the work (along with contract delay claims) will be borne solely by the Utility owner. The utility owner will have to make arrangements to complete their work after the City's project is complete and the work can be coordinated with other Capital Projects. The City reserves the right to recover from Utility Company all contract costs, including delay costs, incurred by the City as a result of any act or omission by Utility Company including a failure to provide the information requested or a failure to provide accurate information during the design phase of the project. The City will issue a work order to the Utility Owner to cover the City's share of the costs, under the cost-sharing formula set out in the Act (if applicable), for the removal or relocation of your infrastructure within the right of way, once a detailed cost estimate has been reviewed and approved. If the required alterations cannot be completed before the tentatively scheduled construction date, please inform us so that discussion can take place concerning the timing of the alterations. Should your company require the installation of additional plant, it would be advisable for this work to be completed before the proposed work commences. If you have questions regarding the preliminary drawings or require additional information please contact insert name of Design Supervisor at (416) 39X-XXXX. Please return all replies to: Engineering & Construction Services Division 55 John Street, 20th Floor, Toronto, Ont. M5V 3C6 ATTENTION: Insert name of Design Supervisor at email address Yours truly, Manager Name, Title Section Name Unit Name Encl. Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Manager Name, Title Section Name Unit Name

Work Request Form (Step 1) Date(dd-mmm-yy)

Project Information

Capital Works - Project Manager / Engineer / Senior Engineer

Date Project Assigned to PM (dd-mmm-yy)

Contract No.

Proposed Tender Date

Requested Report Date

Project Type

Street

Limits 1

Limits 2

Project length (m)

Further Project Information:

Pavement Background Information

Ex. Paving Type (composite, flexible, Unknown, other) (if Other-provide details)

asbestos (Y/N/U) (Y/N-provide source) (if U, provide pav't history)

Brick / slag / steel mesh / reinforcing / granite / other (Y/N/U) (provide details)

Cross streets impacted by construction (Y/N/U) (If Y/U, provide similar data as above)

Pavement Details (based on above response):

Geotech / Geoenv / Hydrogeo Background Information

existing geotech, geoenv, hydrogeo reports or data (Y/N/U) (if Y provide copies - prefer e-copies)

existing land uses that may be contaminant sources (Y/N/U) (If Y, provide details)

historical land uses that may be contaminant sources (Y/N/U) (if Y, provide details)

fill site (waste disposal, creek, lake, marsh, pit, quarry, old BH logs) (Y/N/U) (if Y, provide details)

Ex. or former hydroG impacts (Creek/Lakefill) (Y/N/U) (if Y, provide details)

Expected PTTW (Y/N/U) (if Y, provide details)

Geo issues (loose/weak/soft soils - fill, organic, marsh) (Y/N/U) (if Y, provide details)

Bedrock issues (shallow bedrock, deep foundation, require bedrock) (Y/N/U)( if Y, provide details)

GGH Details (based on above response):

Other Potential Testing Scope Impacts

Railway Crossing (Y/N) (if Y, Provide details)

Overpass/Undepass (Y/N) (if Y, provide details)

Ex. Vacant lands / Hydro Corridor / non-road location (Y/N)

Full EA / Schedule B or C Class EA / Master Plan Completed/Underway/Required for Project

Other Details (based on above response):

Soil and Groundwater Response

Date of Acceptance by SGQ (dd-mmm-yy)

SGQ Assigned REOI Roster Vendor:

Comments by SGQ

ECS-CWP-22 - June 2017


Construction Contract Pre-Award Checklist

Contract No.: XXXX Tender Call No.: XXXX Bidder Recommended for Award: Name of Bidder

Tender Submission Compliance ✓ / N/A

1. Tender Call Page

1.1 Signed and sealed

1.2 Acknowledgement of all addendum issued

1.3 Bidder has attended mandatory site meeting if scheduled

2. Bid Bond

2.1 Bonding company is licenced to provide surety insurance in Ontario

2.2 Amount as specified

2.3 Signed & Sealed

3. Contractor is in compliance with requirements stated in Statutory Declaration or Supplementary Statutory Declaration

4. City Policies Submission Form is properly completed

5. Pricing Form is not disqualified

6. List of Subcontractors Form is submitted where required. (Note: proof of union affiliation where applicable should be verified through Fair Wage Office)

7. Where applicable, "Experience and Qualifications" requirements

8. Where work involves electrical traffic control devices and electrical management devices, only pre-qualified sub-contractors are named in the Bid (tender document Section 2 clause 9 Electrical Items)

9. Other mandatory requirements specified by the Project Lead

Procedural Compliance

10. Confirm that bid evaluation has been completed by at least two staff members to ensure compliance of bids with mandatory requirements set out in Tender document

11. Confirmation by Project Lead or recommendation by external service provider to award the contract to the recommended Bidder

12. Confirmation of funding by clients

13. Confirmation of Fair Wage clearance

14. Letter of recommendation (if award is to be made by Chief Purchasing Official) or letter of recommendation and Bid Award Panel Composite Report (if award is to be made by Bid Award Panel)

Project Lead: Tel: XXX-XXXX Date: Month, Day, Year Contracts, Tenders & Payments, Supervisor:






Tel: 416-XXX-XXXX


Month, Day, Year

Name & Title Contractor Name Mailing Address

Att: M. XXXX

Re: Project Title Contract No. xxxxxxxx Further to our letter dated xxxxxxxx, we are writing to remind you that pursuant to the terms of your tender submission (Clause 18 of Section 1 – Tender Process Terms and Conditions), you are directed to submit the required bonds, insurance certificate, and where applicable, the Supplementary Statutory Certificate, to the City of Toronto. The City requires these documents be submitted along with the properly-executed Form of Agreement within 10 working days of the Form of Agreement being provided to you by the City for execution. The Form of Agreement was forwarded to you with the letter mentioned above. To date we have not received from you a duly executed agreement with the aforementioned documents. Could you please confirm, in writing, your intentions with respect to this matter by XXXX (allow 3 working days for response). Yours truly, Project Lead Name, Title Section Name Unit Name Please ensure distribution to all pertinent contacts cc: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Project Lead Name, Title


Section Name Unit Name

A36r1_Memo to Finance_Execution of Agreement_under $500K

Memorandum Mika Raisanen, P.Eng., PMP. Director Engineering Support Services Engineering & Construction Services

Metro Hall, 20th fl., 55 John Street, Toronto, ON M5V 3C6

Refer to: Susan Samuel, M.Eng., P.Eng., Manager Contracts, Tenders & Payments

Tel: 416-338-5538 Fax: 416-392-5418 Email: [email protected]

TO: Martin Willschick, Manager, Capital Markets Corporate Finance, 7E, City Hall Attention: Alice Fernandes Michael D'Andrea, M.E.Sc., P.Eng., Chief Engineer and Executive Director Engineering & Construction Services, 24E, City Hall Attention: Ruby Suyck

FROM: Susan Samuel, M.Eng. P.Eng., Manager, Contracts, Tenders & Payments Engineering Support Services DATE: mm/dd/yyyy SUBJECT: Execution of Contract No.: xxxxx, Tender Call No.: xxx-xxx Project Title:

Enclosed are three (3) copies of the above Contract for signatures. This contract was awarded by the Director of Purchasing & Materials Management on xxxxxxxx. (Date when Purchase Requisition is signed). All necessary approvals and legal requirements have been obtained from the successful bidder and reviewed as to terms and conditions by Engineering & Construction Services. It is now in order for all copies of this contract to be signed and sealed by the proper City of Toronto authorities. The Agreement is in accordance with the standard template developed and approved by Legal Services. By the signatures provided below, the Agreement is “Approved as to Form” certifying that no changes have been made to the standard template document and that the entire process was in compliance with the City of Toronto’s Financial Control and Purchasing By-laws. Please sign, date and forward the attached contract documents for the next level of signatures.

1. Name of Supervisor, Supervisor, Contracts, Tenders & Payments____________ Date _________________

2. M. Willschick, Manager, Capital Markets________________________________ Date _________________

3. M. D'Andrea, Chief Engineer and Executive Director, ECS__________________ Date _________________ When all three (3) copies have been signed and sealed, please return documents to [insert name], Coordinator, 20th floor, Metro Hall. Should you have any inquiries please contact (insert name of Coordinator) at (416) xxx-xxxx. Susan Samuel, M.Eng., P.Eng., Manager Contracts, Tenders & Payments Engineering Support Services SS/xx Enclosure cc: File Copy

mailto:[email protected]

A36r1_Memo to Finance_Execution of Agreement_>500K

Memorandum Mika Raisanen, P.Eng. PMP. Director Engineering Support Services Engineering & Construction Services

Metro Hall, 20th fl., 55 John Street, Toronto, ON M5V 3C6

Refer to: Susan Samuel, M.Eng., P.Eng., Manager Contracts, Tenders & Payments

Tel: 416-338-5538 Fax: 416-392-5418

Email: [email protected]

TO: Martin Willschick, Manager, Capital Markets

Corporate Finance, 7E, City Hall Attention: Alice Fernandes Michael D'Andrea, M.E.Sc., P.Eng. Chief Engineer and Executive Director Engineering & Construction Services, 24E, City Hall Attention: Ruby Suyck Ulli S. Watkiss, City Clerk 12W, City Hall Attention: Marilyn M. Toft

FROM: Susan Samuel, M.Eng. P.Eng. Manager, Contracts, Tenders & Payments Engineering Support Services DATE: mm/dd/yyyy SUBJECT: Execution of Contract No.: xxxxx, Tender Call No.: xxx-xxx Project Title:

Enclosed, are three (3) copies of the above Contract for signatures. This contract was awarded by Bid Award Panel on mm/dd/yyyy, Item No. xxxx. All necessary approvals and legal requirements have been obtained from the successful bidder and reviewed as to terms and conditions by Engineering & Construction Services. It is now in order for all copies of this contract to be signed and sealed by the proper City of Toronto authorities. The Agreement is in accordance with the standard template developed and approved by Legal Services. By the signatures provided below, the Agreement is “Approved as to Form” certifying that no changes have been made to the standard template document and that the entire process was in compliance with the City of Toronto’s Financial Control and Purchasing By-laws. Please sign, date and forward the attached contract documents for the next level of signatures.

1. Name of Supervisor, Supervisor, Contracts, Tenders & Payments____________ Date _________________

2. M. Willschick, Manager, Capital Markets________________________________ Date _________________

3. M. D'Andrea, Chief Engineer and Executive Director, ECS__________________ Date _________________

4. U. S. Watkiss, City Clerk ____________________________________________ Date _________________ When all three (3) copies have been signed and sealed, please return documents to [insert name], Coordinator, 20th floor, Metro Hall. Should you have any inquiries please contact [insert name], Coordinator, at (416) xxx-xxxx. Susan Samuel, M.Eng. P.Eng. Manager Contracts, Tenders & Payments Engineering Support Services SS/xx Enclosure cc: File Copy

mailto:[email protected]

Agenda – PRE-PAVE MEETING

<<insert meeting date>> Page 1 of 2 ECS-CWP-26 – Rev. June 2017

Meeting Information

Contract No:

Contractor:

Client:

Project Name:

Date and Time:

Location:

Meeting Participants

Meeting Participants

Meeting Chair: Project Lead

Meeting Invitees: City of Toronto Contractor Paving Subcontractor Work Zone Coordinator

Meeting Agenda The following are sample agenda topics only; discussion points may vary depending on the nature of the project. Project Lead to modify the agenda as required.

Item No.

Topic Desired Outcome Lead

Review Field Services Manual task list for paving

Review specification and specials for compliance

Discussion of paving operation:

• What type of asphalt will be placed?

• What is the required thickness?

• Confirm date and time of paving

• Weather forecast for paving day

Mix designs: have they been submitted, reviewed, and approved?

Special equipment requirements (such as shuttle buggy)

Material testing requirements

• Has core testing been done on the concrete road base to confirm thickness?

• Trial batch is required for first mix of the year

Traffic control requirements

PDO's

Meeting Agenda

<<insert meeting date>> Page 2 of 2 ECS-CWP-26 – Rev. June 2017

Item No.

Topic Desired Outcome Lead

Temporary road closing and reopening

Tack coat requirements

Have joints in concrete road base been sealed? Has this been verified?

Review joint sealant requirements for surface asphalt

Temporary asphalt ramps: which ramps are to be removed

Confirm if a check weight is required

Line markings:

• Have they been scheduled?

• Will markings be permanent or temporary?

• Note that no traffic is permitted on unmarked roadways

Has a sweeper been scheduled?

Have depressions been filled in?

Confirm with contractor that all material tickets are to be collected prior to unloading asphalt

Is gutter brick placement completed?

Are all castings set to grade?

Post-meeting:

• walk site to confirm deficiencies have been corrected

• schedule testing and ticket collection

Other business

STAN

Typewritten Text

STAN

Typewritten Text

This form is available at http://www.labour.gov.on.ca/english/hs/forms/index.php#form_0175

STAN

Typewritten Text


Order to Commence Work Checklist Date: Month, Day, Year P.O. No: XXXX File No.: XXXX Project Description: XXXX Contract No.: XXXX Note: Relevant support documents to be attached

Item Yes No N/A Remarks

1 Bonds and Insurance or Clearance from Legal Department regarding document execution

2 Building Permit (list permit numbers)

3 Ministry of Labour Notice of Project (when City is Constructor)

4 Asbestos report

5 MOECC Environmental Compliance Approval

6 Road Authority Permits / Construction Permits

7 "Permission to Enter" private lands (easements)

8 Railway or Pipeline Crossing Agreements

9 Bonding Company and Fair Wage Office approval

10 Toronto & Region Conservation Authority (TRCA)

11 Emergency Contact Information Provided to Project Lead

12 Statutory Declaration confirming contractor's policies & programs meet OSHA requirements

13 Written confirmation of receipt of Designated Substances List from General Contractor(s) and all subtrades / vendors

14 Pre-construction Meeting Minutes (attached)

Project Lead: Manager:


Use Appropriate Director's Letterhead Section Name

Engineering & Construction Services


Manager's Name, Manager

Unit Name

Tel: 416-XXX-XXXX Fax: 416-XXX-XXXX Email: [email protected] Month, Day, Year

Name & Title Contractor Name Mailing Address

Att: M. XXXX

Re: Contract No. xxxxxxxx Project Title Order to Commence Work In accordance with the terms of your contract with the City of Toronto dated Month/Day/Year, this is your official Order to Commence Work on Contract No. XXXX, Description of the work. Construction is to commence on Month/Day/Year and is to be completed by Month/Day/Year. For the purposes of the Occupational Health and Safety Act, you are designated the Constructor for this project and will assume the responsibilities of the Constructor set out in that Act and its regulations. We remind you that under the Occupational Health and Safety Act and Regulations current Safety Data Sheets must be available for all products regulated under the Workplace Hazardous Material Information System (WHMIS). You must ensure that current Safety Data Sheets are provided immediately, for all products requiring them, which are brought onto your project site by yourselves, your subcontractors and suppliers. Copies of the Safety Data Sheets must be provided to the Division Head's representative (Contract Inspector) on site as quickly as possible.

If there are any additional requirements, list them below. Sample wording follows (delete if not required): Special attention to the additional requirements: 1. STREET OCCUPATION PERMIT (obtainable by applying to Transportation

Services, Construction Activities Section, 17th Floor, Metro Hall). 2. ASPHALT AND CONCRETE MIX DESIGNS, including results, are required at least

three weeks prior to the placing of any asphalt or concrete materials.


3. Copies of utility stake-outs must be given to the Contract Inspector prior to commencing any work.

Please contact insert name of Project Lead at (416) 39X-XXXX in the event you require further information or assistance.

Yours truly, Manager Name, Title Section Name Unit Name Please ensure distribution to all pertinent contacts c: Name, Manager, Fair Wage & Labour Trades Office Name, Project Lead Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Manager Name, Title Section Name Unit Name


Month Day, Year

Contractor Name

Company Name

Address

City, Province, Postal Code

RE: Project Description

Contract No.

Order to Commence Site Work

Dear Contractor,

On behalf of the City of Toronto, Consultant Company Name as contract administrator hereby

order for you to commence site work on this contract on Month Day, Year.

The executed contract agreement for this contract has been signed by Contractor, and

received by the City of Toronto.

For this construction project, all correspondence should be directed to Consultant Name,

Contract Administrator for Consultant Company Name.

Sincerely,

Name of Consultant CA

Title

cc: City Project Lead

Consultant Company Name

[Street Address, City, ST ZIP Code]

Tel [Telephone] Fax [Fax]

[Email]

[Website]


Memorandum Name Title

City Hall Address Third line optional Toronto, Ontario XXXXXX

Tel: 416-XXX-XXXX Fax: 416-XXX-XXXX [email protected] toronto.ca

Month, Day, Year To: XXXX, Manager, Operations Contract Services XXXX, Senior Engineer, Water Supply XXXX, Manager, Toronto Water Laboratory From: Name, Title Re: Watermain Construction Project - Notification of Project Start Contract No: XXXX, Ward

This is to advise that the construction of watermain on street name from cross-street to cross-street is expected to commence on Month, Day, Year. The expected completion date is Month, Day, Year. Contacts for this project are: Project Lead: Phone No. (Office): (Cell): Inspector(s): Phone No. (Cell): General Contractor: Contract name: Address: Phone No.: Fax No.:

24-hour Contact name: Phone No. (Office): Phone No. (Cell): Home phone No.:

Watermain Contractor: Contract name: Address: Phone No.: Fax No.:

24-hour Contact name: Phone No. (Office): Phone No. (Cell): Home phone No.:

Yours Truly, Name, Manager Section Name Unit Name


Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Name, Manager Section Name Unit Name

ECS-CWP-32 – rev. June 2017


Holdback Release & Purchase Order Closure Form To: Contracts, Tenders & Payments Date:

From: Contractor / Consultant:

Contract Number: Project Location:

Project Description:

Option I – Substantial Performance / Sub-Contract Completion

Contract not yet completed

Progress payment

Contract substantially performed on

Substantial performance advertised on (copy of notice attached)

Subcontract completed on

Release of Holdback

10% under Substantial Completion Certificate (46 days after substantial performance publication)

10% of Subcontract value (Statement confirming subcontract value needed)

Owner's Set-Off (back-up documentation required) – (Special H/B)

Option II – Contract Completion

Completion of Contract – Contract was completed on

Final progress payment

Contract substantially performed on

Substantial performance advertised on (copy of notice attached)

Substantial Performance not advertised, but contract fully completed on the above date

Release of Holdback

10% under Substantial Completion Certificate (46 days after substantial performance publication)

or All outstanding under Completion Payment Certificate (46 days after the completion date)

Owner's Set-Off (back-up documentation required) – if applicable

Close out Purchase Order #

Option III

Close out Account (Requires Manager and Director Sign-off)

Project Lead Manager

CONTRACTOR NAME: Fiscal Year End:

DATE:

A: NET SALARIES PAID

$ 500.00

Taxable allowance/benefit minus $ 20.00

TOTAL A $ 480.00

B: EMPLOYEE BENEFITS

Vacation $ 100.00

Sick Leave $ 100.00

Statutory Holidays $ 100.00

Training (Professional Development Time) $ 100.00

TOTAL B $ 400.00

% 500.00

C: EMPLOYEE NON-TIME RELATED BENEFITS

Employment Insurance $

Group Life Insurance (Life, LTIP, etc.) $

Specify:

Employer Health Tax $

Group Medical Plan (Dental, etc.) $

Specify:

Workplace Safety and Insurance Board $

Contractor Pension Plan $

Canada Pension Plan $

Union Contributions $

TOTAL C $ 0.00

% 0.00

% 500.00

* I certify that this Form is completed by or under the supervision of the undersigned.

External Auditor External Auditor

Signature: Firm: Date:

Print Name:

INDIRECT LABOUR COSTS (%C)

%C = C / (A-B) x 100

% PAYROLL BURDEN

%B + %C

CONTRACTOR'S PAYROLL BURDEN FORM

DIRECT LABOUR COSTS (%B)

%B = B / (A-B) x 100

Total Salaries Paid

cwp-33-payroll-burden-vertical 1 of 1

Contractor Name:

Calendar Year From January 1, 20 To December 31, 20

A: Net Salaries Paid To All Employees

$

Taxable allowance/benefit minus $

Total A $

B: Employee Benefits (All Employees)

Vacation $

Sick Leave $

Statutory Holidays $

Training (Professional Development Time) $

Total B $

%

C: Employee Non-time Related Benefits (All Employes)

Employment Insurance $

Group Life Insurance (Life, LTIP, etc.) $

Specify:

Employer Health Tax $

Group Medical Plan (Dental, etc.) $

Specify:

Workplace Safety and Insurance Board $

Contractor Pension Plan $

Canada Pension Plan $

Union Contributions $

TOTAL C $

%

%

* I certify that this Form is completed by or under the supervision of the undersigned.

External Auditor External Auditor

Signature: Firm: Date:

Print Name:

Total Salaries Paid

Indirect Labour Ccosts (%C)

%C = C / (A-B) x 100

Payroll Burden Rate

%B + %C

Contractor's Payroll Burden Form

Direct Labour Costs (%B)

%B = B / (A-B) x 100

Page 2 of 2

Standard Rate (40%)

Option for Contractor’s Actual Payroll Burden Rate

Total Salaries Paid: refers to the total annual salaries paid during the previous 12 month calendar year of employment

with the Contractor including all allowances, holiday pay (which includes vacation pay paid to union),

and other additional compensation. Taxable Allowance and Benefit: refers to the income that the contractor pays to or provides for an employee that is personal in nature

such as, reimbursement of personal expenses, free use of property, goods or services owned by the

contractor or an allowance. Examples are, use of corporate vehicle, automobile allowance, room and

board, bonuses, gifts or awards and interest free or low interest loans.Actual Payroll Burden: means the payments in respect of the following list of items. No other items shall be included in the

calculation of the Contractor’s Actual Payroll Burden.Vacation: is the Contractor’s paid time off for vacation earned in each year calculated at salary cost (including

overtime), in accordance with the Contractor’s policy.Sick Leave: is the Contractor’s paid time off due to sickness, accident or injury or specific personal and family

issues such as bereavement leave, jury duty and similar leaves. Such paid time off is in accordance

with Contractor’s policy and calculated at salary cost.Statutory Holidays: is the Contractor’s paid time off in accordance with Ontario law and established custom.

Training: is the Contractor’s paid time for employees to maintain and increase their level of skills pertaining to

their position.Employment Insurance: is the Contractor’s portion of employment insurance premiums incurred in accordance with the

Employment Standards Act.Group Life Insurance: is the premium paid by the Contractor to employee group life and short and long term disability

insurance plans.Employer Health Tax: is the premium incurred by the Contractor for the year in accordance with the Employer Health Tax

Act of Ontario.Group Medical Plan: is the premium paid by the Contractor for group health insurance plans providing coverage of health

care costs not covered by basic government plan.Workplace Safety and Insurance

Board:

is the WSIB premium incurred by the Contractor for the year in accordance with Workplace Safety

and Insurance Act.Contractor Pension Plan: is the Contractor’s pension plan cost including the cost of funding the pension benefits earned by

employees and cost of services of third parties incurred for the pension plan. Canada Pension Plan: is the Contractor’s portion of Canada pension plan contribution incurred in accordance with the

Canada Pension Plan Act or its equivalent for non-residents.

The Owner reserves the right to terminate the application of the Contractor’s actual payroll burden rate and apply the standard 40%

payroll burden rate if the Form is found to be not accurately completed after its acceptance.

Contractor’s labour rates used in the work based on a Time and Material basis are subject to verification by the City of Toronto’s Fair

Wage Office.

All information in relation to Contractor’s Payroll Burden may be audited at the Owner’s discretion. The Contractor agrees to keep

complete and accurate books, payrolls, accounts and employment records and make the records available for audit by the Owner upon

request. The Owner reserves the right to recover any overpayment to the Contractor affected by the audit.

Payroll Burden Rate for Work on a Time and Material Basis

Definitions

Alternatively, the Owner will consider paying at the Contractor’s actual payroll burden rate. To be considered for this option, the

Contractor MUST submit their actual payroll burden rate on the Owner’s prescribed Contractor’s Payroll Burden Form ("Form") prior to

the commencement of any work on a Time and Material basis, preferably at the pre-construction meeting.

The Owner will pay the Contractor’s Payroll Burden at a standard 40% of the wages and salary portion of the Cost of Labour for change

in the work in the Contract that is carried out on a Time and Material basis.

The Form is available from the Contract Administrator upon request and it shall be completed, certified and signed by the Contractor’s

external auditor. The Payroll Burden rate shall be calculated from the total expenditures of wages, salaries and benefits for all of the

Contractor's employees paid during the previous 12 month calendar year (i.e. January 1st to December 31

st). All permitted expenses in

relation to labour costs are included on the prescribed Form.

If accepted, the submitted Form shall be effective until January 31st of the following year and the payroll burden rate will apply to all

Time and Material works carried out within the effective period of the Form. If the Contractor fails to submit a signed Form before the

commencement of any work on a Time and Material basis, or if the submitted Form is not acceptable to the Owner, the Owner will

apply the 40% standard payroll burden rate for all works that are carried out on a Time and Material basis under this Contract until a

Form is submitted by the Contractor and accepted by the Owner.

During the Contract period, the Contractor must submit an updated Form by January 31st of a new calendar year. If accepted, the

updated Form shall be effective until January 31st of the following year. If the Contractor failed to submit an updated Form or the

submitted Form is not accepable, the Owner will apply the standard 40% payroll burden rate to all Time and Material works carried out

under this Contract until an updated Form is submitted by the Contractor and accepted by the Owner.

Page 2 of 2

Union Contributions: is the premium paid by the Contractor to a union in accordance with active collective agreements.

Items such as Industry Funds paid to a Trustee and Legal Benefits identified in such agreements are

to be included under this item.

Page 2 of 2

The following guide is to be used in conjunction with the Toronto General Conditions of Contracts

Field Name Field Type Description

Prime Contractor Text Enter Contractor’s Name as shown on the Contract

Sub Contractor Text Enter Sub Contractor’s name only if the work is performed by the subcontractor

Change Order Number & Description Text Enter the Change Order Number, contract item number and / or work description

Date Text Enter the Start and End date for the work completed on this form

Page Text If more than one page is required, check bottom of page - page 1 of 1, 2 of 2, etc

Section “A” Labour

Classification Text Enter the classification of the labour doing the work, i.e. grader operator, etc

Number Number Enter the number of labourers with the same classification and rate of pay

Hours Each Number Labourers listed in the field must work the same number of hours

Hours Total Calculated Field multiplies the number of labourers times the numbers of hours worked

Rate Number Enter the base salary for the classification of Labour in $

Amount Calculated Calculates the total amount for each classification

Total Calculated Adds the amount shown for each classification

Standard Payroll Burden Calculated It is 40% of a set value as defined in General Condition

Actual Payroll Burden Submitted Form must be signed by the Contractor’s external auditor

Sub Total Calculated Calculates the total amount including Labour Payroll Burden Costs

“A” Calculated Carries Field, Total of Section “A”

Section “B” Owned Equipment

Type Text Enter type of Equipment

Working Hours Number Enter number of hours worked

Rate Number Enter 127 rate in $

Amount Calculated Calculates amount of time worked

Total Calculated Totals the amount for working time

Standby Hours Number Enter number of hours on Standby

Rate Number Enter 127 Rate in $

Amount Calculated Calculates amount for time on standby (35% of working rate)

Total Calculated Total the amount for time on Standby

Sub Total Calculated Calculates the total amount Equipment Costs

“B” Calculated Carries Field, Total of Section “B”

Section “C” Rented Equipment

Invoice Number Text Enter company name & invoice number or type of equipment if no number on invoice

Invoice Cost Number Enter the amount for rented equipment in $

Entitlement Number Increase the amount of entitlement by an extra 10%

Total Calculated Total the amount for rented equipment

Sub Total Calculated Calculates the amount for rented equipment

“C” Calculated Carries Field, Total of Section “C”

Section “D” New Material

Type Text Enter the type of material

Unit Number Enter the unit of measurement i.e. each, etc

Total Number Enter the total number of units

Rate Number Enter the cost per unit in $

Amount Calculated Calculates the material costs

Sub Total Calculated Totals the amount of material costs

“D” Calculated Carries Field, Total of Section “D”

Section “E” Contractor Markup ** only for work by subcontractor **

Sub Total (A+B+C+D) Calculated Adds fields “A”, “B”, “C” and “D”

$10,000 and under Calculated Plus 10% for Contractor on Subcontractor’s work, or else the field is 0

Over $10,000 Calculated Plus 5% for Contractor on Subcontractor’s work, or else the field is 0

"E" Calculated Carries Field, Total of Section “E”

Total Cost Calculated Adds fields “A”, “B”, “C”, “D” and “E”

Prepared, Position and Date by: Text Enter name, position of individual, and enter the date the form was prepared

If more than one form is needed, indicate the total number of pages and carry forward values to calculate the total cost.

Time and Material Summary

User Guide 1 of 2

TIME AND MATERIAL SUMMARY

Prime Contractor: Start Date:

SECTION 'A' LABOUR End Date:

HOURS

CLASSIFICATION NUMBER EACH TOTAL RATE AMOUNT LABOUR ENTITILEMENTS

35% OF FIRST $3,000

20% OVER $3,000

SUBTOTAL

TOTAL 0.00

Payroll Burden 40.00% TOTAL LABOUR

SUBTOTAL 0.00 'A' 0.00

SECTION 'B' OWNED EQUIPMENT

WORKING STANDBY (35% OF WORKING RATE) EQUIPMENT ENTITLEMENTS

TYPE HOURS RATE AMOUNT HOURS RATE AMOUNT

100% - $ 10,000 OR LESS

90% - $ 10,000 TO $ 20,000

80% - OVER $ 20,000

TOTAL 0.00 TOTAL 0.00

SUBTOTAL 0.00

SECTION 'C' RENTAL EQUIPMENT ** total not to exceed 110% of OPS 127 rates **

INVOICE NUMBER INVOICE COST ENTITLEMENT (10%) TOTAL

TOTAL EQUIPMENT

SUBTOTAL 'B'+'C' 0.00

SECTION 'D' NEW MATERIAL

TYPE UNIT TOTAL RATE AMOUNT MATERIAL ENTITLEMENTS

20% OF FIRST $3,000

0.00

15% OVER $3,000

0.00

SUBTOTAL 0.00 TOTAL MATERIAL 'D' 0.00

SECTION 'E' CONTRACTOR MARKUP ** only for work by subcontractor ** SUBTOTAL (A+B+C+D)

SUBCONTRACTOR TYPE RATE MARKUP

$10,000 AND UNDER 10% 0.00 'E' 0.00

OVER $10,000 5% 0.00

Prepared By: Position: Date:

Change Order Number & Description:

Sub Contractor:

0.00

0.00

0.00

SUBTOTAL

0.00

SUBTOTAL 'X' if applicable

TOTAL COST

2 of 2


Note the wording to be included in the "Remarks" section of the Contract Bond Status Query form.

In order to allow us to monitor the progress of our contractor, please complete and return this form.

Your response will not prejudice your rights or affect our liability under our bond(s) referred to below.

We enclose a prepaid return envelope for your use.

ATTN: Contract Clerk City of Toronto 55 John Street, 20th Floor Metro Hall Toronto, Ontario, M5V3C6

Date of Request: 12/12/17

Bond No.:16-555-555 Contract Price: $9999.99 Inception Date: 10/04/16

Contract Description: Cont. #WPC-1-16 Supply, supervision of installation & commissioning of 2 centrifuges @ Highland Creek Treatment Plant

Our Bond On Behalf Of: Westfalia Separator, Inc.

Bond Executed in the following Company: Liberty Mutual Insurance Company

Signed

Liberty Bond Services

1. Has contract been completed?

2. If completed, please state

a. Date of acceptance

b. Total amount of completed contract $

3. If not completed, please state

a. Probable completion date

b. Amount paid contractor to date $

c. Amount withheld as retained percentage $

4. Has work progressed satisfactorily?

5. Are there any unsatisfied claims or liens on file?

Remarks: It is understood that the information contained herein is furnished as a matter of courtesy for the confidential use of surety and is merely an expression of opinion. It is also agreed that in furnishing this information, no guaranty or warranty of accuracy or correctness is made and no responsibility is assumed as a result of reliance by the surety, whether such information is furnished by the owner/obligee or by an architect/engineer as the agent of the owner.

Signed

Date Title

Name Title (Director & above)


Metro Hall Address Toronto, Ontario XXX XXX

Tel: 416-xxx-xxxx Fax: 416-xxx-xxxx [email protected] www.toronto.ca


Month, Day, Year

Name & Title Contractors Name Mailing Address

Att: M. XXXX

Re: Contract No. XXXX Description

It has come to our attention that insert lien claimant, on insert date, has submitted a Claim for Lien against the City of Toronto in connection with the above noted contract for the amount of $XXXX. In accordance with the provisions of the Construction Lien Act, we will be withholding the amount of the claim plus lesser of 25% of lien claim or $50,000.00 as security for costs from current and future payments until such time as we have received confirmation that the claim has been withdrawn. Yours truly,

Project Lead Name, Title Section Name Unit Name Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Project Lead Name, Title Section Name Unit Name






Tel: 416-XXX-XXXX


Month Day, Year

Name & Title Contractor's Name Mailing Address Att: M. XXXX Re: Contract No. XXXX Project Description As Construction Company is aware, the Order to Commence Work for this project was issued on Month Day, Year. Based on the tendered completion time of # weeks, the original completion date was Month, Day, Year. Circumstances leading to the delayed completion as per your letter dated Month Day, Year have been reviewed and are considered sufficient to justify an extension of the original completion time. Accordingly, approval is herein granted to extend the completion date of Contract Month Day, Year to Month Day, Year. It should be noted, however, that this effective extension does not constitute a waiver by the Corporation of any rights under the Contract, nor shall said extension be used for any claim for extra payment. Yours truly, Name, Title Section Name Unit Name Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by)


Name, Title Section Name Unit Name






Tel: 416-XXX-XXXX


Month, Day, Year

Name & Title Contractor's Name Mailing Address Att: M. XXXX Re: Contract No. XXXX Project Description As Construction Company is aware, the Order to Commence Work for this project was issued on Month, Day, Year. Based on the tendered completion time of # weeks, the original completion date was Month, Day, Year. In fact, substantial performance was not achieved until Month, Day, Year and full compensation is still pending. In the City's letter dated Month, Day, Year, the City requested that Construction Company provide justification for the delay in the completion of the above project and show just cause as to why the provisions of Linear – GC 8.02.09 as revised by the Specific Conditions; CCDC – GC 6.5.9 of the General Conditions of Contract XXXX should not be applied. Include chronological details related to the delay here. Accordingly, at this time, the City is obliged to withhold sufficient monies from future payments to provide for potential liquidated damages and additional inspection costs until such time as Construction Company has presented a convincing case for a contract extension. The City will be deducting $ XXXX.XX (inclusive of GST) from monies otherwise due to be released to provide for these damages and costs. The amount of the deduction has been computed as follows: Potential Liquidated Damages (Date 1 to Date 2) # days @ $ LD amount /day $ XXXX.XX We urge you to complete the work at the earliest possible date in order to minimize additional inspection costs and avoid the possibility of further monies being withheld to cover same.


Should you require further information and/or clarification, please contact Name at XXX-XXXX. Yours truly, Manager Name, Title Section Name Unit Name Encl. Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Manager Name, Title Section Name Unit Name






Tel: 416-XXX-XXXX


Month Day, Year

Name & Title Address of Utility Company

Att: M. XXXX

Re: Project Title Contract No. xxxxxxxx As you are aware this contract was to be fully completed within XX weeks of the issuance of the Order to Commence Work dated XXXX, i.e., by XXX. We respectfully request that company name show cause why insert appropriate GC reference (Linear GC 8.02.09.01 / CCDC GC 6.5.9) the contract should not be applied. In addition, please provide a firm date for the completion of the Contract.

Yours truly,

Director Name, Title Section Name Unit Name Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Director Name, Title Section Name Unit Name

SSHR-1


Release and Waiver of Subcontractor Subcontract Statutory Holdback Release

Contract No. _____________________

IN CONSIDERATION of the release by City of Toronto to the Contractor of the statutory holdback pursuant to the Construction Lien Act, R.S.O. 1990, as amended, in respect of the subcontract between _____________________________________________ and (Contractor) _____________________________________________, (Subcontractor) in relation to the project known as _________________________________________, __________________________________________ (Subcontractor) hereby acknowledges that the said subcontract has been satisfactorily completed on ____________________________ and further hereby waives, releases and forever discharges the City of Toronto, its successors and assigns, from any and all claims, actions, liabilities and demands whatsoever, for damages, losses, compensation or otherwise, howsoever arising, relating to or in consequence of the said subcontract which may have been or may hereafter be sustained by the Subcontractor, except for the statutory holdback retained until released hereunder. DATED at Toronto, this _________ day of ______________________, 201__.

______________________________________

Legal Name of Company

By: _______________________________

Name: _______________________________

Title: _______________________________ I have authority to bind the corporation.

SSHR-2


Statutory Declaration of Subcontractor Subcontract Statutory Holdback Release

Contract No. _____________________

IN THE MATTER OF the Subcontract BETWEEN _________________________________________, Contractor AND _________________________________________, Subcontractor Under the Contract between the City of Toronto and the said Contractor for _____________________________________________

_____________________________________________ (insert title of the Work and the Project)

I, __________________________of the _____________ of ____________________

in the Province of ______________________DO SOLEMNLY DECLARE that:

1. I am the _____________________ of ________________________________, (position) (Subcontractor’s Legal Name)

the above-mentioned Subcontractor and as such have knowledge of the facts herein deposed to and have authority to bind the corporation.

2. The Subcontractor has satisfactorily and completely supplied all work, services

and/or materials to be provided under the above Subcontract on __________________________ and has paid all of its subcontractors, suppliers, accounts and assessments and has discharged all of its liabilities incurred in relation to the work, services and/or the materials supplied under the Subcontract.

AND I make this solemn Declaration conscientiously believing it to be true and knowing it is of the same force and effect as if under oath. DECLARED before me at the _______________ ) ) of _____________________, in the Province of ) ) Ontario this _____ day of __________, 201__ )

) _____________________ ____________________________________ ) Signature A Commissioner for Oaths, Notary Public, I have the authority to bind Justice of the Peace the corporation.

SSHR-3

C41 – Rev. April 2017

Release and Waiver of Contractor Subcontract Statutory Holdback Release

Contract No. _____________________

IN THE MATTER OF the Subcontract

BETWEEN _________________________________________, Contractor

AND _______________________________________, Subcontractor in relation to the

project known as _____________________________________________, IN CONSIDERATION of the release by City of Toronto to the Contractor of the statutory holdback retained pursuant to the Construction Lien Act, R.S.O. 1990, as amended, in respect of the above-noted subcontract, the said Contractor hereby acknowledges that the said subcontract has been satisfactorily completed on _______________________ and further hereby waives, releases and forever discharges the City of Toronto, its successors and assigns, from any and all claims, actions, liabilities and demands whatsoever, for damages, losses, compensation or otherwise, howsoever arising, relating to or in consequence of the said subcontract which may have been or may hereafter be sustained by the Contractor, except for the statutory holdback retained until released hereunder. DATED at Toronto, this _________ day of ______________________, 201__.

_____________________________________ Legal Name of Company

By: _______________________________

Name: _______________________________


SSHR-4


Statutory Declaration of Contractor Subcontract Holdback Statutory Release

Contract No. _____________________

IN THE MATTER OF the Subcontract BETWEEN _________________________________________, Contractor AND _________________________________________, Subcontractor in relation to the project known as __________________________________________, I, ___________________________of the _____________ of _____________________

in the Province of ______________________DO SOLEMNLY DECLARE that:

1. I am the _____________________ of _________________________________, (position) (Contractor’s Legal Name)

the above-mentioned Contractor and as such have knowledge of the facts herein deposed to and have authority to bind the corporation.

2. The Subcontractor has satisfactorily and completely supplied all work, services

and/or materials to be provided under the above Subcontract on ______________________ and has been paid for all of its work, services and/or the materials supplied under the Subcontract and the Contractor has discharged all of its liabilities incurred in relation thereto.

AND I make this solemn Declaration conscientiously believing it to be true and knowing it is of the same force and effect as if under oath. DECLARED before me at the _______________ ) ) of _____________________, in the Province of ) ) Ontario this _____ day of ______________, 201__ )

) ________________________ ____________________________________ ) Signature A Commissioner for Oaths, Notary Public, I have the authority to bind the Justice of the Peace corporation.

Construction Lien Act - R.S.O. 1990, Chapter C.30

2. (1) For the purposes of this Act, a contract is substantially performed

(a) YES

(b)

(i) $0.00

(ii) $0.00

(iii) 1 per cent of the balance of the contract price. $0.00

$0.00

$0.00

No

Idem

2. (2)

NOTE: A copy of the latest deficiency list with values for outstanding work is to be attached to this sheet.

This sheet is to accompany the Certificate of Substantial Performance.

Project Lead:

Telephone :

Date:

For the purposes of this Act, where the improvement or a substantial part

thereof is ready for use or is being used for the purposes intended and the

remainder of the improvement cannot be completed expeditiously for reasons

beyond the control of the contractor or, where the owner and the contractor

agree not to complete the improvement expeditiously, the price of the

services or materials remaining to be supplied and required to complete the

improvement shall be deducted from the contract price in determining

substantial performance.

Enter Value of Remaining Work, Including Deficiencies

Contract Price, Exclusive of Taxes

Contracts, subtantial performance and completion

When contract substantially performed

when the improvement to be made under that contract or a substantial part

thereof is ready for use or is being used for the purposes intended; and

when the improvement to be made under that contract is capable of

completion or, where there is a known defect, correction, at a cost of not

more than,

3 per cent of the first $500,000 of the contract price,

2 per cent of the next $500,000 of the contract price, and

Total Subsection (b)

Improvement Value (b) vs. Deficiencies

Substantial Completion Achieved?

Confirmation of Substantial Performance

Contract Number:

Tender Call Number:

ECS_CWP-45 - Rev. June 2017 Page 1 of 1





To: File From: Name, Title Date: Month Day, Year Re: Project Description Contract No. XXXX

Contractor: Order to Commence Work: Tender Completion Time: Original Completion Date: Substantial Performance: Actual Final Completion Date: This project was finally completed on Month Day, Year. As indicated in the tender documents, the Order to Commence Work for this project was issued on Month Day, Year. Based on the tendered completion time of # weeks, the original completion date was Month Day, Year. Include detailed reasons for the delay. An example is included below for reference. Despite the fact that all work was completed on both ends including road restoration, the contractor could not complete the disinfection of the watermain at ABC Street due to the faulty drain valve and complexity in shutting down the existing Butterfly Valves.

Detail why liquidated damages are or are not being applied in this instance. An example is included below for reference. Since the delays were essentially due to factors beyond the Contractor’s control and the watermain operation was not affected by these delays, and since inspection was being provided only on an as needed basis to monitor actual contract work, no significant additional inspection costs resulted. In addition, there are no damage consequences to the City due to these delays that would warrant the imposition of Liquidated Damages in this instance.

Based on the above, it is recommended that a contract extension to Month Day, Year be granted. Yours Truly,


Name, Title Section Name Unit Name Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Name, Title Section Name Unit Name





Month, Day, Year Name of Contact Title Mailing Address Dear Name of Contact Re: Contract number and description Certification of Substantial Performance and Substantial Performance Statutory Holdback Release Payment Certificate We are writing in response to your Month, Day, Year application for Certification of Substantial Performance for the above-noted contract. Please find attached our Certificate of Substantial Performance. As required by the Section 32(1) Paragraph 5 of the Construction Lien Act, R.S.O. 1990, c.C.30, as amended, you are now required to publish a copy of the certificate in a construction trade newspaper including placement in the Daily Commercial News. As per clause GC 8.02.03.05.04 of the City of Toronto’s General Conditions of Contract, the Substantial Performance Statutory Holdback Release Payment Certificate shall be due 46 Days after the date of publication of the Certificate of Substantial Performance but subject to the provisions of the Construction Lien Act and the submission by the Contractor of the following documents: (i) a Release and Waiver of Contractor (see attached form SP-1); (ii) a Statutory Declaration of Contractor (see attached form SP-2); (iii) a satisfactory Certificate of Clearance from the Workplace Safety and Insurance

Board; and (iv) proof of publication of the Certificate of Substantial Performance. Should you have any questions regarding this matter, please contact me directly at 416-XXX-XXXX. Yours truly, Name, Title Section Name Unit Name


[Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format.] (Original signed by) Name, Title Section Name Unit Name Attachments: Certificate of Substantial Performance, Form 6 Release and Waiver of Contractor, Form SP-1 Statutory Declaration of Contractor, Form SP-2 Copy to: Contract File

SP-1

ECS-CWP-48a – Linear – Rev. June 2017 Page 1 of 1

Release and Waiver of Contractor

Re: Statutory Holdback Release Payment Contract No. _____________________

IN CONSIDERATION of the release by City of Toronto to the Contractor of the statutory holdback retained pursuant to the Construction Lien Act, R.S.O. 1990, as amended, in respect of the Contract between City of Toronto and _____________________________________________, (Contractor)

in relation to the project known as __________________________________________, the said Contractor hereby acknowledges it has achieved substantial performance of the above Contract on ___________________________, as defined by the Construction Lien Act, R.S.O 1990, as amended, and further hereby waives, releases and forever discharges the City of Toronto, its successors and assigns, from any and all claims, actions, liabilities and demands whatsoever, for damages, losses, compensation or otherwise, howsoever arising, relating to or in consequence of the said Contract which may have been or may hereafter be sustained by the Contractor, save and except claims related to work not yet performed and/or claims of the Contractor properly submitted in accordance with GC 3.14.03 of the Contract in writing. DATED at Toronto, this _________ day of ______________________, 20__.

_______________________________________

Legal Name of Company By: ________________________________

Name:

Title:

I have authority to bind the corporation.

SP-1

ECS-CWP-48b – Vertical – Rev. June 2017 Page 1 of 1


Re: Statutory Holdback Release Payment Contract No. _____________________

IN CONSIDERATION of the release by City of Toronto to the Contractor of the statutory holdback retained pursuant to the Construction Lien Act, R.S.O. 1990, as amended, in respect of the Contract between City of Toronto and _____________________________________________, (Contractor)

in relation to the project known as __________________________________________, the said Contractor hereby acknowledges it has achieved substantial performance of the above Contract on ______________________________, as defined by the Construction Lien Act, R.S.O 1990, as amended, and further hereby waives, releases and forever discharges the City of Toronto, its successors and assigns, from any and all claims, actions, liabilities and demands whatsoever, for damages, losses, compensation or otherwise, howsoever arising, relating to or in consequence of the said Contract which may have been or may hereafter be sustained by the Contractor, save and except claims related to work not yet performed and/or claims of the Contractor properly submitted in accordance with GC 5.5.1.2 of the Contract in writing. DATED at Toronto, this _________ day of ______________________, 20__.

_______________________________________

Legal Name of Company By: ________________________________

Name:

Title:

I have authority to bind the corporation.

SP-2


Statutory Declaration of Contractor

Substantial Performance of Contract No. _____________________

IN THE MATTER OF Contract No. ___________________________ (the “Contract”) BETWEEN _________________________________________, Contractor AND CITY OF TORONTO For _____________________________________________


I, ______________________of the _____________ of _________________________

in the Province of __________________________DO SOLEMNLY DECLARE that:

1. I am _____________________ of ____________________________________, (position) (Contractor’s Legal Name)


2. The Contractor has achieved Substantial Performance of the above Contract, as

defined by the Construction Lien Act, R.S.O 1990, as amended, on ________________________.

3. The Contractor and all of its subcontractors have paid all their respective

subcontractors, suppliers, accounts, assessments and discharged all their respective liabilities incurred in relation to the Contract and the work, services and materials supplied under the Contract, except for statutory holdbacks properly retained.


) ________________________ ____________________________________ ) Signature A Commissioner for Oaths, Notary Public, I have the authority to bind the Justice of the Peace corporation.

XX th Floor, Metro Hall

55 John Street

Toronto, Ontario

M5V 3C6

Contractor: Change Directive No.:

Project:

Location:

References:

City’s/Consultant’s RFQ No. and date:

Contractor’s Proposal:

Approval/Authorization

Project Lead Manager Director Chief Engineer and Executive

Director

Print Name Print Name Print Name Print Name

Signature Signature Signature Signature

Attach additional page(s) if necessary

Pursuant to General Conditions of Contract GC 3.11, you are hereby ordered to carry out the

“Change(s)” described below.

Change in the Work related solely to quantities will be paid according to GC 8.01.02 – Variations in

Tender Call. Payment for Change(s) not related solely to quantities may be on a Time and Material

Basis according to GC 8.02.04 or as specified in the Change Order issued in respect of the Change(s) in

the Work set out herein.

Description of “Change(s)”

Contract No.:

Date: (yyyy-mm-dd)

Unit Name e-mail: firstname.lastname @toronto.ca

Toronto.ca

Change DirectiveProject Lead Name Tel: (416) 39X-XXXX

Title Fax: (416) 39X-XXXX

A53 - Linear - Rev. April 2017 Page 1 of 4

0

Location: 0 Date: (yyyy-mm-dd)

Contract No.:Project: 0

0

Change Directive

Contractor: 0 Change Directive No.:

A53 - Linear - Rev. April 2017 Page 2 of 4

XX th Floor, Metro Hall

55 John Street

Toronto, Ontario

M5V 3C6

Contractor: Change Directive No.:

Project:

Location:

References:

City’s/Consultant’s RFQ No. and date:

Contractor’s Proposal:


Project Lead Manager Director Chief Engineer and Executive

Director



Date: (yyyy-mm-dd)

Change DirectiveProject Lead Name Tel: (416) 39X-XXXX

Pursuant to General Conditions of Contract GC 6.3, you are hereby ordered to carry out the Work

described below.

Payment for Change(s) may be on a Lump Sum or on a Time and Material Basis according to GC 6.2.3

or GC 6.2.4, respectively, or as specified in the Change Order issued in respect of Change(s) in the

Work set out herein.

Description of “Change(s)”

Unit Name e-mail: firstname.lastname @toronto.ca

Toronto.ca

Title Fax: (416) 39X-XXXX

Contract No.:

Attach additional page(s) if necessary

A53 - Vertical - Rev. April 2017 Page 3 of 4

0 Change Directive No.:

Location: 0 Date:

Change Directive

0

Project: 0 Contract No.: 0

Contractor:

(yyyy-mm-dd)

A53 - Vertical - Rev. April 2017 Page 4 of 4

Contractor: Change Order No.:

Contract No.:

Project: Account No.:

Location: Date : (yyyy-mm-dd)

Extra time allowed for completion of Contract: Days

Schedule of Prices, Negotiated Rates, Lump Sum or Cost Plus

Details of Change(s) to be Performed Quantity Unit Price Amount

0

0

0

0

Attach additional page(s) if necessary Subtotal $ -

H.S.T. $ -

References TOTAL $ -

City’s/Consultant’s RFQ / Change Directive No. and date:

Contractor's Proposal No. and date:


Project Lead Manager Director Chief Engineer and Executive Director



Contractor

Print Name

Signature

Change Order

Pursuant to General Conditions of Contract GC 3.11, you are hereby ordered to carry out the “Change(s)”

described below in connection with your Contract and in accordance with the conditions of the Contract.

The TOTAL amount listed below represents full compensation to the Contractor for the Change(s) in the

Work specified in this Change Order. The Contractor agrees that no other amounts or claims shall be

payable by the City in relation to the Change(s) in the Work specified herein, and without limiting the

foregoing, any claims for delay or consequential damages.

Works done on this Order must be examined and reported by the inspector assigned by the City.

Schedule of Prices

ECS-CWP51_Linear - Rev. June 2017 Page 1 of 2

Contractor: Change Order No.:

Change Order

Location: Date: (yyyy-mm-dd)

Project: Contract No.:

ECS-CWP51_Linear - Rev. June 2017 Page 2 of 2



Change Order Checklist

The following items form part of a complete change order package. Whenever possible, all items listed that are available must be part of the package provided for financial approvals.

Contract Number: ####### – CO#

Mandatory Items Included N/A

Change Order Form (ECS-CWP-51)

This Checklist

Contract Change Summary – CO Summary plus Overrun/Underrun Summary related to unit price items in linear contracts (ECS-CWP-55)

Signed Change Directive (ECS-CWP-50), if applicable

Briefing Note for all COs requiring approval from the Chief Engineer and Executive Director.

Copy of Report of Changes in the Work Completed form (TS102) including reference to daily reports where extra work was documented, if applicable.

Routing form, if applicable

Supplementary Attachments – Include where applicable and available

Included N/A

Report of Changes in Work Completed (TS102)

Time and Material Summary Sheet, if applicable (ECS-CWP-35)

Copy of Time and Material Payroll Burden Form, if applicable (ECS-CWP-33, ECS-CWP-34)

Request for Quotation (TS118 or email)

All correspondence relating to the negotiation of the final price (e.g. original proposals, emails, etc.)

Contractor's Invoice

Contractor's Documentation, including but not limited to:

• Time and Material Summary Sheet, if applicable

• Weigh Tickets

• Material Tickets

• Material Invoices (highlight material used in CO)

• Dump Tickets

• Pay Duty Officer Chits, if applicable

• Submittal Drawings, if applicable


• Invoices for rented equipment

Drawings and/or Specifications Used

Photos of pre, during and post construction conditions

Arithmetic checks of Contractor's invoices

Copy of Local Union Rates, if T&M

Copy of Contractor's Equipment List with reference to OPSS 127 equipment rental rates, if T&M

Other Supplementary Attachments (not listed above) substantiating the Change Order

Included N/A

Checklist Prepared By:


Name Title

Metro Hall Address Third line optional Toronto, Ontario XXXXXX


ROUTING FORM

PLEASE FORWARD TO NEXT LEVEL OF AUTHORITY FOR INITIALS/SIGNATURES

TO: (Only include to the level required for signing authority) SIGN INITIAL DATE

Chief Engineer and Executive Director Name

Chief Engineer and Executive Director Title

Director Name Director Title

Manager Name Manager Title

Project Lead Name Project Lead Title

From: Project Lead Name and Title Date: Month, Day, Year Re: Contract Number Reason for Signature Enclosed are the following documents for review and sign off:

• List appropriate supporting documents here

Should you have any inquiries, please contact Project Lead Name at 416-XXX-XXXX. Please return signed copies to Project Lead Name, Metro Hall, XXth Floor. Yours truly, Name, Title (with appropriate signing authority) Section Name Unit Name Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Name, Title (with appropriate signing authority)


Section Name Unit Name Encl.






Tel: 416-XXX-XXXX


Month, Day, Year

Name & Title Consultant Name Address of Consultant

Att: M. XXXX

Re: Project Name Description of Scope Change Change Order No. xxxxxxxx We acknowledge receipt of your memorandum dated Month, Day, Year which provides describe the scope of the additional work, and the additional costs required to complete this work. The current scope of work allows for describe the base scope of work as it relates to the proposed scope change. Based on describe the additional scope of work requested and reference documentation date when City requested the additional work i.e. City letter, meeting date, and the total additional cost inclusive of HST. The additional work was requested to provide describe why the additional work is required. Provide cost information; see sample clauses below: In accordance with the unit prices allowed for in the Contract, the unit cost per odour panel is $XXXX. Therefore, the cost for 2 additional odour panels is $XXXX inclusive of disbursements and HST. OR Per your quotation, the additional effort to respond to the additional comments from the MOE is $XXXX including taxes and disbursements. We have reviewed your quotation with Insert client division lead of the Client Division and, with their concurrence, hereby authorize you to proceed with the work as per your quotation. The fees for the above authorized additional work shall be billed on a time basis and shall not exceed $XXXX, inclusive of disbursements and HST, and paid for against the contingency allowance of $XXXX provided for in this assignment.


Should you have any questions concerning the foregoing, please contact Project Lead at 416-XXX-XXXX Yours truly,

Name, Title (as per appropriate signing authority) Section Name Unit Name Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Name, Title (as per appropriate signing authority) Section Name Unit Name

*All Amounts Exclude HST*

Contract Value 1.00$

Base Scope (1.00)$

Provisional Allowances 1.00$

Contingency 1.00$

PO Amendment Added to Contingency -$

April 10, 2018 Total Contingency 1.00$

Total COs to date: -$

Remaining Contingency 1.00$

Remaining Provisional Allowances 1.00$

CO No. Account Code Description Contingency Amount Provisional Amount Schedule Impact (work days) Approved Date Approved By

CHANGE ORDER SUMMARY

Contract:

Consultant:

PTP Code:

Last Updated:

Revised End Date:

End Date:

Report No.:

Approval Date:

Approval Authority:

ECS-CWP-55 - Rev. June 2017Page 1/1


Certificate of Completion Contractor’s Name and Address:

Name & Title Contractors Name Mailing Address Contract No.: XXXX (the “Contract”) Location: Street A from XXXX to XXXX Street B from XXXX to XXXX Description of Work: XXXX Total Contract Price (A): $ XXXX.XX Price to complete remaining work: $ XXXX.XX Price to correct known defective work: $ XXXX.XX In accordance with clause GC8.02.03.06 of the General Conditions of the Contract, this is to

certify that the Work on the Contract is deemed completed in accordance with the

Construction Lien Act (B), effective as of the date of Month, Day, Year (the “Completion

Date”).

Contract Administrator (signature and print name)

Date: Month, Day, Year (A) Total Contract Price is the total of the original Contract price and all approved Additional Work and Extra Work, and any price adjustments otherwise made as a result of a Change in the Work as of the Completion Date

(B) Section (3) of Construction Lien Act states that “a contract shall be deemed to be completed and services or materials shall be deemed to be last supplied to the improvement when the price of completion, correction of a known defect or last supply is not more than the lesser of,

(a) 1 per cent of the contract price; and

(b) $1,000”.





Month, Day, Year To: Client Contacts From: Name, Title Re: Completion and Acceptance of Work City of Toronto Contract No. XXXX

Please be advised that the above contract by Contractor was completed and accepted by the City on Month, Day, Year for the following work: STREET SERVICE LOCATION XXXX XXXX XXXX The 2-year warranty period commenced after certification of Substantial Performance on Month, Day, Year. The Contractor is required to rectify any deficiencies due to workmanship or material during the warranty period. The Project Lead for the above contract was Name. Should you discover any deficiencies or have any concerns regarding this work, please promptly contact him/her at 416-XXX-XXXX. Yours Truly,

Name, Manager Section Name Unit Name Ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Name, Manager Section Name Unit Name






Use appropriate letterhead and modify as necessary

Month, Day, Year

Name & Title Contractors Name Mailing Address

Att: M. XXXX

Re: Completion Certificate Contract No. XXXX Description

We are in receipt of your letter dated Month, Day, Year indicating that the deficiencies listed in our letter of Month, Day, Year have been rectified. This contract is now considered to be complete and is accepted by the City. The Certificate of Completion is attached. The 24 month warranty, stated in section GC 7.15 of the General Conditions of the Contract began on the date of Substantial Performance, Month, Day, Year. An inspection of all works under the contract will be done prior to the expiry of the warranty period. If any defects in the work, resulting from poor workmanship or improper materials, are found during this inspection, the contractor is required to promptly correct the defects at no additional cost to the City. Yours truly, Manager Name, Title Section Name Unit Name Please ensure distribution to all pertinent contacts c:


Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Manager Name, Title Section Name Unit Name

CP-1



Completion of Contract No. _____________________

IN CONSIDERATION of the release by City of Toronto to the Contractor of the statutory holdback retained pursuant to the Construction Lien Act, R.S.O. 1990, as amended, in respect of the Contract between the City of Toronto and _____________________________________________, (Contractor)

in relation to the project known as __________________________________________, the said Contractor hereby acknowledges it completely performed all work under the above Contract on ______________________, in accordance with the terms and conditions thereof, and further hereby waives, releases and forever discharges the City of Toronto, its successors and assigns, from any and all claims, actions, liabilities and demands whatsoever, for damages, losses, compensation or otherwise, howsoever arising, relating to or in consequence of the said Contract which may have been or may hereafter be sustained by the Contractor. DATED at Toronto, this _________ day of ______________________, 201__.

______________________________________

Legal Name of Company

By: _______________________________

Name: _______________________________


CP-2


Statutory Declaration of Contractor

Completion of Contract No. _____________________

IN THE MATTER OF Contract No. ___________________________ (the “Contract”) BETWEEN _________________________________________, Contractor AND CITY OF TORONTO For _____________________________________________


I, ______________________of the _____________ of __________________________

in the Province of __________________________DO SOLEMNLY DECLARE that:

1. I am _____________________ of ____________________________________, (position) (Contractor’s Legal Name)


2. The Contractor has completely and to the satisfaction of the City performed all

work under the above Contract, in accordance with the terms thereof, on __________________________.

3. The Contractor and all of its subcontractors have paid all their respective

subcontractors, suppliers, accounts, assessments and discharged all their respective liabilities incurred in relation to the Contract and the work, services and materials supplied under the Contract.


) ______________________ ____________________________________ ) Signature A Commissioner for Oaths, Notary Public, I have the authority to bind the Justice of the Peace corporation.







Month, Day, Year

Name of Contact Title Mailing Address Dear Name of Contact Re: Contract number and description Completion Payment Certificate and Statutory Holdback Release Payment Certificate Please find attached the Draft Completion Payment Certificate for the above-noted contract. Our records indicate a total amount to-date of $XXXX.XX plus HST (including holdback). Please review the quantities and respond in writing stating your acceptance or objections by XXXX. As per clause GC 8.02.03.07 of the City of Toronto’s General Conditions of Contract, submission by the Contractor of the following documents is required prior to release of the Completion Statutory Holdback Release Payment Certificate: (i) a Release and Waiver of Contractor (see attached form CP-1); (ii) a Statutory Declaration of Contractor (see attached form CP-2); and (iii) a satisfactory Certificate of Clearance from the Workplace Safety and Insurance

Board. Please forward the required information in a timely manner so that we can process the payments. Should you have any questions regarding this matter, please contact me directly at 416-XXX-XXXX. Yours truly, Name, Title Section Name


Unit Name Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Name, Title Section Name Unit Name Attachments: Release and Waiver of Contractor, Form CP-1 Statutory Declaration of Contractor, Form CP-2 Copy to: Contract File

Capital Projects Standard 2-Year Warranty Tracking

DeadlineD

Date Sent Taget DateE

Date Sent Taget DateF

Date Sent

Notes:

A. Date of Substantial Performance as appeared on Form 6

B. Standard warranty is 2 years after Substantial Performance

C. Inspection should be performed at least 90 days prior to warranty expiry

D. Letter to the Contractor requesting rectification of defects should be issued at least 60 days prior to expiry

E. If defects are not corrected, letter to the Bonding Company should be issued 30 days prior to the warranty expiry

F. Final acceptance letter should be issued 10 days after warranty expiry if there are no defects or all defects have been corrected.

Warranty

Inspection

DeadlineC

(yyyy-mm-dd)

Warranty

Expiry

DateB

(yyyy-mm-dd)

Substantial

Performance

Date A

(yyyy-mm-dd)

Letter No. 3

Final Acceptance

(yyyy-mm-dd)

Letter No.2 to

Bonding Company

(yyyy-mm-dd)

Letter No.1

Notice of Defects

(yyyy-mm-dd)

Contract

Price

Contract No. Project Description Project Location Project Lead Contractor Bonding Company/

Bond No.

ECS-CWP-62 - Rev. June 2017 Page 1 of 1







Month, Day, Year

Name of Contact Title Mailing Address Att: Name of Contact Re: Contract No. XXXX Description Correction of Defects and Deficiencies under Warranty We are writing to advise you that the warranty period for this contract will expire on Month, Day, Year. We have completed our final inspection of work performed under this contract. Based on our inspection, we are providing you with a detailed list of defects and deficiencies in the Work attached to this letter. Clause GC 7.15.02 of the General Conditions of contract requires the Contractor to correct promptly, at no additional cost to the Owner, defects and deficiencies in the Work which appear, prior to and during the 24 month warranty period. Therefore, we are requesting that your firm correct all defects and deficiencies by Month, Day, Year (30 days from the date of this letter). Please contact Project Lead Name, Title, at 416-39X-XXXX to arrange for a Road Occupancy Permit and contact XXXX at 416-XXX-XXXX to arrange for a City of Toronto Inspector to be on site while corrections are performed, at least 48 hours prior to the start of Work. Should you have any questions regarding this matter, please contact me directly at 416-XXX-XXXX. Yours truly, Manager Name, Title Section Name Unit Name


Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format. (Original signed by) Manager Name, Title Section Name Unit Name







Month, Day, Year

Name of Contact Title Mailing Address Att: Name of Contact Re: Contract No. XXXX Description Correction of Defects and Deficiencies under Warranty We are writing to advise you that the warranty period for this contract will expire on Month, Day, Year and the requested corrections as outlined in our attached letter to Month, Day, Year have not yet been completed. Please take action to correct all defects and deficiencies prior to the end of the warranty period as required under Clause GC 7.15.02 of the General Conditions of contract. Should you have any questions regarding this matter, please contact me directly at 416-XXX-XXXX. Yours truly, Manager Name, Title Section Name Unit Name Please ensure distribution to all pertinent contacts c: Note: If sending electronically, the following sign-off should be included instead of a signature. Signed, scanned PDFs are not an accessible communications format.


(Original signed by) Manager Name, Title Section Name Unit Name

INTERNAL USE ONLY

Contract No.:

File No.: 0 weeks

PO No.:

Contractor:

Project:

-

$0.00

$0.00

$0.00

$0.00

Approved Change Directive and Change Orders

Full Partial None

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Total Change Orders $0.00 $0.00 $0.00

Contract Item Overruns and Underruns (Underrun items are shown as negative values to reflect unspent funding that is available)

Item # Unit Description Unit Bid PriceContract

QuantityContract Amount Total Quantity

Overrun /

UnderrunCD #

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00

Total Overruns / Underruns $0.00 $0.00

DescriptionExtension

(Working Days)

$0.00

$0.00

$0.00

Total Amount

$0.00

$0.00

$0.00

CD # CO#Outstanding

Amount

Date

Approved

Consultant Responsibility

for CO CostsClaim AmountAmount Paid To

Date

$0.00

Original PO Amount ($):

A. Contingency Allowance ($):

B. PO Amendment ($):

E. Total Overruns and Underruns ($):

Revised Completion Date (yyyy.mm.dd):

C. Cumulative Contingency Amount (A + B) ($):

D. Total CD and CO Amount ($):

Remaining Contingency Allowance (C - D - E) ($):

Contract Change Summary

Date:

Date of Commencement (yyyy.mm.dd):

Tendered Contract Length:

Original Completion Date (yyyy.mm.dd):

Contract No. <<enter contract number>>

ECS-CWP-65 rev. August 2017 Page 1 of 2

INTERNAL USE ONLY

Account PO Summaries

(Linear projects only)

Account Description

Contract

Amounts

(A)

POAs

(B)

Total

(A + B)

Amount Used

(C)

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00

$0.00 $0.00 $0.00 $0.00 $0.00

Amounts Remaining

(A+B-C)

$0.00

$0.00

$0.00

$0.00

Total Contract Purchase Order Required

Divisional Capital Account

Nos.

ECS-CWP-65 rev. August 2017 Page 2 of 2

please ensure distribution to all pertinent contacts · ecs-cwp-17 – rev. june 2017 page 2 of 2...

Documents