Backup Documents 09/27/2016 Item #16D10 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 01
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 0
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Routed by Procurement Services to the Office Initials Date
Following Addressee(s) (In routing order)
1. County Attorney Office County Attorney Office
Cal& /0. 11. 1(
2. BCC Office Board of County
Commissioners ( cS VA1.<\t to
3. Minutes and Records Clerk of Court's Office 10 I tilt Co -3 xiD ewt-
4. Return to Procurement Services Facilities Management
Division Contact: Leandro Goicoechea
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing information.
Name of Primary Lissett De La Rosa for Leandro Phone Number 239-252-8354
Procurement Staff Goicoechea, 10/4/16
Contact and Date
Agenda Date Item was 9/27/16 ✓ Agenda Item Number 16.D.10
Approved by the BCC
Type of Document Work Orderf Number of Original
Attached Documents Attached
PO number or account N/A Solicitation/Contract 13-6164 Q.Grady
number if document is Number/Company Minor&Associates,.
to be recorded Name P.A.
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? LD
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be —MI--
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's LD
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip 4rD pr
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on the date above and all changes made XXX
during the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the ,• ik
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16010
MEMORANDUM
Date: October 11, 2016
To: Lissett De La Rosa
Procurement Services
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Work Order for Contract #13-6164 "Professional Services for
Engineers and Architects"
Contractor: Q. Grady Minor & Associates, P.A.
1
Attached is an original of the document referenced above, (Item #16D10) approved by
the Board of County Commissioners on Tuesday, September 27, 2016.
The second original has been held by the Minutes and Records Department as part of
the Board's Official Record.
If ou have anyquestions, please contact me at 252-8411.
Y
Thank you.
Attachment
1
6 010
WORK ORDER/PURCHASE ORDER
Contract 13-6164"Professional Services for Engineers and Architects-CR"
Contract Expiration Date: March 8,2019
This Work Order is for professional engineering services for work known as:
Project Name:Barefoot Beach Toll Booth Replacement
Project No: 80242
The work is specified in the proposal dated May 19,2016 which is attached hereto and made a part of
this Work Order. In accordance with Terms and Conditions of the Agreement referenced above,this
Work Order/Purchase Order is assigned to:Q.Grady Minor&Associates,P.A.
Scope of Work: As detailed in the attached proposal and the following:
* Task I Engineering Survey
* Task 11 Architectural Coordination
* Task Ill Civil Base Plan Design
* Task IV Coastal Construction Control Line Permitting
* Task V Collier County SDPIC Permitting
* Task VI Bidding
* Task VII Pre-Construction,Construction and Permit Closeout Assistance
Schedule of Work: Complete work within 365 days from the date of the Notice to Proceed which is
accompanying this Work Order. The Consultant agrees that any Work Order that extends beyond the
expiration date of Agreement#13-6164 will survive and remain subject to the terms and conditions of
that Agreement until the completion or termination of this Work Order.
Compensation: In accordance with the Agreement referenced above,the County will compensate the
Firm in accordance with following method(s): ONegotiated Lump Sum (NLS) ®Lump Sum Plus
Reimbursable Costs(LS+RC)®Time& Material (T&M)(established hourly rate—Schedule A)O
Cost Plus Fixed Fee(CPFF),as provided in the attached proposal.
Task I $2,587.00 LS
Task 11 $ 555.00 LS
Task Ili $3,198.00 LS
Task IV $4,068.00 LS
Task V $6,792.00 LS
Task VI $2,275.00 T&M
Task VII $7,180.00 T&M
Reimbursables $ 400.00 With Back-Up
TOTAL FEE $27.055.00
Page 1 of 2
16010 0
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PREPARED BY: ,...a... „ L S— D 4–/t,
Lro.eand . Goicoeehea,P.I ., Pr ect h a'I nager Date
Facilities Management Division
REVIEWED BY:✓ 1111 `�/ 3JJHan. Jine-'fJ.,Principal Proect Manager Dat
Faciliti. :n. .ement Division
APPROVED BY: / / A G/ t/ /iBarry ‘ '!hams, Director ate
Parks&Recreation Division
By the signature below. the Firm (including employees, officers and/or agents) certifies, and hereby
discloses, that,to the best of their knowledge and belief, all relevant facts concerning past, present, or
currently planned interest or activity (financial, contractual, organizational, or otherwise) which
relates to the proposed work: and bear on whether the Firm has a potential conflict have been fully
disclosed.
Additionally, the Firm agrees to notify the Procurement Director, in writing within 48 hours of
learning of any actual or potential conflict of interest that arises during the Work Order and/or project
duration.
ACCEPTED BY: Q Grady Minor& Associates, P.A.
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Mike Delate PE, Senior Vice President Date
i,RD OF COUNTY COMMISSIONERS
ATT s s EST: COLLIER a•UN'TY,FLORIDA
Obi: Brock,1.jerkeAcutiaes_urts ,,/
�1 /
gr
tonna Fiala,Chairman
Dated: i, tti 1 ( fes ..„y,._... .,
(SEAL) Attest as to Chairman's
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n;liipillre o IV.
Approv r a e al`, • ti a.,-3r
' ' ' ' , to 9 t I .
Assistant Mtwitt,rivt.
Print Name .� Page 2 of 2
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