Backup Documents 12/13/2016 Item #16D20 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP ion
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents arc 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.
Route to Addressee(s) (List in routing'order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office
V-JT* a)/di
4. BCC Office Board of County Commissioners sDF Sc--\
\r € S—/ 2i \U ,
5. Minutes and Records Clerk of Court's Office . 12 f i b//b It 9c t%%
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 Staff I-tarry Sells/Tessie S lery Operations Coordinator Phone Number 252-4980 or 2 2-5840
Contact/ Department PTNE Division(ol ATM Dept)
Agenda Date Item was 12-13-2016 Agenda Item Number 16.D.20
Approved by the BCC
Type of Document Attached Work Order Modification/Change Number of Original 1
Order Documents Attached
PO number or account
number if document is to be
recorded
Special instructions:email a copy to Harrysells@colliergov.net and Tessiesillery@colliergov.net
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? HS
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 HS
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 .118--
Office
18^Office and all other parties except the BCC Chairman and the Clerk to the Board �V1/
5. The Chairman's signature line date has been entered as the date of BCC approval of the HS
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 HS
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip _Lik
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 12-13-2016 and all changes made HS
during the meeting have been incorporated in the attached document. The County pp.t 31
Attorney's Office has reviewed the changes, if applicable. t kiiaj'
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 V" =p twx,a,a�
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
IAn0
tui LnaF` �i
Teresa L. Cannon
From: Teresa L. Cannon
Sent: Friday, December 16, 2016 12:42 PM
To: Sells, Harry; SilleryTessie (TessieSillery@colliergov.net)
Subject: Item #16D20 from 12/13/16
Attachments: #13-6178 WO (Hole Montes).pdf
Teresa Cannon, BMR Senior Clerk
Minutes & Records Department
239-252-8411
239-252-8408 fax
Teresa.Cannon@collierclerk.com
1
Colter County Procurement Services
Administrative Services Division Change Order Form 2 yA�yi!
Procurement Services 1 6 � �/
Amendment iP.
0 Contract Modification ®Work Order Modification0
Contract#: 13-6178 Change#: 5 Purchase Order#: 4500152314 Project#: N/A
Contractor/Firm Name: Hole Montes Inc. Project Name: Vanderbilt Beach MSTU Utility Conversion
PTNE (Public Transit& Neighborhood
Project Manager Name: Harry Sells Department: Enhancement)
Current BCC Approved Amount $ 586,493.00 11/10/15 16 E4 Last BCC Approval Date; Agenda Item#
Current Contract/Work Order Amount $ 586,493.00; 4/17/2017 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 103,000.00; 26.26% Total Change from Original Amount
Revised Contract/Work Order Total $ 689,493.00 17.56% Change from Current BCC Approved Amount
Cumulative Changes $ 143,400.00 17.56% Change from Current Amount
Completion Date, Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed 8/25/14 Original 8/24/16 Last Approved 4/17/2017 Revised Date 4/17/2017
Date Completion Date Date (Includes this change)
#Of Days Added 0 Select Tasks 0 Add new task(s) 0 Delete task(s) 0 Change task(s) ®other(see below)
Provide a response to the following: 1.) detailed and specific explanation/rationale of the requested change(s)to the task(s) and/or
the additional days added (if requested); 2.)Why this change was not included in the original contract; and, 3.) Describe the impact
if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed.
1. This CEI and Surveying contract was let to oversee all of the construction activity in the Vanderbilt Utility Conversion Project area
which includes Phase, II, Ill, and IV(geographical areas). The original amount the Work Order of the CEI was an estimate that
was made before any of the contracts were bid.There are six contracts that were or will be performed in this project area requiring
CEI oversight. Three are either complete or partially complete. As contracts were added,the CEI services were extended to cover
the new contracts but no additional funds were added.
2. This was not included in the original contract because the construction contracts had to be extended to fix issues they encountered
when the ground was opened;therefore this CEI contract needs to be increased in value to provide the necessary CEI services
while construction is taking place.
3. If the CEI contract is not extended, important observation, recording and advising on the construction process will not be
performed which presents the potential for failure . Without the services of the CEI, contractors become self reporting which
increases the potential for failure.
Task 2.1 -2.5 Total Line item is$491,856, increase line item by$88,000 to$579,856.
Task 6.1 Prepare Record Drawings of FPL Facilities, increase item by$15,000 to from$20,000 to$35,000
Prepared by: 4 ,/,(/-,___, Date Oct 17, 2016
Harry Sells,PCiblic Transit& Neighborhood Enhancement
Acceptance of this Change Order shall constitute a modification to contract/work order identified above and will be subject to all the same
terms and conditions as contained in the contract/work order indicated above, as fully as if the same were stated in this acceptance. The
adjustment, if any, to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/Vendor/Consultant/
Design Professional) ari�,o• out of or related to the change set forth herein, including claims for impact and delay costs.
Accepted by:
Gov" Date: l /706W.Ter C le, PE Vice President Hole Montes Inc.
Approved by: Date: 11•'•/
Michel e Ar •Id, Direc or, Pu is Trans' & Aeighborhood Enhancement
1, 1/ -�e / Date: I `il—1 644
Approved by: I
t- - Ca ell,Adm;istrati' ';ublic Servic,s Division /
Approved by: f I r / / A Date: '(. —7...../6
(Divisions who may requi e additional sig tatures may include on separate sheet.)
Revised: 10/28/2014
Page 2 of 2, Change Order#6
Contract#13-6178,Vanderbilt Beach MSTU Utility Conversion 6020
IN WITNESS WHEREOF, the parties hereto, have each, respectively. by an authorized person or
agent, have executed this Work Order on the date and year first written below.
ATTEST: BOARD OF COUNTY COMMISSIONERS
Dwight E. Brock, Clerk of Courts COLLIER COUNTY, FLORIDA
By: X/blll7
Dated:
Donni Fiala, Chairman
(' ' ��
(SEAL) ,fest as to Chairman's
;•l rf.;;I nfl'" Hole Montes,Inc
1/2 By:
First W. ness S nature (� ��e"
W ( Coll
�e V1 a Re51td �f
,r� iG'Ztt L-'-- L_- tType/print signature and titlet
tType/prin witness namet
econd Witness
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tType/print witness namet
ppro ed a to Form 4 'egality:
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ant County Attorney
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Print Name
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Agenda 61113
Date
Date
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Deputy Clerk