Backup Documents 07/10/2018 Item #16C 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 C 6
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 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.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JAK 7/10/18
4. BCC Office Board of County �� b
Commissioners \ # /
5. Minutes and Records Clerk of Court's Office
n44,L i (1( ( 4t4
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 Claude Nesbitt,Facilities Management Phone Number 252-2351
Contact/Department
Agenda Date Item was 7/10/18 Agenda Item Number 16-C-6 2
Approved by the BCC
Type of Document Work Order— 14-6213 Number of Original One
Attached Documents Attached
PO number or account n/a
number if document is
to be recorded
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 JAK
2. Does the document need to be sent to another agency for additional signatures? If yes, JAK
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 JAK
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 JAK
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 JAK
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 JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAK
should be provided to the County Attorney Office at the time the item is input into
MinuteTraq. 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 7/10/18 and all changes made during the JAK �Il is not
meeting have been incorporated in the attached document. The County Attorney's o ®•honfo
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the s
BCC, all changes directed by the BCC have been made, and the document is ready for the / aan %•Non:for
Chairman's signature. / thi' e,
[04-COA-01081/1344830/111: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
6
MEMORANDUM
DATE: July 12, 2018
TO: Claude Nesbitt, Project Manager
Facilities Management
FROM: Martha Vergara, Deputy Clerk
Minutes and Records Department
RE: Work Order for Contract #14-6213 -
Underground Utility Contractors — Lake Trafford Memorial
Gardens Drainage Improvements (Project #52525)
Contractor: Quality Enterprises USA, Inc.
Attached for your records is a scanned copy of the document referenced above,
(Items #16C6) approved by the Board of County Commissioners on Tuesday,
July 10, 2018.
The Minutes and Records Department will keep the original for the Board's
Official Records.
If you have any questions, please contact me at 252-7240.
Thank you.
Attachment
1 6 C
WORK ORDER/PURCHASE ORDER
Contract 14-6213"Underground Utility Contractors"
Contract Expiration Date:July 7,2018
This Work Order is for Underground Utility Contractor Services for work known as:
Project Name:Lake Trafford Memorial Gardens Drainage Improvements
Project No,: 52525
The work is specified in your Firm's proposal dated May 25, 2018.It 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: Quality Enterprises USA,Inc.
Scope of Work:
Task-1 Lake Trafford Drainage Improvements as specified in ABB's permitted plans and
specifications
Schedule of Work: Begin work once a Notice to Proceed (NTP) is issued. Complete all work within 90 days
from the date of the NTP which is accompanying this fully executed Work Order. The Contractor agrees
that any Work Order time that extends beyond the expiration date of Agreement# 14-6213 will survive and
remain subject to the terms and conditions of that Agreement until the completion or taro. inatitiuu ofthis_Work.
Compensation: In accordance with the Agreement referenced above, the County will compensate the Firm in
accordance with following method(s): E1 Quoted Lump Sum (QLS) DLump Sum Plus Reimbursable Costs
(LS+RC) DTime&Material (T&M)(established hourly rate—Schedule A) ❑Cost Plus Fixed Fee(CPFF), as
provided in the attached proposal.
Task I Lake Trafford Drainage Improvements $212,965.26 LS
Total $212,965.26
•
j
PREPARED BY:
W\cAl\t--DVA± 05/31/2018
Claude Nesbitt,Project Manager Date
Facilities Management Division
•
REVIEWED BY: _
: h‘'ff 3ti
Lt:d . -st MBA,Sr. Operations Analyst ate
Facilitir s Management Division
Page 1 of 2
16 C 6
Project Name:Lake Trafford Memorial Gardens Drainage Improvements
Project No.: 52525
'
3 REVIEWED BY: r - txr. /3
Margaret :4 hop,P.E.,Principal Project Manager Date
Facilities Management Division
/ /
REVIEWED BY: 6 ' I? . 18
I Carballo,CPM,Manager Date
iac..hies Management Division
(---
APPROVED BY: ..-� ,e ,� ? ,,���',''>-/ �� l:w..
Dan Rodriguez CFM,4BA bep Dept.Head Date
Public Utilities Department .
By the signature below, the Finn (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 II
bear on whether the Finn has a potential conflict have been fully disclosed.
I
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: Quality Enterprises USA,Inc.
lificl, 6-73 /t
Allison Murrell, `o pporate O 'fiver Date
Page 2 of 2
16C6
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; `` 4,o
BOARD OF C• "TY COMMISSI•► 'RS
Crystal Kinzel, Clerk of Courts COLLIER ' NT LORID.
By��l "`-�_ I AArai a
� By 10
6.1111111111" :�dy olis, Esq. Chairman
Dated: 6� I .-
(SEAL Iv
Attest as to Chairman's
signature only. QUALITY
WALL"
ENTERPRI ESU A INC.
By:
First ` Illness r Signature
Allison Murrell, Corporate Officer
Margarita Negron TType/print signature and title"?'
^
I Type,/print witness nameTh
,--41(1,1.4. "..._---Q
Second Witness
Maritza Lora
1 Type/print witness name T
i
Approved , t. ►r a 4 y:
—"In!
.. , ti ' tol ey
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Prin at;
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