Agenda 12/14/2010 Item #16E 6
Agenda Item No. 16E6
December 14. 2010
Page 1 of 52
EXECUTIVE SUMMARY
;
Recommendation to accept reports and ratify staff-approved change orders and changes
to work orders.
OBJECTIVE: To enable the Board to oversee the execution of administrative change orders
and changes to work orders and promote accountability in the use of staff authority.
CONSIDERATIONS: On April 22, 2003, the Board approved a recommendation to implement a
plan to enable changes to BCC-approved contracts (Section XV.C, Collier County Purchasing
Policy) of not greater than 10 percent of the current Board approved amount or $10,000
(whichever is greater) to be authorized by staff. Also included in the report are changes to Work
Orders. These include work orders issued under CCNA Contracts that are less than or equal to
$200,000 (Section VILC, Collier County Purchasing Policy), and changes to work orders for all
other contracls (Section XV.G, Collier County Purchasing Policy) that are not greater than 10
percent of the current Board Approved amount or $100,000 (whichever is greater). The
Administralive report identifies the percentage changes 10 contracts or work orders that have
occurred since the prior BCC approved amount which are below the threshold limits as
referenced above.
The plan calls for staff to submit a monthly report lisling Ihese change orders from the previous
reporting period. Enclosed is the monthly report of the Administrative Change Orders and
Administrative Changes to Work Orders. These reports cover the period of October 19, 2010
through November 19, 2010.
FISCAL IMPACT: The total change to contracts is $68,701.84. The total change 10 work
orders is $125,099.60.
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with
this action.
RECOMMENDATION: That Ihe Board of County Commissioners accepts the enclosed
Administrative Change Orders Report and Administrative Changes to Work Orders Report and
ratifies the listed change orders and changes 10 work orders.
PREPARED BY: Diana De Leon, Contract Technician, Purchasing Department
Item Number:
Item Summary:
Meeting Date:
Agenda Item No 16E6
December 14. 2010
Page 2 of 52
COLLIER COUNTY
BOMW OF COUNTY COMMISSIONEHS
lGL6
Recommendation to accept reports and ratify staff-approved change orders and changes to
work orders
12/14/2010 9:00:00 Ar~
Prepared Ily
Diana DeL(~on
Administrative Services
Division
Contre;cts Tt~clllliciall
Date
PlH{;Il<dn~J g Ge1l01al Services
11/30/201010:08:04 AM
Approved By
S"leve C;:mlc,ll
l\dluil1istralivL Servjc<.:s
Dh'ision
Djn-'c!~)r - F'urcha:;it1gfGC! leral Services
Date
Pt,II"c!l;Jsinq D Gf.'Jlcral Services
1211/201010:41 AM
AplJroved By
Li?r1 Golden Price
AdministraUvc Sell/icas
Division
i\ (fm illi~~,tr at'"'r /\dlilinisH2I1ve SOI"vices
Dale
/,dl1Iini3trative Services [livisiofl
12/2/20109:31 AM
Approved Ily
CHJf3 C(:tfl din;;!o(
C(H!llly M,Hlf'l~_Wr'S ',)fiil'-'
Dalc
Uj(ice d L'.lhiWc~lnen! ,s, UlJd(rct
12f2f20-10 2:11 PM
Approved Ill'
-~ lv~rf'~~<:' Stnnky
()Hics Df r,~;~rliJ:1 .<r r'nl ,".
t',II1.icW~
Fi ''I ":~~1~!1 C'jI ,ratkHIS Sn!'purl - 1 t 2115
Date
'.'ili :i,' 'Ii f', ,)li1~F'IIH'nl 8, !3w!(i'.:t
12{31201D 5:08 PM
Approved By
1..':'0 L ',1::1 ;', ,':
(Olm1'{ M;:111:Y:'~I'; ':.lHicn
"'lI'l!': rlid:" (:,'1
Uate
:'iPll\ l~ltT:;[I'''S r. rjt";f'
12/7f?010 10:33 PM
/\genrla Item NO.1 GE6
December 14, 2010
Page 3 of 52
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CONI RACT/\\llRK ORJ)ER ~IO[)[FICATlON
CHECKLIST FORM
PRO.IEeT NAME:
:()JL~~UI11_cX:~~_L;Ji_ QLLllI!PUL::~'i:_lJ]G_ll ~::J!}uth 91'~L;~.mj.;!!)ji TrC!LUL;;~ PR OJECT #: 60016
PROJECT IIIANAGER: L~I.l2..Q[!L~r1<g CONTltACT II: 0':'.._2197 MOD #: L PO#: ,1500119653
DEPART1\lENT: TransportHtion Encinrerillf! D{'f)(lrtlll(,llt
CONTRACTOR NAME: Quality Emomr',es. Inc.
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Original COlllr~lc:t Amount:
s :~7.::::U7A8_~
(Starting Point)
Current Bee Approved ,\mulIllt: ____,_____J;..~)~,A_ _ _ ________..__._
(Last I'utal ;\moullt ;\pproVl'd by the Bee)
Current Contr-R\:t AmoulII;
(Including All Changes Prior
ro "l his i\lodiflcation)
Rc\-isl'U COlliract/\Vor!\ Order Amount:
./
Change Amount:. ",~_~J,(j_Oq.ijil
(lIlc]udillg Ihis CIMllgl' Order)
CIlIllUh!tiH' JJulbr Value orf 1t:1I!gt~ tn this CJlltnl\:I/\Y()d~ Ordl;T: S;-.i:;~ I-F!jJ.tt"
. (I ~ f (, (.. ,"I
Date of Last Bee' Approv;d
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Agenda Item No. 16E6
Uecem5er 14,2010
Page 4 of 52
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CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Corridor Management Planning Sllpport Services PROJECT #: N/A
ROJECT MANAGER: r:;~~ie Armstrong
BIDIRFP #: r;;.'Z; if I ( MOD #: 002 PO# 45~1046G5 WORK ORDER #: AIM~FT-4198~09~G1
DEPARTMENT: Transportation Planning CONTRACTOR/FIRM NAME: AIM Engineering & Surveying
c,'> kC,,<1
Original Cont-rnct Amount:
$ 40,000.00
(Starting Point)
$~ tJ(-A
(Last Total Amount Approved by the BCC)
Current Bee Approved Amount:
, / n
Current Contract Amount:
S40,UOO.00
(Including ArI Cflanges Prior To This Modification)
Change Amount:
$
0.00
Revised ContractIWork Order Alllount:
$40,00000
(Including 'I his Change Order)
Cumulative nollar Value of Changes to
this COlltraclN'Jork Order:
$
0.00
Date of Lm"t BCe I.\.pproval: WA, work order at $40,000.UO under existin~] an annual fixed term contract Agenda Item # N/A
Percent"lge of the change over/under current contract amount: 0%
Formula: {Revi!;ed Amount! Last Bee appfO\ied amount)-1
CURRENT COMrLf'lIOI, IJf\ IE (S): ORIGINAL: E<dn~"'Y l~~OJQCURRENT: !,galJ~"~Da June 30. 2011
Describe the ch"ngo(s): lime extension ollly requested for cornpletion of survey and deliverables
Specify the reasons for the d.ange(s) r 1. Planned or Elective (' 2. Unforeseen Conditions r 3~ Quantity
Adjustments r 4. Conection of Errors (Plans, Specifications or Scope of Work) r 5. Value Added
(;-, 6. Schedule Adjustrllcnts Note: Olle or more may be cheeked, depending on the nature of the change(s).
Identify allllegalive impacts to the project if this change order were not processed: The consultant will not be able
to delfver the final fangu:Jge and eJdlibits as directed to finalize implementation of the County's Corridor Management Plan
as pr...:;vious approv'?d by lhe F3C:;C in Grv1P .1r1lcndrnents __..__
This ctlange ww~ requested by: f-iContractorJConsultant rr Owner FI Using Department r CDES
[D0Sigll Prafess~iondl r-'iRHguli!tory f\~.wncy (Sp9cify)__~______. rOttler (Specify)
CONTRACT SPECIALIST PARTICIPAIIOI, IN rlEGOTIA liONS:
J- .
'res
[.1 r.' . .
'10, no negotIations necessary
This form is to he sizttled and date-d.
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APpr~()VE:D B'{: ,/~c~Ll::j:,'_~L/'l'~I,'J:.ltf.:.s.;t:}L_L~_",_
(.r2ybtJ<~ef-\!ni::;trun7p r)r(lj;~ft MCl!l2'l'Jcr
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REVIEWI,,!) F,y !/J~ ,.j.,:TYL",,-(LtJ.,.;///4;'" ..,.,,=::,
RI, o"da GUlnrnings. (;,;f;!Cact ~~)li3t.,
Date: !.i~~_Ll~/l__
Date It/ltJ2L
Fevised ! 1.1 'i.J.:U() 1
Aqenda Item NO.1 GE6
Dg''''Mrnblfi'r 1/1 'm1n
Paqe 5 of 52
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CONTRAC f/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: 1-75/lrmnokalee Rd Interchange Support Services
ROJECT MANAGER; Debbie Armstrong
07 1/1~
BID/RFP #: 'f~; l! MOD #; 003
PROJECT#: 60109.1
PO# 45-1 D0167
WORK ORDER #: AIM-FT-419B.08-04
DEPARTMENT: Transpor1ation Planning CONTRACTORJFIRM NAME: AIM Engineering & Surveying
\ (
Original Contract Amount:
$ 4:i.460.00
(Stoning Pom!)
$4(>~-QQ- (J / A
([ast Tolal Amount /\ppruved by the neC)
CUrrent Contract Amount:
$.45,4(j1J()()
(lncludi'lq All Changes Prior! () This Modification)
Current BCe Approved Amount:
Change Amount:
$
0.00
Revised ContractNVork Order Amount:
$45,460.00
(Inclucli;lQ 'lIlis Cb;:HlflE' Ordel')
Cumulative Dollar \/alue uf Chanqr:3 to
this Contract/Work Order:
~
0.00
Date of last BCe Approv,'31: N/A, work DIU'Jr ,it $4!\4GO under cxisling an annual fixed t~lrn contr~ct Agenda Item # N/A
Percent.."'lp!!' of tfle cfHJl1fle :)v~Jr/UlH;k"r CUfTr.llt. conlr<1ct, :J1I10Wlt: 0%,
Formula: (Hevi:~2d !l.rntlI1ll1/1 ::1',,( f!.CC UPPI'lvCc'd .jInollnt)-l
ClJRF\ENf COr,.1PU,:Tn.)f'~ D.'\Tr:: (S): ORIGINAL: rA::1!'~h 1
.CURRENT: ~~~mJ"est~I}9.QC8~mbQil1 '--.~G 1 Q
Describe UH~ channe{s): -11m::; e):{eilSirYl ollly requ(];;l::~d fur cumpletion of survey and deliverables
Specify lhe reasons for UIO change(s) C" 1. Planned or Elective (' 2. Unforeseen Conditions r 3. Quantity
Adjustlf1ent3 r 4. Corr~cti':Jll of Errors {Plarrs, Specifications or Scope of Work} r 5. Value Added
(;. 6. Schedule Adjustments Note: One or mOre may be checked, depending on the nature of the change(s).
Identify all negative impacts 10 the project jf this cliarmc ordur were not processed: The consultant will not be
able to defiver tlw fioi'll ROW IllllpS Ilrwded to i1cquire the final pieces of ROW for the improvements along
lmmok<'llee_ Rd for 1htJ I-TS J !mmol~alee Int':lrcllanqc- m....___, _____,_____
This 1:11ar1tPJ WJ:~~ nnpu~stctJ "V: r-k;ontr;,Jr;:tcnIColl:,alltalll
n Owner
PI Using Department C CDES
C-D9si~;n PrlJfc-~:-,iollal '-ir~cuufabry f\HC'liey (~ipeGily)
r- Other (Specify)~ ._._~_
cor,l RJ\CT Sl'cCII\LlS f P/\J1TI(;IFA liON IN IJEGO IIATIONS:
f-
'l'C:;)
r;;; J . t.
r' 0, no negctiCl Ions necessary
rhis form i~ (II IJ'_' F!~pled <Hid uated.
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Date:
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Agenda Item No. 16E6
Dt:;Ltll10cl 14,2010
Page 6 of 52
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Horizon Study Transpor1ation]l1fr<t~truct:l!I:g.l!eeds Assessment Update PROJECT #: NIA
ROJECT MANAGER: Debl3ie Annstrong
SIDIRFP #: .fiJ -if'] q"OD #: 002 PO# 45-100168 WORK ORDER #: AIM-FT-4198-08-03
DEPARTMENT: Transportation Planning CONTRACTOR/FIRM NAME: AIM Engineering & Surveying
~'.".,~t ~_'.Atl-'
Original Contr..act Amollnt:
$ 49,920.IJO
(Starling Point)
~U:OO tJ fA
(LaslTotal Amount Approved by the BeG)
Current BGe Approved Amount:
Current Cnntr.a~tAmount:
$49,920.00
(Including All ChanQcs Prior To This Modification)
Change Amount:
$
0.00
Revised ContracUWork Order Amount:
$4n.g20.00
(Including This Change Order)
CtmHlI~.tjve Dollar Vall!<? of Changes to
this Contracf/VVurk Order:
$
0.00
---1
Date of Last Bee Approval: ~~II\ work order at $48,920.00 under exi!=',ling an annual fixed term contract Agenda Item # N!A
Percentage of the ct1ange over/under current contra~,t amount: 0"/0
i~ormul;): (Revised I\nlount! la~:;t Bee aprroverl iHl101Jrlt)-1
C-UF.!\ENT C()r,n)LET!C}~',! D/\TE (8): OrUG!N/\L: )1!i:L1:L~POQ_CURREtn: LQmm:;;\ilJ;t~1.uf'@_JO, 2011
Describe tho c!lange(s): TillIe crtem::;ion only rc~quested fur completion of survey and deliverables
SpeGify tlw reasons for the cI13nge(s) (~ 1. Planned or Elective C 2. Unforeseen Conditions r 3. Quantity
Adjustmenf.s (- 4. Correction of Errors (Plans, Specifications or Scope of Work) r 5. Value Added
(., G. Schedule AtljllslJ,,,,nls Note: One or more may be checked, depending on the nature of the change(s).
Idenlify all negative impacts to the project if this change order were not processed: The Horizon Study is an
ongoing process and continued consultant support is rleccssary ~__'________~_
TI1i5 challg~: was requested by: '-IContractor/Cons-ultant r-j Ov.'ncr P-I Using Department r COES
r::Desigll Prof",.,,.,ioJlal r-[1'"UlIl"lory i\U"Jlcy (SpecifYl__ ____.__ IOther (SpecifYl____
CONTRACT SPECIALIST PAHTICIPA1ION IN NEGOTIATIONS:
r-
Yes
P' f~o, no negotiations necessary
Ttlis fOrll1lS to be rvnod iJnd datr:!d.
( j / / /)
!\ppn,OVEO[3'y J..1..,L}.Jil.N_~'~!(!i;_;.'L(.!.L--,-'...l(- _ __ fJ2te:
Del:5DIf[J^rrT:(">trd~q, Plqcqt r,,1al{aCl-".:r
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REVIEWE [) ilY -J r/ t/i LeU .1-- __v /D_'~~_~ c':;?,j LJate
f-:1Elnd] Curl1ll1lflgS, Contfdct :)Pt~CJ31~.s.kl
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Auenda Item No. 16EG
Ct:\...-t:lllLcl 14,2018
Page 7 of 52
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CONTRACl/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Vvork Ordur/ PO 450CJHj8UJJ j.'roject N3rneForest Lakes r....1STU - Bond Issue PrOject No. F-56 _
South Woodshlre Ditch lrT'pruvernents'
PROJ~g.Ltt~_ Work Ordar/PO ,!j 5D01 C?.Q3J
PROJECT MANAGER:_Darryl f{;chard. I'.LA. Propel ManaS]U. ATM Depariment ~M ')
BID/RFP #:C;giJJcgfLO;;}"jG~.:l:'roiect rvbn.",ggCr1i'&t Ov_ers;otrt5_eryicg:e'_MOD #: f~I{[!f)7
PO#:_ 4500108033_WORK ormER #: WOI k Order/PO 4500108033
DEPARTMENT:_J\ TM Dcpt. _._.__
1-----;-0.--;-:.- ..-'. --.
, Original COfltr<lGl ^mount:
CONTRACTOR/FIRM NAME: Malcolm Pirnie Inc.
$ . }L1lW.___~_._,_.
(Slmtil1Q p(linl)
Current BCe Appro',I(ld Amount:
$_~t~__ _______~
:J a~;t T ()tal !\mounl r'.pprov~d by H18 [lee)
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I
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Current C::::r;truct ;'\n;vunL
(I!1dudiny 1\11 Chon:y;,s hi Of -j () 1 hb "v1oejificati'Jn)
Change AlllOLlllt:
Hevi:icd Conl.r<lcU\lVorh Order Amr)unt
~. ~;2.S??!L,___~
rIW~lll';li'llll :Ii,; CII;'l:I;]'.? Urder)
Cumulativ'C.' Dolbr VaJ1J-3 of (;-rl;:'nge~, tu
this Contract/Work Order:
$.__5'1.4'7').
Date of Last r3CC ApfH'oval___ ';..\
Aqenda Itelll f.t N/A
Fl'rcenb9'~ of the Ch;:1I1gC (I l(]r"~IlH1Cr ClJrrent Cf.nltri'H.;t ,lJI1011ntf_ '~':~
hHrrIUIi'l: (i?e\ji~~c'd /\i'l~_"'~P:t i [:-\.';1 f-j(,;C Dllpruv';d il'llOUllt)-1
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This chanue order will:
fidel ;1 1),'\'\/ T,l~',l~ lor J;
[:J Ill('re;J!~c fn,,;k Nurnb(:r __5___~uD.950
/\:ld r~'C'e5 <In'.! 1:111( te) '{;i':)I:' Ultj"r: C:lfl\jirl"-'I (,,(>lI\(;1\:,! ''',.:!~; '~(J di.l:"'5. [his Cll;:lrlqe adds ~1,~_(l':.~I~~ji\DO); Heviscd Contract period
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Sp(;n:il'y the !'(;;ISIIlL~ lor lk: r;l!rl!19(;(b) 'I. PL:ll1IH_:d l}f L:I,,:clivr; 2. Unforeseen Conditions 3. Quantity
Adjustlllr'llt'.; .1. C'I)nr:<:f.loll <.'1' E~ron-; (Plall:~, Spr:-Giiicatiol\s or Scope of \Vork) ,.:. 5. Value Added
G. Sclicduh: I\djw:;frllcflt'-~ ~lo!e: (Jna or 1110["1.' may be cllCckt;d, d(.~pelldil1q on the nature of the chul1ge(s).
ldpfllify ~II! ll!.'lJat:,I{' illq:;H~b f~) OIl! project il tlli:::. c/lall~J(.' ord,::r w~r0 flot processed: LJ :9cltl\.-''0._JJi'!Da~t \:'.'l2!.;JLtJ~s::
; -J Ii ~ ! ~: ; , ..; ~ j c' : ; l. i!! (,~
"lIlis dFU1HC ....V;Y3 r(:quc~'.;l',;d 11,/:
! C Jntrtlc-lor/Co!E;ull,:1I1t ~'! Owner
I Using Uep(lrtmcnt
CDES
I LJest:]1l PlofC'o;~-;jlJll;d
!1~C9tllato,y AW,'IIt::y (SpscifYL
, Otller (Specify).
COIHFUIC r SI'ECU,UST I'M,lICII'^lIOr~ II, IHc(;OIIA lIOI",:
This fOrlll is to be signed ;-Hld dilled.
! '!'v:;
I No
!\L.:'.-i',:<d (I i;; (i')
l
Rc"j,;"u 6 IS U9
Date .-1t2' 1. ,;>'Iv
Date I () / bJ-I /; ()
( I
Agenda Item No. 16E6
DeCt;fllUel 14, lB 16
Page 8 of 52
,~
.~"
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
A~enda ltelTl No. 16E6
December 14. 2010
Page 9 of 52
t'
PROJECT NAME: GGCC- Field Liahtina
f 'I(~"~.)I
PROJECT #: PROJECT MANAGER: Tonv Ruberto
BIDIRFP #: 06-3970 MOD #: _-.1___PO#:-1f>00115158 WORK ORDER #: 4500115158
DEPARTMENT: Park. & Recreation
CONTRACTOR/FIRM NAME: HSA Enaineers & Scientist
------~---~---_._-
I, .~ \ ,_'., (.
Original Contract Amount:
--.-----_.~---~~-------_._--
$ _12.500.00__
(Starting Point)
Current Bee Approved Amount:
$__NfA I . I
(Last Total Amount Approved by the BCe)
Current Contract Amount:
$__12,500.00_
(Including All Changes Prior To This Modification)
Change Amount:
$
0.00
Hevised Con tracUWork Order Amount:
$_12,!JllO.OO__ __
(Including fllis Change Older)
Cumulative Dollar Value elf Changes to
this Contract/Work Order:
$__0.00
Onto of Last Dee: Approv;ll__.___hJ/A_________~.____ Agcnd3 Item # _N/A
Percentage of the G!1<J,ng(~ over/under curront completion date _N/A
Formula: (Hevir,ed Amount I L8st Bee approved amolll1t)..1
%
CU""E'NT COMPI_E 1101" [),~I E IS): ORlGIN^L:
January 14. 2010
CURRENT:
.),c I (
March 15. E010
This chango order will: [OJ Add a new Task for $~__~. Ll IlIcrease Task Number by $
Other
-----_.~----_._,...~-,._~~..~-,-~--- -
Describe lhe cllal1ge(s): 8,jdal1 additional.155<1!!ys to Ihesche<1ule to. accommodata lhe remainder of the
~onstrllction r2h<lSe. Del.wed was cause bv the delay in manufacturina the liQht Doles.
Specify the masons for the change(s) r 1. Planned or Elective 2. Unforeseen Condilions r 3. Quantity
Aclju:;;lmenls ,1. Correction of Errors (Plal1s, Specifications or Scope of Work) 5. Value Added
X 6. Schedule Adjustments NfJte: One or more may be checked, depending on the nature of the change(s).
Identify all rwyative impads to the projt~Gt if tllb change order wel e not processed: Nacd more time to complete
f_{Lns~!J!cti(!ll,:
This ch~J1W~ \'vas teque~.;I.~d by: X Contraclof/Cunsultant O~"'l1er r'l Using Department r CDES
Design Praressional rii'\:::.'~Juf;].tory Agcwcy (Specify) ________ r- Other (Specify)
GONT"P,(;T SPEGIMJST f'MnICII'AilON IN llEGO nAnor,s:
,-
Yes
P'
No
I hiS form IS tu br~ SiqflLd alld dnfed.
i\1-f"rWVEU ll'r-Z~!.AJ.-4It:.~rZ.ti_____ O"to
(Y~I~)I~UI]!!rIC;7:Jefllorz,t:ct Mdfl8f1U
W=VII::WU) ll, ~,jMJ::-t\:d/il... ttfJd11!d.. __,' Delt',
PII(1'd" ~LHlIr'"l1gS, C ntraciSP;,:~f-
( )
, '----'
c_d3-/(~I
d2-f40
l(cviscd 'L 1 ()
',~.., .A
,,- '}u:~i:l';2:!:.~~,~:~.,~' " "~"\i~):;h<''''';''''''"''');l< _1:..:..
'V
Agenda Item No. 16E6
December 14. 2010
Page 10 of 52
7
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: yvork O~erf PQ 450909856~_EI91~~;t t~ame: Forest Lakes fv'lSTU Bond Proiect No.7 (F-53) Quail Run Lake
?hor~line Restoration and Stabilization
PROJECT #: ~QrLOrder/PO 4500098!,i,Q.,2..._
PROJECT MANAGER:~I Richard. RLA. Project Man3QCr. ATM Departrnent .
CONTRACT #: Contract 05-3657 "Prolect Manaqement Oversiqht Services MOD #: 02 (Two)
ORDER #: 4500098562
PO#: 4500098562 WORK
.~DEf'II.'3TM E ~J.:r: ._",TI'II_Dc 1'1.
CONTI,ACTORIFIRM NAME: Malcolm Picnic Inc
-- -----..-
r ",
Original Contract Amount:
$ .88,500
(Startin:~ Point)
Current BCe ApprClvecJ Amount:
$_!.lLL-
(Last Total (\mount App!Oved by the BeG)
;:
Current Contract AmoLlnt:
$-1Jj2cQ5L__~
(Incll!din~] All Changes Prior To This Modification)
Change Arn()unt:
$ 41,B60
n,C!vised ContracUWork Order Amount;
$_~L9L910___________
(irlGluding This ChUllgl' Olde]r)
Cumulative Dollar Value af CI1<lngcs to
this ContractlWod~ Order:
$ 109,:!j,.Q__...______,___
Date of Last Bee ^pprov;:J/__,.n/a~_____________ Agenda ItC'1n #- _-,--Ilia
,.-" r'''''I'7
~:erce~t<1~: o~ th~ ~hann~ ?"erl~n:.cJ_er .current conl.m'.::t mnounc~;?~p ,p~ ' ,
hJl'iT1um: \r{evr:;eo p.rnOUlll/ U'l-Sj ULL, C1lJplUV'~(! i'H1luunt)-l
Cl,jFF~[NT C(JtJPL.[TIOf'-) [1/\1'[- (:3},' ,~~:E1.2'-~!!2qrjfl..:..19J!J. f~EVISED: DI;1",2Q!JJbe~_1:!.J:.9JiL____~_
Thi~; change order will:
[] Add a new Task for $_____
IncrC;lse Task Nurnber .]Q,Q..J2Y $4'1.86~
,l\rld Fees and Time to Work Order; Original Contract \V~l~:; ~65 (:1.Q_y'~-, this change adds ~~I.?__Y_s.j/~DO); Revised Contract period
is llf?...flrrY2
D(~scribe the- change(5):
r. ;il::ij',C1C !s j,:-, ,';;dd (/.1 (:; "iill,:jl ':.:;1". ::',j II: I !(:" :;11C! II ii, ":.:.,1; (11(:': 1;~';1
fJil()\I;"
T !"',S!< ;:)(~U .-. C:i~)I,L,~Ti~U(::-TI(JN f"t:.J'i/\(~~E;,/l[~.1'n '. ",;::~I /',,!'!C;F..~ 111,:'1"::::; :'~~ ~;41 ,8GOOO l!l order 1.0 prOvid9
;;vJdiUc,ll-kl ,::),',',,> \\'\,:'1 1("1 ,(,t-,U:]' iT,d (jlf' ~:;!Il' "J;~-\il :.;:',') ~i'1rj l~(kii~i~):Hi aun'1i11Slration needed for
~_':~lcr"!rI~,:d 'Ie, "{'j ',un~',~',: ~c:j:c;r-' c ;~::pt>IL,' ,-iu(' l,:, (-: I" :(,1,1 I :-,';]DW11 :',m:,~ <,;,tl1i::.'r (if)furC~.PH: site cCJrld:tions for OU81ity
<',:u!':l.r, ;ct iT r,; 11" :;,+,1;5 f'o ;;~,l 1_ ::ik,' ; 1\/1:."11U r:L'>IIC: L:', .'t;" f::":;:J ()lidil I:L;n [,:lIcE) ~:;hol-e!ine PPstor;~ti0n fA
(_;!,J\:;I!i;'::'l:k 1.1r:,t.'., ,,~;r:!:,::,,-:i ;.il)<,' I',". ,)':1;'11')1:3 ~(i I. ::iU,q'\F;r 'rj ::'(:IU te. au::)un~ for d!1tlClpated conslruction
~~.C:IC:(illle
Specify Ule masons for the change{s) 0 1. Plallned or EI(~ctive 2. Unforeseen Conditions 3. Quantity
Adjustments 4. Correction of Errors. (Plans, Specifieations or Scope of Work)" 5. Value Added
( G, Sclwdule Adjustments Note: 0110 or ll10re may IH~ cllccl-::cd, depending on the nature of the change(s).
Identify all neyative impacts to tile project if this chanue order were not processed: .l:t~g?tive irrlpact would be
_illt0.!IldfJti Oil 0 f cQi.L1!.J It~J 0 t s.tIJ)PQJ150J~J!;:'~~,-_"-:lD~tti:Qj CCLC;QfI!Q~.~iiiQ!l s ,
This change was requested by: ,-:>IContractoriCoTlsultant .. Owner
Using Department ' CDES
LOesign Professional i'''iRcgulatory Agency (SW;Glf~')_____
, Other (Specify)
IZcviscd 4. III
CONTRACT SPECiALIST PARTICIPATION IN NEGOTIATIONS:
This form is to be signed and dated.
APPROVED CY
I~E:VIEWED 81'
1\c\'i,';l'd ,1.11)
., ";P'
~/
r -', (
___~= _(~~ nm___ Dale
~.iaFr)' ~"Chard''/J'18ct r',~[lager .. _.
:'.. 1/1bJ.fZ/i--l//fl.11il:... Datc,
~, ""' 'omm;"". C"",,,,,, ""rr
r
y'es
· No
. ~. / /
( (~ L... C', (1'
----.-..---
1c?j2,;JPo/()
Agenda Item NO.1 GE6
December 14, 2010
Page 11 of 52
.-;
1'1
#
Agenda Item NO.16E6 ,7
December 14, 2010 ()
Page 12 of 52
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Hazel Road/North Road safety improvements PROJECT #: 60016
PROJECT MANAGER: Julio Ord6r~.:
CONTRACT #: 09,526L- MOD #: -1. PO#: ~.w1l<l1 S23~ WORK ORDER #: 4500117970
DEPARTMENT: Transportation Enqineerinq Department CONTRACTOR/FIRM NAME: AIM Enqineerinq,
Inc.
I Origina~~~~~~::o~'r:;-' ..---; 94 2~J ~~~~---'--'-
(StartIng Po:nt)
l
Current BCC Approved Amount:
~ N/A___.
(Last Total Amount Approved by the BCC)
'~/o
Current Centrad Amounl:
$ 94,2~LOQ
(Including Ail Changes Prior To This Modification)
Change Amount:
$ 12,8nOOO
Revised ContracUWork Order Amount: $107,177.00
(Including This Change Order)
Cumulative Dollar Value of Changes to tllis ContracUWork Order: $..14,,1),80.00
Date of Last Bec Approval
";C;7?\~----
Ma retrS;-x04&
.~.__.._-~
Agenda Item # __N1L-_
Percentage of the ctlallgG over/under current contract amount__t;lf1S?........-%
Forrnula: (Revi,:>cd /\mount I Last Bee CJpproved 3I1lount)-1
CURREIH COMPLETION DATE (8): ORIGINAL:, December 25.2010
CURRENT: June 23. 2011
This change order will: [.I Add a new Task for $_ In increase Task "A" by $$ 12.880.00 Other_
Describe the challge(sLJ=xl',a"cLI"lk~~:..L9,,~!?lgllJiljlVe\'Ji~LvjcesillJl'.ovide additional survey for the existing"ditch
;Jlonq NOIlh Read. as !.~.mlli:~d P.Y the South Florida_'iYilter~.,ma~nent District (SFWMD). This requirement resulted
in extenqillqJh~f,!1..i.9jJE.jL~~911tract time f9.LIe.sk "fu!lJ20 ~alenc!9L day~.?nd for .Jask "C" (storm water desiQ!1
pg[ll}!Jtil1-9YJJsJ__,5;J.l"{iI.y.J.lnJ~'!}L~L_~gc{~_~;iLl!1.JJ2Q_.~;~j~lJ~L9_r claVS_lJl"-"QrQer liL.Q.L9vig8 all survevinq, enqineerinq and
P9!:ruH.tf.i.lg_".:?_QT0~.rc~s fQLtlJ8 J!!gjf'~L:
W!LJill'i' .ll"zell~()ac1!t"Q!tLI, P,-ojid":;3,,,Iect-L.I!!lprll'Lernerrt'-.projgcL iLQ"'D9....rj~""Lqned in-house with survevinq,
er:rgiDeerill!Li3nd envjronn!~f]taJ2~Jm.Clr:J.lr()r,,-AIMJ;:1!gi,n!'_~rlug,JDS::~QrjginaJ~ AIM Enqineerinq was under contract to
P~sJQQ.n._9.~.?jgLJ~s"!'!.CY_~:Lseryjg~? fOI- !b~_~L~.F!Jg._rQ~d\I@L with the intent. hLA~ for a permit exemption since the
)J,-()!)ose.cJs"f~Jy illJProVe.I,,,mls.Jnet the5fWMD criteri.2lcw.e..mee.L",jtb.:;;E.WMQ staff on 1 0/5/1 0 to review the proiegh
sil1r:;eJl:r.e,s?fetyj[m:J1.0V'3I!lf')lll5jncl~!te. tQ.El.leC.9.1.1o;jlllclion of the north bank of the existinq ditch alona North Road, the
P.L~..lI1GL~_~9ff detenD.iIJ!~siJllaJjllJJ2fg~ement~L~Jhe exj~.llilg_._(:jjJf~had)o be included with the rot;!d proiect to re-
t;:onstruct the ditch banks <;j.Qd .remove sediments from Ule bottom. As .a result, th.e oriqinal survey work bv AIM
E;;g[ri;;-e!I;1<i;;;e~iiQj2"-:~)m~:ri~g~~iQ,'illa,,-rj? tllS',~~~tin'Lci[c!lJor C..Qiller County to be able to secure a SFWMD
General Permit for JI1~..coO~!rt,Jction,QLth-",-m.c>rJ.Qs~iLlIDQ.r.9'yemen.@,This chanae order is to tl3ve AIM Enqineerinq
'-2I-"""tU.l9"dd1ti9J1.aJJ;UrvQy.9Ltl:re. ..EJ!IJ2!im.dj!,h 310110 the sQlJlh sid_e.gf North R03_,t '
Revised '1. I ()
..
Agenda Item No. 16E6 V. q
December 14, 2010 C\ \
Page 13 of 52
Specify the reasons for the change(s) r 1. Planned or Elective r 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) r 5. Value Added
r 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change(s).
Identify all negative impacts to the project if this change order were not processed: Collier County will not be
able tR-~~V1:!'._q~en.eral Permit from SFWMD iflmJJX9y.ements to the existinq ditch alonq North Road are not included
''is pali ofJIJEJoadway safety improvements m:g@g; consequently the Hazel RoadlNorth Road improvements could
not be constructed.
This change was requested by: rlContraclor/Consultant n Owner n Using Department r CDES
[~Oesigll Proressional II'!Regulalory Agency (Speci(y)_~~I.~~,,-_ r other (Specify) FOOT
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: [:>:ves r No
This form is to be signed and dated.
APPROV"D flY
'. // ...
\.... .
"t~I" //_./'.- .(v:,.....I~.'
-._ _"_,,..1_,..__,;:::;.:'_.__~.......:...1.'~":"::"-.............._-.;;.'_ ~ ~~,
.Julio'F. S6f(f0H)ez;-tJl~}j8cHdd:)110'~'r \
/ / ___~_c.-.,;;:.>- - 1'\
{'eJJ1/n~f&-_(;t1tl/~1(P
I-a"~](j,, CumminDs, Contract SpeCf8()
)
Date"
,
\'.'./7. -:-,-/reJ
H,E\iIL::'v"'/ED [;'{-
Date -~/n/111
I~cvi:;cd .L' ()
Agenda Item No. 16E6
DCGCI"b6. 14.2010
Page 14 of 52
?
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PHOJECT NAME: Roadwav Maintell3nce Cost Estimatinq F:rocess
PHOJECT MANAGER: Claudine Auclair
"'0- 3Q,5'
CON1RACT #: .Gll4'l9.MOD #: 001
PHOJECT#: N/A
lOr;
PO#: 4500107;1'22
WORK ORDER #: CH2-FT-3975-Q9-Q1
~QJ~J:~!!I~EJ(r.:_~~~!.1!!.~9.aD_~!_.B!;_9!Jt!ff.?)~~_~i~v:!t!)~ M~!.~.gcfr~ent__g.i~_i_~!~_~_C~f'!TRACTQ~FIRM NAME: CH2M HILL INC.
Original Contract Amount:
$ :lO.OOQ,QQ
(Starting Poin!)
Current BCe Approved Amount:
$ NIA
(Last Total Amount Approved by the Bee)
Current Conlr;Jct ^mo(ll1t~
S_:lQ_,QillLOQ
(Including All Changes Prior To This Modification)
Change Amount:
$0.00
Revised ContracllWork Order Amount:
$30,000.00-.
(f1Ycludlng J his Clmnqe Order)
CUlllulatlve Dollar Valu(~ of Changes to
this Contmcl.lVVOlk Order:
$0.00
Dale of Ulst aGe f.pproval Ni^ Agenda Ilem #___.._...
Percenl,;'ge of Hie chan~}c over/WIder currc/lt conl:r;Jct mno1Jnt_.__J?L~~..____.___%
FDlf1lu]a: (Revis"~d r',rnOllrlt f Last Dee i:1pprcr,red cJIIIOUII1)-1
CUf~nJ~r'JT COr,:1PLTTiOiJ D/\TE (C} ()t::IGir~AL: _:~{;.vi?(!jCL__.CURHENT: J2/31.t?Jl..Ll
This chang~ ordor wiil: i] iu:Jd a fl'.:'W T3Sk fer $__,,___~_. [1 Incre35e Task Number
by $
0111\": CllNiGE THE COM,'L[TION DAl E OF lHE PROJECT
Describe tile chnllge(s):_Completion date must be modified ill order to allow the contractor to provide the final
report.
Specify the reasons for trlf~ chan~le{s) (' 1. Planlled or Elective r 2. Unforeseen Conditions r 3. Quantity
AJi'ustnwtlts C 4. CorreGtion of Errors (Plans, Specifications or Scope of Work) (" 5. Value Added
( 6. Schedul!; P.djustment~, Note: Olle or mOle may be checked, depending 011 the nature of the change(s). ,
--I (' I) dt/l f. I
I(;er~tlfy allne","I:~P ill'pocts 10 tile projc'ct If tlli'; c1!lill~ge(,:rdPr vt~r~nol p~o:essed: !/\.Z~~{LZ' ! L~ l rd.,)? C-
L"!.cl,. ,k!~uL" {;~ JI_I..,.. ~I' Il....(/. _'e.CL. .It. "~L: 'ILf... (0'.',1_1,,>1.'1 .!L!~f.j(L,IJ 1.r.::L_(_..1~)dJ~iL1,Ll _0" _e. _ 11 C, (0",-. ltLP_
'L' " (II .! "I . (., I' /
(-1(\I~,~';.-(1_,.~I'_~\..L~' )"~,,,(,:"i,l,r ':" ';:"1'<-1,. '" _ __
I his,\:l1aflU" was reqlwsled by: I !CulIl'aclorlCIlIlSlJltanl f I Owner r I Usinu Department C CDES
[Dnsi~J,n Profess!onal lir~':~Jur~;!ory l\~H;ncy (Spcr;ify)___..__._.~ ______.___ [-Other (Spedfy)
CONTEACT SPECI!\L1ST PM<TICIPATlOflIN NEGOTIATIONS:
r-
Yes
r- IJo
This form is to be
]J';:;ite:
/':".PF)f~O\j[U BY
"1C'!IE'NI=D BY.
Date ! Ii /! / I /\
~-'-I~--T~--
RC\';';cd ,1.1 (j
A[JelldCl Item No. HiE6
. . ~- --O"""mbGW4c-2Q.:W-
Pa[J8 15 of 52
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CDrHRACTIWORK ORDER MODIFICATION
CHECI~L1ST FORM
PROJECT NAME: f,iriffin Road Filter Marsl1
PROJECT /I, 51101.1 PROJECT MANAGER: Marqaret Bishop
ro#: ~5JliU0619L__~_~ ~_~ WORK ORDER #: 45 "0 I 0<(0 ('i 3
CONTRACTOR/FIRM NAME: PBS&J Inc.
---------_.__...._._--~--~--
CONTRACT II: !ifJ-3959_MOD II: 1
~EPAR.L~EHL TranSjJortation Erwincerirlct
Original ContraeVWork Order Amount:
$1!)LE;~~(L___~__________
(St8rtin'j PUillt)
$147 ,6~9_9~_:"J' //1,__________..
(L3st! otl.ll ^:l1UL'flt /\PPlOvcJ by the Bee)
Current Bee Approved Amuunt:
Current Contr<lctfWork Ordcr Arnol111t:
$1SJt: S~~)o_(;,rL_ _n'
:ll)clLldln~J /,11 Clldl1Q(:S PtiDf To This Iv1odific8tion)
Change Alllount:
SJlJl___.m
Revised COlltJactiWork Order !\mount:
$1.~Lli/Q.Jlf)_^___ "_
(lnc;I~ldin9 rll:'; CkJllge OrJen)
CUrTlulative Oollilr V~:JlIe of Clwllgt's to
this ContracllVVOl k. Order:
:;;lL9_____
--~~--~
Date of L<lst Dee Approve;l JJU'",-_
I\w:nda Ilern if
P('fccnt;)~1C (~f th'J Gh"H1IY~ ';verhliHhr GUrrellt (;()jitr,H:;Uw011, Uld'2f' dnlUUtli 0.0 "~_~,~
tCI!rlul:::1: (r'\~\.'i'';'>i /\'::IC\'l!(,I L~!:';t [~CC; ,q)PIT'JE~d iJll:C:U:ltj ,1
CUI:;Ft:-_NT C(J!,1f;IEli(JI-1 Liil'iL: !!:,i: Or'\IGIf~/\L: !-\!l~EI;iLl, ?q1.Q__.ClJRf;ZENT: M~Y.L~~.9J1__"
This challql' ()i~!CI \.I.'ill:
i"-I ;'.(.I(/;J Il'?\\' l8~~k fur $
[J Increase -Task Number
__by $
UtlE)r_j\D1Li1_IJY1Jl(!.Tl;lL_tU1JQ.._f.?LJ~.!J)littjqra..1.~1~'.i}.l:;;lL> ;JllcJ tr:msfcr $5,000.00 from Task XII
liJQl bU!2;:;,l~r.~~_~~;"~! )"~'JJ.3g~?_ Lq Lrt0J5__.~~L C OJIS true ti 01.!..t.L~!:!?_~~}l_~ ~2~ql!Lc a tiQ!l2
Oescribe t1w cl1allqo(~~): bJlrl~~:...f5.!_~r)~l(~!L~)IXZ~U!i.ly~js,.rt.tq~~(!~~J.Q.~J to respond to penniltil)q requirements from
tIle SF~JH!2~_{\.I'~q~'_I:'~~U~~_tJi~:!J(.:!~.?,OO!L,Q.P__!Xg!.1_1 T~~sh XII reimbursable expenses to Task VI Construction Plans
<l"!..!.~ ~~~~~!_~GaE~!.!~s is il!S~~ mq_t1(!~te('-~
~;peGify tile' waSOll5 fur triC ch"wUe(s) i. Planllud or Elective (" 2. Unforeseen Conditions (' 3. Quantity
i\d.iustI1H~llf~; C 4. COlT')cfion of Fnol'~; IPl<1Il;,-;, Spr;cjfjcat.ions or Scope ofWorl<) r 5. Value Added
(. G. :;L!i(:duf<.. r\{ij!!<~tTI1<!nf.s N{ltC-: CIIIP or fll'!rP IlF!)' he checked, depending ('1\ the nature of tile challge(s).
Identify .]lIl1('~ptivc irl\pacl<; I,) UH~ pH}" ~;! 1l Ow; r:II;Hl[l<:' order ',';J~)I'C' !lot processed:
Thi:'; cll;lnw~ \,i?'~ If-:r,F}(,\~;iyd! y: r 1~:lJtltr,'f(:(or!Cu:I:~ll:liJ!1j
O'",."I1C[' r~i Using Department C COES
1,-Uesiqrl !'(~'rL::.~j'::~!1,\1 i "i)<:'LiUl~1,toIY /\q;.:ifi(;'\' (;:p(;cifj')
I- Otller (Specify)
COIJ1RACI :,['i,CI/I!.!"!' l'I\f'lICIP!1 llUIJ Illl'JI CO I'll, I i'JlJS:
i
1(',';
,-
Ilu
Tllis fOrlll is h L':, :;iH'I'~'d am! d:llr,!d.
, F'!'J,'
['.I'I'I,UV[[) Hi' .;)",.,.,.),.{ C\ y.')J'cJi'J'
rvi'Jrbn-l':ttf r)i~J",,::;t~. pr"ojj\;r 1'o'1:_;;/h1'-';"
,,//~, .l'/ /1 .'
'-'/''-Vlj' ,:. {..f ,1'( r 1(' ;,. /1 '(I
j:.[\jIF-V'.:!_~fJ ITI ,L--I:U'}fi."j-:(:.._;...-:._/
'Pi i11i lel::l C!:' iHnil-:u:~:" C':)nlr .:-~
L"-'!!"
~~~L~"_"
1)'("
il-j~!lJ
Ft'\j' ,.d ] 1-)
Agenda Item No. 16E6 II
December 14, 2010 . ;.
Page 16 of 52
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Publjg-<~..ommunications Manaacment System
PROJECT MANAGER: Tamika Seaton
PROJECT#: TBE 00026-030-01
BID/RFP #: 03-3465
MOD #: 3
PO#:4500100197
WOFlK ORDER #: TBE-FT-3465-06-02
DEPARTMENT: COLLIER METROPOLITAN PLANNING ORGANIZATION CONTRACTOR/FIRM NAME: Cardo TBE
Original Contract Anwunt: $ _ 41.184~
(Starting Point)
Current BCe Approved Amount: S ~ N i:!.'t
(Last Total Alnount A[)proved by the Bee)
CUrrent Contract Amount: $..-=11JJH_.___ ..____
(Including AU Ck'll"lrjBS Prior To This i'.,1odification}
Cllange Amount: $ 0
Revised Contract/Work Order AmQunt: $.....Q-"' L{ [( 1 i 'f
(Inducjjng This Change Order)
-
CUnlUlcltive Donar Value of Cl1allqes to
this ContractJWorl{ Dreier:
$ 4471-&+
o,co
-_._---------~_.....- --- ---- ~_.__._._-----_._--,--" ----_.._---".._.__.._~--_.._._~ --_.-._._--_._~,-~~-
Date of last BCC l\Pproval__.__.tJfL\
Agenda Item tt
P(HCentage of the change ovcriunder curn?nt contract iJmount_~_..O_~_.~____(111
r'Jrrnu!'J: (f-Zev!sed ..fI.nKl!..int,' L~,:~~t LV;C c)ppu\ri~{J cH1E)unl) 1
CUf;r:z[~i!T CC:lviF'L:--nO;.J [A-ii: i.'::,): OF;iGlhil\L: iJ7fQ8f4.ll.U\1
Describe tile! cili.1rl~le(~:;):_TIHS c1lCHl~Je order is to
Ellginecril19 Servic(~s
C:UHRENT (Revised): 06{30/~Q..1.1
extend our contract with TBE
(Contract
for professional Traffic
#03-3465)_
----- .._._----~--~._--_..._."....._-_.._----------- ----. -~------------"---~~--------_._._----
Specify the r(~?soIlS for the change{s) '1. Planned or Elective ( 2. Unforeseen Conditions (" 3. Quantity
Adjustments (~ ,1. COITHction of Errors (PL:HlS, SpE~cificaf.iuns or Scope of Work) co., 5. Value Added
)( o. Scheduf(! /\djus1.nJ'J!lts r,)otf~: OlE) (Jr morc nl<.l'y' be ched~ed, depending on the nature of the change(s).
Identify ull rjt~uative irnpacts to tile project if this cl1ang0 order V,fflre not processed: ]]18 MPO would not have a
~~~J2-~j.tiL.\1VS: !oqli(,L::.;L__U~~9J.g"\.rJ-.Q!J!tt_f;1.(t.l~2__Q.;,,:!erl.~(JJ2L_~Q~!l'tf?j-L2.f..Ql.l~j.1Lve.3r or 360 dQYXi..frorn the date the VI/ork Order
r.~I-2dJE~.2H~2.rl!5j2l?l:L(:~~<C:(tt) ,~i! fS,!\"( _MI_::~).,::~_! QJLLiL:.-:;i:!l~ti~,11,.LlL1Jl~,.i:lr!?fE:iLl_C;.r~__qfJL~_tv1PQ' ;.L~y'.QtL_~]!L.v~J] II e or-eo a rino Reouest for
This chanue '.'125 requested by: r'IContractol'!Consultant
COr;sign Proff;:ssional j"" fReuulatorj/ Aoeney (Spccifyt.__
Owner x n U sing Department C_ GOES
Other (Specify)
CONTFU,CT SPECIALIST
IH NEGOTI/\TIOr~S:
YC3.
r-
Uo
This form is to be
1,1; ~/.'I '
/'/70 C
'~--T-'-'~--~
!\r~'PF<C)\lEU 8'(. ,,~
mViC'WE.D [<Y. 'fl:~-;~~i~~~(-~=--.
..' CO! dr;wt ;:)pe:~I~Jk)t
Rc\i:;('(! .2-12-1);)
Datf:::
----_._-;----/-
_U_L JD
I: : -, I "~
A[lende limn ~Jo. 16E6
December 14, 2010
Page 17 of 52
{ ,~l
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Mar-Good Harbor Park PROJECT II: B0024 PROJECT MANAGER: Vicky Ahmad
BIDfRFP #: 99-5305 MOD #:
1
POO: 4500119968
WORK ORDER #: 4500119968
DEPARTMENT: Parks & Recreation
CONTRACTORlFIRM NAME: Victor J. Latayish. Architect
Original Contract Amount:
$ __14,910.00
(Starting Point)
Current Bee Approved Amount:
$_NIA
(Last T atal Amount Approved by the BeG)
CurrCllt Contmct Amount:
L_14,91000
(Including All Changes Prior To TillS Modification)
Change Amount:
,_6,BOO.OO
Revised ContractJWork Order Amount:
$_21,710.00
(Including This Change Order)
I
Cumulative Dollar Value of Changes to
this ContracUWork Order:
$_6,800.00
Dale of Last BCe App, oval
~_~~if\'___~.__.
Agenda Item # _N/.A___
Percent.-'lgc of the ChalJr]Q over/lmder curmnt completion date..__ 45.6~_~~__%
FormLila: (Revised Amount I Last Bee approved arnount)-'l
This change ord[~r will:
lJ Add a new Task for $,_11 Increase Task Number....L by $_6.600,00 TI M
OUwr
CUI;F~[I..JT COfv1f-lLE:TIOU DAI E: (::~): OR:IGJ~V\L:
Januar'{ 20. 2011
CURRENT:
Januarv 20, 2011
Describe the cfJange{s): g~~J~si(I!LrR'=.JJpl!!.ent. storaue &. restroom areas to accommodate IT eClu;pments and
r,9:vise related olans ,!nd documents 1.0 coorctinat~~ IT cQui.omellts and reauirernents.
Specify the rs<:tsons for the- change(s} ,.
1. Pianneu or Elective 2. Unforeseen Conditions 3. Quantity
I\djustmenls ,-. II., Conecliun of Errors (Plans, Specifications or Scope of Work) X 5. Value Added
6. Schedule AdJustments Note: One or more may be chcclwd, depending (;>0 the nature of the change(s).
Identify all ne!lativ9 ifnpacts to thr~ project if till:; chan~e order were not processed:
Changes are needed to finalize plans for the State (DUR) and Grantor (FCT).
llli5 ~hal1ge was wquesh;d ljy: Coutract'Jr/Consoltant OWlIer r I UsinfJ Department r~ GDES
)( Dgsign Professional f1egulatory f~ueIlcy (SpecifYJ _.______._~_~___ Otlter (Specify)_.
CONTRACT SPECIALIST FARIICIPATION IN NEGo-i lATIONS:
Yes
XNO
This fonll is to be signed alld dated. )/ ,_ /"
/ , /' / ~
'/~ ; if ' I / ,.,'" c' ," n
AI'P"OVI:UD; Yl-l,y/'JlU!Ed,____kZ"'-1~CV;-L: !Jote _ _'(,./0':;://(,/
f''''jeet lv1ana[wr \~' 1 i' 1/
REVIEWED B', _ rclLorlda C:Ufllfllln_t.ill[rr'&___ _f.. c'/tl'ljPfJ~)e) ~11{3 4-()
c.>mtract Speclahst ( C___~
, I,
/
FcviseJ 4. I (J
'\,:~.p"::~~'f":;;';M.;:~,/7J!~;~~~.;..'f'~~."",:."if:.,:'" 'k;~'r:::.:-"o :.'r:~',\':''''_~:;:-~:j?Jn.:,~~;~'~:"li/''\:~~:~'3::;t~~!f.~'el3:''''''''''I' -'*.,,~.."~' . ~:;:;rt'.3~.-r""':W::~::"-:i~~..,iI:,t:l.;1"j.i::;"G"~,~,',r-...~~.;:!,~~~~I:~'7'lI
CONTRACT/WORK ORDER MODIFICATION
CHECI~L1ST FORM
Agenda Item No. 16E6
December 14. 2010
Page 18 of 52
(j
PROJECT t~AME: Access Manaqel11cnt Polic,1'. PROJECT # 601R PROJECT MANAGER: Joiln Podczerwinskv
BID/RFP #: QJ;.3975 __MOD #: 2
POIt:_ 4500106279
WORK ORDER It:
same as PO#
DEPARTMENT: Transportation Planning CONTRACTORlFIRM NAME: CH2MHill
Original Contract Amount
$ 27.065.00._________
(Starting Point)
$.2Q,715.0a .-~A
(LClst T olal Amount Approved by the Bee)
Current Bce Approved Amount:
Current Contract Amount:
lb'!J..L~"_Q!L_..__._ ___.___._~
(Including All Changes Prior To This Modification)
Change Amount:
.&JL_.._
Revised Contract/Work Order Amount:
gg,I1.~.Q!UH9 revisionl
(Including Tllis Chan!je Order)
~uJllulative Dollar Value of Changes to
this Contract/Work Order:
~;:~_!illJle9______~~__~______
M ' .. - - ... ,." -, .,.....----..
Date of Last Bee Approva[J!~~":ife~2,_~Q~,_-)~_ Agenda Item #
Percent.'lge of tile charj~je over/under curront cont.ract amDull~____Jjm~~Q.....nlt r:' C r'>
I:'urmula: (i~(-;vised Amount I L.asl Bee approved arnount)-1
.... CURf.:nn VJI,1I'LETiOI.j [),~If' C;): OftlGINAL:_Clc.LQIJf2rJQ,;:<i1(19.. CURRENT PROPOSED:.l!larcil31, 2011
fJescf!be th~ Cfla!l~le{s):_T!]i~L~~Q.rJ:~__Q~:Q?rJl,qg~,not _~GQIL_(;QlI1J2LcJ.?J Y{ltllUl.1jJ~u!riginal allotted time, and an extensioli vf
l~!LQ.[~~tj.imeUtJft.l~EJC~D_~1Etes 8xt~rJ:ilC2U..J2f the \vork Q!:Q~L__~:IQ9~OUt date_:..-.J:he extension will not incur additional costs
_':l_n~t,,_g.Q?~"i_,[lgLYL~J.~1t~,.J_JlJY.." stattA19LIl,.or' re.filll.?J:.gl..YJf;,q_lu.c.Qmenl2..__I!l~,_chanoe is _D~_c~ssarv in order to accommodate
~J1E!PfJ~sUJ.~L!~erG ns~.Lan"~Lg.iJ2"ci1:~~U-L~!!.iU.fL(~Q_c~!l9JL~l1Jhe_Qrlgt!JELG.W_d prevj~russhanqe order- to) the proiect scope.
Specify tile reasons for lIw c1"'"ne(s) r '1. Planned Dr Elective t' 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correc!ion of Errors (Plans, Specifications or Scope of Work) r 5. Value Added
(, 6. Schedule Adjw;trnenls Note: 0110 or more may be c:hecked, depending on the nature of the changers).
Identify alllleuative impaets. to ttJe~~lfojcd if this change urder were 1I0t processed:l_tJ.~~l!l!Q~~~!itiveJhillJ:his Pxgiect
.r;:_QlttU!.~~:5n[~JL'!::'~}[~L~~!.L~L~'~li.rl~~ldt;:J.P!~;'f),,\~~11_9Ljll.Q_i:JJ.JL!!-J e..C2 r(I~.f.Jbi~.prQj~ct wilUlre IZ,_!?JEjL~!JQ.fi:1lL
Ihis change was requested by: r"IContractol/Consultant r-I Owner F;rl Using Department C GDES
r::.Desi[jll ProfeGsiullal f"'i'1C[llrlatory AUellcy (Spcocify)".,... j- Otller (Specify)
ccmTRACT SPECiALlS'f f'ARt ICIPAIIOIJ II, IJEGOTlfiTIOIjS:
!- '((~S
17 No
This form is fn be. siqlled ,HILI d~l!
. ~
/ /
./ /,
i\!JPI-\CJ\/E:D (Jr" ___ "__
iJat(-;"
I<EVlfcWEU EIY
!"j'W'i) ikJi1iVYlJ //) /
,!/ {, I' 1 / 1 t
. .1\:.(/I/V~I\ti.J,l-'l..il1J//j/ll!t~\f
(~';i\lrjc;l ;(Vccnl".t (j
[late'
u)y)/ tL
F c\" i:;i.d 11.1!) ; ('Ii),:'
Auellda Item NO.1 GE6 ('f
December 14. 2010
Page 190152
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Boston Ave. PROJECT #: 33122 PROJECT MANAGER: Dan Hall
CONTRACT #: -'29~'-llQ~~-:~D #: _1~io#;~.QJl1JQ:JIL-.-..-_ WORK-~RDER #:
DEPARTMENT: Transportation Enqineerinq Department
CONTRACTOR/FIRM NAME: a. Gradv Minor. Inc.
I Original c-:n~~act Amount:-
i Current BCe Approved Amount:
S ~4.{t~OQJ1D______,__
(Starting Point)
$-,~I6. .__ _ _ ___..___________
(Last Total Amount Approve,l by the BCC)
I Current Contract Amount:
$_1llc112Q,QO_._____
(Including /\11 Changes Prior To This Modification)
CHange Amount:
$ ___QJJ[J
Revised COlltracUWork Order Amount:
$'HI,~OO.OO _
(Including This Chanqe Ordel")
Cumulative Dollar V8Jue of Changes to
t1lis ContracilWurk Order:
$ _ _p.OQ_____
Date of Last BeG Approv;:!!
1\C1!?nda !tern
Percentage of the change over/lJrHI~~r GtH'rent COlltl';1Ct <llllOLlnt_. ILQ___%
F olFlula: (R('!viscrJ Amount / Last [lee npproved mnounf)" 1
CUHF::E}JT CCJivlPI ~n(JN r-jf\TF (;:;). OR/(':;INL\L: .II.Hl~,'lrl :~Ulr)
("':"1 rRR~NT' r!orc.lllhor'1.1 'In-l1
- -... --. -. . --=~'::.:..~~~_':'~_::::..::::~
This change ord0r will: 1] Add a new "lash for $__
Extension over 2U% of oriqj!..@J.__.~
Increase Task Number ~ by $
Other Time
Describe the chall!Je(s):,~11e llosl9n Avenue "idc\N91i<j,Jroiect was.<Ji'@.:B..d since the Stormwater Manaqementj3ection
Le.s.:_Qivgd_g[ilrJtfL1nrIiD9_1Ll,!.!'{IIIILCljIQy,;,for IJR~1IadlngjllP,_dJalnaq~5yste'lLOn Boston Aven lie. The proposed drainaqe
"'istel!LIJVl!LgLc~tlYilffQc;LU1~.e)"i~tiD9_L9_~_dw'iL This_ c;IJ-<'llQ"'-.ord"'Lls..Ior aljrl1<eextension of the contract to allow time for
lh e Q.Lfl!TlBgQ_~.YS?J_Q!.1_1'J2E2.Lf~U_~,~2r_~_iL1_Ll;JK:.LlJlrj_Qf_-JI) Jtlt;-';~9..?!9n /'Wf.; Q.!J e .~ id ~w9-1k p rorect,
--_._--------..-...,,-------.---- .....--..-------.--.".-........ ..----.------......-----..------------- -_._----~_._-~-----~--"
Specify the rea';ol!s for Ui!} chall~JlJ:(s) (' 1. Planned or Elective (' 2. Unforeseen Conditions r 3. Quantity
AdjlJstIllPnt3:' 1. Correctioll <,f Errors (Plan~. Specifications or Scope of WOIk) r 5. Value Added
..,f''((-' 6. ;jeileuIIle ArJ]ustnwnt, Note: Oll(~ or more may be checked, depending 011 the nature of the change(s).
identify all IH'Oillive impa:;!s to the project if this change oreler were not processed: The ~<Jewalk on Boston
.;:~Y_~J:)_IJ.0 _YLQ ~;.1Ql.L<?_"L::-UJJ:;E.l)_!..;_(-~rJs truct~:rL~~)l.iJ'l_J~l_l~,:; tOrt) _LIPJ )'y.."UJ e d~flj!:!.~19~__Qloi ~.~LQtl Bas tq_[L A VgQU_9:
This change was requ€"l.cd by: r~!C()ntractor!Consultant JT Owner f"I Using Department C. CDES
[_Design Professional j'IHBgulatory A~lenGY (SpecifYI__
. __ r- Other (Specify) FOOT
f- ~
Y',s . No
CONTHACT SPECIALIST l'AHTlCIPATION IN NEGOTIATiONS:
This form is to be signed and dated.
APPPOVED IW
1\ ., , .1
. . . /It I'V'
j'1' ,,- C)... IJ J'/
.' ..4.. -'J "'" .'..,'.,
!/\.-----' L"t'L-, \_, C. / '" '(. c:L..-,_ ..'
.. _._-~".._----_.__..'-.._.----_...__... ----..---..--"-.... ..,,--.- ----....--.-
Da.!liel (} Hall, Sr. Project r~1anaw~r"
I,)',)
,'/ 'i /) I, : .
..llLL1Ll~lk!Ll:..{ltlltol/LI/~/~ .
HI,blll]a Cummings, COlit"""t "ltClI)'st
Date:
---,'1LS//o
r,[VIEWED BY
IJClte
) I"(r /0
[(cvised'l.ll)
Ag.enrlc> IIp'lLUO. 16E6
December 14, 2010
Page 20 of 52
;c,
~
CotHRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Uorizon ~1l!.dy
ROJECT MANAGER: Debbie Annstrong
O&-3t('eO
SIDfRFP #:-NlA- MOD #: 002 PO# 45-100163
PROJECT #: 60109.1
WORK ORDER #: VEE-FT-3980-07-03
DEPARTMENT: Transportation Planning cornRAcToRIFIRM NAME: Gannetl Fleming, Inc.
Original Contract Amount:
$ 198,929.60
(Starting Point)
$-+Atl rl~"" ~,O- Nl'li:
(Last Total Amount Approved by the BCC)
Current Bee Approved Amount:
Current Contract Amount:
$198,929.60
(Including All Changes Prior To This Modification)
Change Amount:
$
0.00
Revised ContracUWork Order Amount:
$198.929.60
(Induding This Change Order)
Cumulative Dollar Value of Ch<1nges to
this ContracUWork Order:
$
0.00
Date of Last Bee Approval: N/^, work Older under existing un annual fixed tenn contract
Agenda Item # NIA.
Percentage of the ctlangc overfunder current contract amount: u%
,__ Formula: (HevisBd !\fI10Ullt J La~1 Bee approved arnount)-l
CURRENT COMPU'lION Dl\lT (S): ORIGINAL: September H. 20Q~ CURRENT: reque5tin~ June 30, 20.11
Describe the change(s): TiJll(~ extension requestc~d for flJr1her utility coordination, FOOT review process and LAP
contract adllerE~nce, final deliverables, and post design servio3s
Specify the reasons for the change(s) (' 1. Planned or Elective r 2. Unforeseen Conditions r 3. Quantity
Adjustments r -t_ Correction of Errors (Plans, Specifications or Scope of Worl<) r 5. Value Added
(~ 6. Schedule Adjustments Nole: One or more may be checked, depending on the nature of the change(s).
Identify all negative impacts to the project il this change order were not processed: The consultant will not be
able to deliver tlw fin;",,' dclivcraLJle.
] his change wac; requested IlY: r-:ContractorfConsultant II Owner PI Using Department r CDES
[Design Professional IIr,egulatory Agency (Specily).___....__,. I Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
"
Yes
17 I' . .
\10, no negotJatlons necessary
This form is to bf~ signed and dated.
REVIEWED BY
/.1
/,' /'/'
r / / i, .' ,'. ;'/' .
l~~_L~tUL,ILI::__,;.,L}~j;'(.:::lL_cJ,::'c~:!!.;,:.ll. _ _____ f)dl'.~:
[~YJI!Y) /\Irn"'?l[m(j' prQj(~llt'''..1::)h:]~:~cl
iylJJ~\:{{t..<.. L~Ull1~!!Jd,tL(f~:11e
f'\honda Curnminqs, Contract Specialist ;/ )./
\.,
A!"PHOVED BY'
,_ll-:t-It2
Revised lI.l9.2()()7
CONTHACTlWOHK ORDER MODIFICATION
CHECI{UST FOHN!
i\SI,"Ilda Itelll NO.16E6
December 14. 2010
Page 21 of 52
n
Underctrotf.nd Storaqe T!Jlll{ Pcrn~Hnj; 4315 Q_ID'jih21? Drive
PROJECT MANAGER:Dav;d Jacks"n
06-397() 1,100 #: ~_~PO#:450011187S___...____ WORf{ ORDER #:_45001'11875
Triangle CHA CON THtlCTOHlFIRM NAME:HSA Enq;n""rs & Scientists
ChafI9E!Arntmnt:
~ Ll00
$ ____49,200__
(Sbrtin9 Point)
Bce JIPW"ve<:! Amount:
IJIA
iL 8st 'l'ot~~i All1o-ljilt)\.i;rrov.e(ri;:yth-e-BC~-
Current Contract Amount:
S 11!j,420___.~_~____ .___~~_~_,
(Including t,!j Changes Prior To -J his Modlficatloli)
Rd'vi~edC()iltractiWori{ Oro'eT /uilOtmL
,",. _M" ~~."" 1 J) /) I ,<J /J
~'.___"_____,:t"'e'".;"!fl"~___L!2~,J.,.-:~-1~-=L1-
tlli::iudinr! "j his Clmnge Order)
. ::l , ,
_~IJ_m4,1~~jvepoHarYaJ~!eOrC!li>nqes to
this Contract/Worl, Order:
""r,'Utl- 2" /.1 P :J {.l
._-, l..:j'_b '1 ~__
I
I
---~____.m~__~___._~__~___J
DatE{bfL:afi'l nee Appro'v~! NII\ A(f~nda 1l'2f11 # fill/.\
Y Y. ." ..... ....... '. .' . Nr.:1~f';i (':
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CURREIH COIAPLE'lICJtJ [JAI f~. C,r (1I<IOfl",~I_;
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Febn;arv 28. W1'{r
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._----_._--_.._---_...,-_.,.,.~_._'''"-,....__..,,..-..-,-".. ............ .....'----.-.......,--,........_._-.._-,- .. .-.-..--"...--- ._---_..._..._"'-_._-~-'"
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Agenda Item No. 1fiE6 I f7
December 14, 2010
7 ' P\ljJe 22 of (i2
N~ud II-I l-fV
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Savshore Gate_wav Trlanale CRA StreelsoaDe Guidelines PROJECT MANAGER: Sue Trone
.t.!/O
CONTRACT #: Q!l.5060 MOD #: 1 PO#:4500120152
_ OEPI\RT!-1~!'!!: Sa ho e Gatewa T ian Ie CR CONTRACTOR/FIRM NAME: JR
Original ContracL'Work Order Amount: $ 27,400.00
(Starting Point)
Currer\t BCe Approved Amount: $2'7j40f}:ao-~ />t /A
(Last Tolal Amount Approved by the BCC)
Current ContracttWork Order Amount $27,400J)O
(Including All Changes PriorTo This Modification)
Change Amount: $0.00
Revised Contract'Work Order Amol.mt: $27,400.00
\Including This Change Order)
Cumulative Dollar Value of Changes to
this Contl'act/Work Order: $0.00
Dat.a- of Last Bee ApPl'olj'al NfA (Fixed--Term Contract)
Agenda Item # N/A (Fixed.Term Cnntracl)
Percentage of tlw change over/under current contracUwol k order amount 0 %
FOrnlllla: (Revised Amount I Last BGe approved amounl)-1
CURRE1\jT C:Of-J1PLETiON OATE (~): OHl'3ItJAL: Marcll2.11..21lli CURRENT: -Seotenlber 26, 2011
Thio change Ndcr\vill: [J Ivid a neVi T85k. for $___._______ [) Increase Task Number __ by $
X Otlier
Describe the changers): Add time to (~olltr<'1ct f~H a final completion date of Sept. 26, 2011.
Speci:y the .easons for the challC]e(s) (' 1. Planned or Elecllve ('. 2. Unforeseen Conditions n 3. Quantity
Adjustments (' 4. COllection of Errors (Pia liS, Specifications or Scope of Work) r 5. Value Added
){ 6. Sc;hedtlte Adjustments I~ole: 0,,,, or IllO'O may be checked, depending on the natu.e of the change(s).
Identify alf IJl';yative ilnpacts to the project if this change order were not processed: _If this change order is not
processed, JRL's worl< order will expire in MarGh, which is only 3 mo.nths Into. the LDG amendment process. It is
possihle the Phmnlllg Cc'lIll1ni:;sion may mqucst .. ";~ I (i/;' (. Hel.,'C' :;-'7 ;,...'/<.
This r.hange! \V~1S requosted hy: r-!Cofltn~ctc.\r!Consultant j'.j Owner x Using Department Q COES
COeslfjnl'rofe""iDIlHI I "1""Llulatory r'Y'lIIcy (SpccifyL____ I-Other (SpeclfYl-
CONTRACT SPECIAliST PARTICIPATION IN NEGOTIATIONS:
ri Yes
x No
This fonn Is to be Sirl.1.o~:!:'rdat9~.
APe'ROVED BY -----/-:..~Lf./Y"'---~--.------.-----
SUG-.l (o1}.0.{Project Manager
" . '"' \ ,/ ~ ", I
REVIEWED BY;{' (), \ )} I ;' ( .. L ',I f;(
--:--'-"---t- -,""--------~------- .-.------"
.' ,! (:,?'iltrElct Specialist
Date: \ \. \'l.7- 01 0
)i"')
Date: __LL...I I
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Agenda Item No. 16E6
~. ,
(
Page 26 of 52
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Purchase :and Doliver Chemical for Public Utilities PROJECT #: N/A
PROJECT MANAGER: Dale Waller
BID/RFP #: 09,5170
MOD #: J
YO#:...!Q1"-~___ WORK ORDER #:
CONTRACTORIFIRM NAME:
NIA
DEPARTMENT: Public Utllltles DIvision
Alraas Scecialtv
Original ContractAm ount:
S NfA
(Starting Point)
Current BCe Approved Amount:
$ "fA
(La!3t1otal Amount Approved by the BeG)
Current Contract Amount:
$_~___.__IY1L-
(including M Changes PriorTo This Modification)
Chango Amollnt:
$__--'L.illL-
.
Revised COlltractIWorl{ Order Amount:
$ "'A_
(Including ltlis Change Order)
I Cumulative Dollar Value of Changes to
this CotltractlWork Order: $___,__,~__ N/A
---'-~-'-~-----'--'- _._--~--_.._.~----------_._~-~-~-~_.._-~-----
Date of last nee Approval 7/2812,009
Agonda ltarn #
16C5
Percentage of the chang9- OVQr/under current c:ontract arnount
POlmulu: (Revised Amount I LasfllCC approved amount;-.1 --
O~)L___%
CURRENT CCMPLE1ION DA fE (S): ORIGINAL: _______,CURRENT:
Tht8 l:hiHIIJC order will: I.J Add a new Task for $
j'n] Increase Task Number
by $~__
OtlH"r__"IJ2J!~.!!.L!iL!!J2-1!dc.Q!Qr..A.r.l!!J'drous Ammonj~r ot;t."1ched Exhibit A1..A
Describe tile chango(s) Fi::iJlU prjcu:!...o..LE;.K~liblt A 1..A based additio.l1al_..9J!€I_rter1v neuotlation review meetinQ.
Specify the reason'J for tile change{s) K 1. Planned or Elective (' 2. Unforeseen Conditions r 3. Quantity
Adjustment.!; ('" 4. Corroction of Errors {Plana, Sp()(;ific::ltiofm or SCOW} of Work) X 5. Value Added
(' G. Schedule Adjustmollts Note: 0110 or more may be checked, depending 011 the nature of the change(s).
Identify all negative impacts to the project If this cha.nge order were not processed: _The price schedule would
not rorlcet the noVl' t1fJgotiated priGf:!'.
This change was rcquC:fiteu by: r-iConfraf:tor/Gt)llsultanl X Owner r-l Using Department C COES
CDcslgn Profonsional nHcguiafory Agoncy (Specify) r' Other (Specifyl____
PURGHASING PHOFESSlor~AL PARTICIPATION IN I~EGOTIATIONS:
X Yes
r
1'10
1 hIs form is to b(> ~ltJoed rind d~\t~'d. ., ,)
/' " r) ,) / f(
,\PPflOVEIJ f'Y \ ~Y_l\",4,.~t,_ CI)1.i,.;~_",.=._
';,lle' ';I'e~'r"l''''''I''r
REVIEWED B ( -.! Jtit . 1;~l_____~_
l'ufchasmQ PI:ofec;~;:Dni""J!
Date:
I~' /)~) 1/
.Ll.:! -(-rC' --Ie)
Dale:
12la-LLQ___
Revised Ij J R 09
'l~'!>'':,".N:',.'i,:"",_;-
(0
Agenda Item NO.1 fiE6
norn.rnhr",- 1;1 0('11n
Page 27 of 52
EXHIBIT A-I I'l1eruoranuum 01' Understanding Amendment # 1
"Pul'clIMe aud lJeU\'el' Cllemicals for'Public Utilitie,,"
Tllis nmendment, dated C1ctober 19, 2010 to tile referenced Memorandum ofUnderstand.ing shaH be by
and between the parties to the original Memorandum of Understand.ing "MOU", Airgas Specialty
Pr()Qucts (to be referred tu as "Vendor") and Collier County, Florida, (to be referred to as l<County").
Statement ofUnderstandillg
HE: I,fOD #. 09~51 70 "Pun::ha:-,e HJl{l L;cliver Cllernicals for Public Utilities"
III order to conLinue the services provi~cd for in the original MOU document referenced above, tho
Ve,naal' agrees to amend the abDve referenced MOU as per Exhibit "Al~A", Price Schedule, attached to
this AmClldmtnt and incorporated herein by reference. This Amendment shall increase pricing us
ri.:dlows:
'1 he auditions to the existing Attachment A - Price :lchedule aro shown herein by underlinilH:!: deletions
, , ,".' ,
aie :"1.HlWIIU)' ~[fi1iemfEH-lgHfr;
Clumgc: )\ttaL:lJ[ll~'l1t A, Price Schedule,
~ It-(:m three (]) Allll110Hia ~ ~....g,4gin1 iIll.::rerL"tllD f, 069 J 11l?-:.
AU other tenus and cO!Hiitiun;; of tiH: nglCGlllent ,shall lel1wiJJ ill f;)J"~:e.
iN \'VITNESS \\IUIi~RI!;OF: the \/ (:JJdor Hnd lb\.:, t.""rJUllty have each, respectively, by an aumoril.ed person
OJ" agent, h~;n~tllli.tc!" :;ct their :lr1nd:: aad seab on tile: datlJ(s) indicated belo\\',
Acccplcl: ______: (1
;J!.-~_~.2010
VEl..JU(l!{: '/~;~>f.:l('}:..J-
,- 'J
~':);I-' C(':i~ /r'y'
I
I
,-',
r: "(;i..(,~~(/T OWNER:
UUARD OF COUNTY COt-.'lM!SSrONERS
c.:ULLlER CClUN'IT. FLORIDA
.,
__/ r7?
Uy <:.~~::-,~c:..~_:f2:--~~:0...---b_":;:;
. "'~A I.. --, ..... (J
.c.,-;;:.'l/L I ~I.L_ :/Iil/'c, /_): Z~{JJ!i')r.: " c (J
]-.!tlmc l'IlId JHle f (~()j{1y,:{'/:;
. // ,-<,"'. ... .,
l...,.f" .-1'..<, > ~/.1':_ /, // /,
J::--..,~...~;K~:'.:2:'~''?_{~~:'')-::'',~_"'::',,-:~~'~<~_;'-r/:'___
\Vi[Jle~-;') !
I'!lOJIOCT MANACiER
By':DiLJ2 (JclJf1__
Dale Waller, Plant hlJaJlager, Wastewater
!);lt~q.l:
I.Cj I
. \/ I
. I
Pi PARII'lnirlJlRECTOR~ I
1 \ /) I"...
r \, - (\ l/A- .-- L-ld.ty1LCc \
t;':f "- ~L~-'-MLk-0J)!..:--=-_ -;fI,~~d,l1.-./ _,c:..-' 1~ ()
r)e lI.r,e YtIIJla7., PhD(Dir cto-r f I 'Dr
\$ . J, )0/''510
::I,'j'C!4;#lP~\
/,)\,-1/t JL)h'l:,OTJ
'---
. ~J.Ml'l"'~U'llll!r''''---
I
~-
_,.....i'!!~._~.~~jF..::..~
__._._.._,_.____.~._".d____"~_~~_..._,__...+._._..."._'~.,,_" " "------~-,-_.._..,.._._--_._._._---,-_._-- - Decenl5er 14, 20'IU
Exhibit A1-A
Price Sc~~~d~~c-- Page 28 of 52
-----
No. Company Name Product Description Unit of
Measure
ThirdQtr Fourth Qlr
July '10 - Sept '10 Oct '10 - Dee '10
-
1 Brenntag Mid South 25% Sodium Hydroxide WW-3 GALS
$ 1.343 $ 1.343
-.------------ ---
" ~~""'<;:I Chemical 25% Sodium Hydroxide WW-3 GALS
$ 1.480 Not supplying
..---.-.----.----- ----
2 Allied Universal Corporation 50% Sodium Hydroxide W.11 LBS $ 0.119 $ 0.133
Key Chemical .----- -----.--- ---
50% Sodium Hydroxide W-11 LBS
$ 0.135 $ 0.135
Airgas Specialty Products, Inc. ---.,-.----------- --.- -
3 Ammonia W-1 LBS
$ (I,l;OO $ 0.691
..._--,---,-,--_.~._---' "._-_._~._._---,-~,- ----.-
4 Allied Universal Corporation C<Jlcium Hypochlorite W/WW-1 LBS $ 1.225 $ 1.225
~-'--'-"----- -. ~.~-
Brenntag Mid South Calcium Hypochlorite W/WW.1 LBS
-- $ 1.352 $ 1.352
-------_.-
5 Airgas Carbonic Carbon Dioxide W-2 LB5 $ 0.100 $ 0.100
6 Aiiied Universal Corporation Chlorine W.3 LBS $ 0.229 $ 0.229
. -
Brenntag Mid South Chlorine W-3 LOS $ 0.241 $ '0.241
7 American Water Chemicals Corrosion Inhibitor W-4 LBS $
$ 0.598 0.598
Carus Corporation Corrosion IIIIlIUIlUI W-4 LBS $ 0.608 S 0.608
8 polydync Emulsion Polymer WW-1 LBS $ 0.960 $ 0.960
Carus Corporation Emulsion Polymer WW-1 LOS $ 1.441 $ 1.441
9 The Dumont Company Inc. Fluoride W-5 LB5 $
---- '----.-- $ 0.412
- ----->-
10 Chemical Lime COOlp<HlY Lime W-6 LB5 $ 0.115 $ 0.115
11 Can.!s Corporation liquid POll W-7 LB5 $ 0.696 $ 0.696
-- The Dumont Company Inc. i liquid P04 W-7 IB<;
S 0.630 $ 0.630
-.- Brenntag Mid South !
12 Muriatic Add W-8 LOS $ 0.151 $ 0.151
.....-. --...--.. .-. ......---....-----.--.--- "".------- --.----..
The Dumont Company Inc. Muriatic Acid W-8 LB5 $ $
- -
------"--,,
13 ThatchN Chem;c<11 Phosphoric Acid WW-2 GALS $13.050 $ 13.050
.H' ... ." -_........._.__.._....~
Brennttlg Mid South Phosphoric Acid WW-2 GALS
<" c., S 13.642
H - -- ..-.--..- -.. _.--..-
14 PolydynC' Polymer W-13 LB5
--is' $ 1.303 $ 1.303
-----..-
Americ21rl Vliater Chemicals Scale Inhibitor W-9 LBS $ 0.676 $
.. ....... ',' 0.676
lOng Lee Tech SCClle Inhibitor W-9 LB5 S 0.695 $ 0.695
.... .. -.: -...
16 polydYIlf! Sludge Polymer W-10 LB5 $ 1.303 $ 1.303
17 Od'{55C:Y fvlarlufacturing Sodium Hypochlorite WW-3 GALS $ 0.690 $ 0.690
"-~~ '-' .-
Allied Universal Corporation r Sodium Ilypochlorite W/WW-2 GALS $ 0.680 $ 0.680
18'.. -".--" --
Sulpl1uric A.cid Trading Co , Sulfuric Acid W-12 LB5 $ 0.062 $ 0.062
... ---. ...-.-........- .---....-..-.---.....--
lransarnmonia,llle. Sulfuric Acid W-12 LB5 $ 0.049 $ 0.049
-. _.
Agenda Item No. 16E6
I ~~
Agenda Ilem No. 16E6
np.r.prnhpr 1.J ?n1 n
Page 29 of 52
-,-J-
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME; Purchase and Deliver Chemical for Public Utilities PROJECT #: NIA
PROJECT MANAGER:__Dale Waller
BID/RFP #: 09-5110_MOD #: _L-___PO#: 1.o1~6770
WORK ORDER #:
NrA
DEPARTMENT: Public Utilitios DIvision
CONTRACTOR/FIRM NAME:
Allied Universal COrDoratlon
Original Cor1tract Amount:
$ NIA
(SldllillY f~oil1t)
CUrre-llt BGG Approvl1d Amount:
$_ ____ IUA ..
(LJi:.t T utal Amount ;\pproved by the Bee)
Cum.Hlt Contract Amount:
$________ rJ/A _ _ _ , _
(inc!ud;ng-/,.:tcr;d'~ges'f-\ridr To TJ\is r"lodificatTo~) -
Change AmDunt
Rc",h:;cd GOlltractlWoffc Order Amount:
f,____._._g~Ii9_.__
$_. ...._.____ .NIA
{ll1d;dir:g ihis Ctlange ()rder)
l. Cumulativo DQllar Va"'" or ';[mn",," to
thi~ COlltJacflV'./ork Order:
,_n"__"'M ... __....nu.____...___. ......
$__ ._..____.. N/A_~
DaLe of Last liCe /-'",ppro"al__!!ZQLZpn9
Agenda Item #
16G5
1>{;r;;ont,:IIJO af tlw chango oVGr/undor CUfff'lllt contract ;:,nIOLlIlt'---___.Q.im.._...,__._"'~_%
rmlllul;,; (Re:is.eJ r\mC\'Hlt I L~l,A FJee apPIOV8(1311\()[If,\)-1
Ci.JnPf:lfT CCH,1PU~~IION (.If' : E (~3)' Ol~~GIW\L: ___iJ,.'\ __....ClJRRENT: ____ _ _.tW:,
Thh ch<lnf}c ()f'd()l' vIii!:
L I Add~, new 1 ~''$lk for $
1-'1 IncreR5D Tank r~umber
_ by $
Other_ __ ..J~()_<!fn.P.IL:LH!s:J..~.r.jr;9.J!2.~$g.ill_llr.!l1J..Y~!I~~~ide..Q.(Jr attached Exhibit A3.A
[hmcdtJe t.ho ch.mgo{s) f1!J.rJll.!lri{~(~..'pBr Exhil!ft A3..A based additional QUurterlv neootfation review mcetlna.
Specify Ow rcmlOflS for the chanw~{s)'{ 1. Planned or EloctivG ("" 2. Unforeseon Conditions r 3. Quantity
Adju5tmenV_~ c.... 4. Corl'ectft)!l of Errors (plnlls. Specifications or Scope of Work) X 5. Value Added
C' 6. Schedule Adjtmtments Note: Orm or more-may be (~hecked, depending on tho natura 01 the change(s).
[dentll,Y all lle~lative il:lpacts to thE! plOjnct if this CllrH19") OrdfJf were /lot proces5[Jd: _The price schedul9 would
!lot mtlr!ct tho new ll'Jgoiii.'ted price.
Thin ctHHlg'~ w"m roqupstclj by: riCorltr'iclor/ConslllLuH X Uwner r~i U5lng Department C GOES
r:Ucujg;1 Profn'.;sional ;'~ir<J:'!lui8.t()!y )\~jcncy (Spel:i1y;._
j- Otfler (SpccifYL______
PUnCHf\::ING PROFESSlONf\L Pfo.RTICiPA'IIOI4 riJ I.JEGOn^lION~;:
X '{<:s
r No
Ttlis form h to bf'::--sig,lIcd and r~\I.t.erJ.
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,/ I;
iiEVirV!! U ir! .I {/~(~ t_ 1- /-
./,r( laolll':J fJ[,/,., ,I', \1
U,,'i()
_LO-=-~;;dj()
u,~~~:
ID(zr ~Z7
,_ .____.______:lJi_
j{cvi::;crl (,; Ii:: (1\,
..... ~c,~Ji".}l:JSfiJli!'t""1'.':!'/"rJ':'}i,,3[~.:l:\!-K_~
~ _ 1""0\<- " ~""f~,~", ~''- 'if" ... ..t. "l; ,"..;it '.., ..', ......"'~
I
Agenda Item No. '16E6
Page 30 of 52 "
cjC1
EXHIBIT A-3 Memorandum of Understanding Amendment # 3
HPun::hue and Deliver ChemicALJ for PublkUtlUtles"
~n1is amendment, date~l October 19, 2010 tu th-; i.-eferenr.:ed Memorandwn of Understanding shalt be by
RIld between dll'; parties to the oxiginal Memorandum of Understanding "MOV", AUled Universal
Corporation (to be referred to as "Vendor") and Collier Count)', Florida., (tu be referred to as "County'j.
Statement of ~rucJentAndJng
RE: MOU # 09-5 170 "Purchase atld Deliver Chemic.1s for Public Utilities"
In order to continue the setviC09 provided for in lhe originar MOU document referenced abovel the
Vendor nere~ to amend the abCNe referenced MOU as per Exhibit "A3-A"f Price Schedule. attac~ to
thi', Am~ndment and incoq1orated herein by reference, This Amendment shall Increase pricing as
follows:
Tb~additions to the existing Attachment A - llricc Schedule are shown herein by ID!f!.erlininf!: deletioDS
are sbl)wn by strilwdifl'Htgh9r
Change: Atladllnent A. PdC""e Schedule,
. Item. t\1(() (2) - !:O:-t-tWn.~ iucrease to ~flh-=
AU olll~r Ir:nn~ and eondi!iolls ~}f the agreement shall remaiu in force.
IN Vi.r.JTNESS WHF,REOF, the Vendor-nnd the County have cnch1 rer:pectively, by an authorixcd person
or agent.lu':re,mder Be,f the,it hands nnd seals on the dutc(s) indicllte.d below.
Accept,cd:
",. {
:7;J
,2010
VENDOR:
Allied Univcrnal, Corporatioll
A /~-" ;-)
Hy: 21';';:;,~;,4~;~~~~(-,~~~",~.(_,.;~;;:;..{-:r;:_<;/
catlJi:~J::inu- C1lrl.l'--, ITKXl _e_ ---- --
l!:'!(~(..'Ut~Vf! t!!jj&l~ J_st..rato::r
~._-_.._.._... -~_.._-_.._~-- ~._--
~~;;'~~~~--- ---------
e7-~..()(;tcl.x_'r ;;;;, 2010
Pated;
OWNER:
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
rl\O:~ MANAG;\ '^'~
By: \ hG...- k. CLD
Dale Waller, PluntMannger, Wastewater
D;i:'~r:rMg;TDmECT?R _ 'CJ . .. 1"" ,-
By: _!::rVi2:::l\!J -"L"':0_i-::'~' _f~_l,-_Ifl." _I ,).'c - t..C..1 ;'"\
rJtorge \'i1~", PhD. D(,~l~ ;0/2-& I ~ 0 _
::~,:RCH^~:",' 'PRO 0 (1/L~-'
. ---..L
I' " H Johnso
.. ,t,;I'.-" ;,..b "'~. . :r}J:"""-',.;'..;k;; ",,'1ii:... .L~,'::.-.-.".:~
~"""'. ,-",. .:...,'
No. Company Name
1
Brenntag Mid South
Chemical
Exhibit A3-A
Price Schedule
'~9"",da Ilem NO.1 GE6 ;) l)
~
25% Sodium HydlOxide
WW-3
--oecem er ----
Page 31 of 52
------;-- ------
nit of
easure
Third Qtr Fourth Qtr
GAlS- July '10 - Sept '10 Oct '10. Dee 'll.
$ 1.343 $ 1.343
--.--
GALS
$ 1.480 Not supplying
LBS $ lM.11j $ 0.133
----
LBS
$ 0.135 $ 0.135
-
LBS
$ 0.600 $ 0.691
-,,--
LBS $ 1.225 $ 1.225
~--_.
LBS
$ 1.352 $ 1.352
-----
LBS $ 0.100 $ 0.100
----.--. ,
Product
Description
U
M
25% Sodium Hydroxide
WW-3
-..-.----.-.. --..-......_ ... _._.__._.'_._.___"'.~___.u_. ~__.~.___".___~__
W-ll
I{ey Chemical I 50% Sodium Hydroxide
Airgas Specialty prOduct5:ln~_~! ----Ar~;~~;;i;- -. [
Calcium Hypoehlorite__l n
Calcium Hypochlorite !
2
Universal Corporation
3
4
Allied Universal Corporation
Brenntag Mid South
5 Airgas Carbonic
6 Allied Universal Corpuratiojj
Brenntar, Mid South
7 American Water ChemicClls
Carus Corporation
g I-'olydyne
(;nus Corporation
9 The Dumont Company Inr;
10 Chemical lime Company
11 CarU$ Corporation
The Dumont Company file.
12 Brenntag r,,1itl South
The Oumont Company Inc.
13 Thatcher' Lhf'fnical
Brenntag rvlid :louLI1
Polydyne
AIlH~lit(l1l VJ'ltcr ClI~lllk~ll';
l~im~ tN' -j cd\
Fo!yd':n~~
Oc1yssr:'y lvlVflUf,lctulinj;
Alli~~d UniverSClI (elt pOfi.l'-ion
18 Sulphuric Acid! fading (,0
lr<lI1~<1rlHlIOllia, Inc.
50% Sodium Hydroxide
W-ll
~.,-------,--~-.._.""_._-
W-1 J
. --....,--,.-....- --,-
W/WW-1
W/WW-1
i=~_~~2__~==[=~
LllIUf Ille ' --1m ilV-3 i U:S$ ! $ $ 0.229
ChlOrine! . W-3 1----iBS~----~$ :::;:-~-- $ 0.241
:~,:::,:ii:r~ Ilrr:ll~ii:ii:::.i :~--~--~--f=:.-~~~:-:=l-:-:::::~--~~- : :::::
Emulsion Polymer -"'-..1 ww~in_-.~-J~._~_-LBS-r
!:rnuls!oll Pal\'m~r :,_,__ ..__~~_~^~=,__ .-J---~~~,-~_.-_
Fluoride !. W-S I. LBS
Liq~ii:;r~04 ::;JII::_::~LLBBB:s=-J,_~ O.69.!i j_ $ 0,696
Liuuid P04 W-7
Muriotic\cid W3' [.. -- LBS----+~~~:: -I: :::::
P:~:::~:i:~:jid \!~:82 i -=~~ts::-:-FL~~~:==-~-=lE~:--
I'hosphor Ie Acid WW-2 --GAl-s:-_=r~~~642~_==_.~-' ~ 13.6~~-
l'olVllwr !" 1/11-13 LL1Il'S5 ~~~JI!,I ~-0l:.,.G3Y7'-63.__-"-----_._.._._..,: ::::: ___.11
See;l,::, Inldbill'f VV-9 :;>
...1----.---.-1-------.-
! $ 0.695 ,$ 0.695
LBS!-; -1~~~;---------!-~--L30;-----
GALS .-i.~~~~~------I-~690 ---
____..J ___. _ ___._._______.
GALS . L_t~:68~__.______I.-~-- 0.68~____
laS i $ 0.062 I $ 0.062
.-I---._.__.-_.__...._~_..._._-_.".!---
I $ 0.04~_____.-LL...E.049_____
Carbon Dioxide
~
j
$ 0.960 $ 0.960 I
$ 1.441 $ 1.441
--
$ 0.412 ___. $ 0.412
--- ---~
$ 0.115 $ 0.115
S~{lie lnhiui,or
'/\'-9
laS
Sludg(> POIYllIf:'r
W-10
Sndillfll llypathlorite
WW-3
50dlLlfH Hypochlorite
WjWW-2
Sulfuric (',Lid
W.12
Sulfurfc t\cid
W-12
LBS
Agenda Item No. 16E63
December 14, 2010
Page 32 of 52
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: C-Ol-W~ ~ ~p. PROJECT #: q OO?f1. I PROJECT MANAGER:c..l..o.J\ .f'~np,J
CONTRACT#:D"I-5i.bJMOD#: rt.- PO#:4.5'-lo7778 WORKORDER#: d1 ':::1(,.;3 4'S-{O"1l1~
DEPARTMENT: C:z.-t...T COIHRACTOR/FIRM NAME: 'P'E>5
Original Contract Amount:
$_JiBO,419 00
(Starting Point)
$-----1.00/ dfl, 8 c)
(Last Total !(mount Approved by the BCC)
$ uq ,62-1. CJ 5
(Ineluding Ali Changes Prior To This Modification)
$ -Jd
L 19 7 , 62--/. V~
(Including Tr'li~.ChaHgt1- Order)
CUrrent BCe Approved Amount:
Current Contract Amount:
Change Amount:
Revised Contract/Vl1ork Order Amount:
CUf1mfative Dollar Value of Changes to
this ContracUWork Order:
LlJr=?fO?- .0E;
~:te :~I~=,t BC~ A;~::~. <:r. Ct[O~1.---.-..~ge~'::ltem~-LGO~\"
Percentage of the change over/under CUrr~nt contract amount.__~__.0:J!Z';~1~%
Formula: (Revised Amount r Last Bee approved amount)-1
CUI,RENT COMPLETION CiA TE (5); ORIGINAL: 10. \1.l:.Jd::j__.GURRENT: _(,CL.:-f:::<1" I 0
This change order will: [] Add a new Task for [J Inc.m.~~~ T~q-k Number by $
r;~~2..........:1::f-.l c.{t'i'7.-A~..e:... (:;,...?,_\'TlltJOl~\dl!.~ .!h..\2..A-'\Dvr-l
Describe the Change(S~/ J:;!::l.c..{2.q,,(t$~ cOt-'-r:a..r.>-c'\"""" Ttlvt$.. TO CAJ~
..___________,,~Qk"r.z...Pc;:{-. u{.oSf'" ._.12_<.). ,;,
,/'~""
Specify the reasons for the chan(le(s) C' 1. Plallned or Elective (v.'Z. Unforeseen Conditions (' 3. Quantity
Adjustments C 4. Correction of Errors (plans, Specifications or Scope of Work) (' 5. Value Added
C 6. Scheelule Adjust",ents Noh>: One or Illore may be checked, depending on the nature of the change(s).
Identify all negative impacts to the projr,,:t If this change oldecwere not processed: r..,<o1,f"flo(?fZ..IZ-.
__.._.._.....__.. C&2h,LL~f.\a:=:...c..lQSJZ~c;'l~.....t~(4l CE".-t>cJ'l'-c:C
..~. ------
This chan[Jo was IPqllestl!d by: ItJG6r,'t;actorIConsultant ro.{)v;;';r ['-I Using Department C COES
CDesign Professional IIr,egufatory Agency (Specify)____ _ ___ I-Other (Specify)
CONTRACT Sf'ECIALlST PAr~TIGIPATlorlIN NEGOTIATIOl<S:
r-
Yes
/
rLJu'''''--
This form is to be signed and dated.
APFPOVED EJ'{:
Date: (i:~:~,_'?='~~_~
FEVIEWEU [3Y:
, ~}roject l'v1anag..]f"". r
" J' L
,J//~J ' , ',-', II'! '" ','
--j~I"'GZ;c}:L..2 /L.._t.:i.J..CJCS:':
/ (' t t Co . I' t
, :j)11 rac 0pCCI311S
IJatf! ....L.Q ....;; 7- /0
Revised 4.J ()
Agenda Item NO.1 GE6 i(
December 14, 2010
Page 33 of 52
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAM:: ~Af~-j,J :EHt16FE.. r :RO,'ECT # f\c::Oto.1 PROJECT \ANAGER:'JaayrJ~'1JtW-.,
CONTRACT #: IY-'2jfVMoD #:1- po#:4~~\qLJ.OB WORK ORDER #:21~,,_
_~~PA~TMENT: C 'Z-t'1"C()NTRAqQRlFI.f'M N",ME: K~.{.Df De.ql\~
$ __.... ;77~'Z.,7-. 0 c; 0 . 00
Original Contract Amount: _ .. ..~ __=_ . /. ::. -l;/ {
(Stal ling Puint)
$_____ -~S .-/; 1..'2"1 ' 00
(Last Total Arnount ft.pproved by the Bee)
$ 7 2/1 (..1 S(l . aD
____~,,~2~_,,__(__~_ __~~__ ".____
(Inclwflrlq ,~.II Changes Prior To This Iv~odification)
$1...1 0 i-?. . ';;;. 0
I_'__~--I--.._-"--_..
s______'2'?~,_~_::;.,I, GO ___
Current Bee Approved Arnount:
Current Contract l-unount:
Change Amount:
Revised c.ontract/Work Order Amount.:
(!rwludi/l:J ['his Change Ordm)
Cumulative DoHaI' Value of Changes to
tl1is ContracUWork Order:
,7-:/ 0'-1'2-. ,,<;;0
~ ~.-..._"-~._j,-,-_.._~._~,---
,,-----..J
Date of Last: Bee f<prrov?!___,~~2:,:?:~~J::=.?_~m Agenda Item tI- J y.~ [) J.=-.
pcrccr.taga of the change overfundr}!' current cOiltr~!;t amollnt_ -~.___f2_L_.__%
Ff)llnul~J: (F~~;visi~d /\!nDunt;' t:J~t flee c'ppiOVi~d ;~fl1(;UllO,l
CUi<F~[NT COIAF'l.ETION [JAq~ (~::;); ORlGIIJAL:_,I._'?:,~r,1. ,
CURRENT: ..1,_2~f.JL_..__
Tllis cl1<lW1C ordf,r will:
I>,dd a tlGW Task for':;
rr!l:rl:~!'S~' Task '~L!:nbe!'
hu (:
~J""___
", (,'''- I, r'" 'l
00 HJ r, w__~~E__0i-':h1f)_5,,,f2.,,. ".:,~i..(:':.f:::'_J,::fE___~~:j;=....~:J_'?fLF--__,_:::~".c... '( fA :~re... rw.o E.P
DC5cri~lC the change{s ):,~,_f""{:~~2J=~-{~ .li:.LL!:::~,qu~)_'_',;)__~~t~eLn~E-.fk_.)c..J':'~~TD-!(1 D'OqL_ fZ-..A-r--J?,-__
_.C'c<"U:jL.. C'''",!:,:~j"-'T_J:,~j'f'.9;:;;;"EL(5.".. ,,:i='t::!cE',_ Cc:!:J4:Io;;.u.";: :?J__ .
Specify the reasons for [lie cllange(s) (' 1. PlallllNi or Elective r- 2. Unforeseen .Gon1fitions r 3. Quantity
, rt -
Adjustments ( 4. Cormction of Errors (Plans, Specifications or Scope of VI/ork) "'" 5. Value Added
(' G. Scheduln I\djuslrrwnts Nole: One or more may be checlwdJ depending on the nature of tho changc(s).
!'.:.kntifj' an negative irnp<Jcts~!.o, 1,h~.yruJect if tlli~-; _'?.hanqc.OIuer v.'~~re not processed: __
-- --,-".. n_"... I---::,L.f~;fIE3=::Tr:o:{~:~ .._~)~) t-:~~ S _.~Z.:;;:::c:~:_ /_ ,_t:"(,~_:>~:' F:,. i~~,(:;::t~?:d':S~L("~;:~" _, ,_ (\~:<'~,5:~-1.&~ L.--C:__,______
I
Thts C.ll~\Jlge wa~; !cqu,::.:,.ted by: L-ir;ol1tractor/C(Jn'.ill~:~allt it::'J"O~\'nCl r-j U::-iing Department C COES
L~Der:,if;n Profe~:,~;!Ollar f -;He~JLJlat()ry /I.U0rlCY (SrF.'C(fy;,..
1- Other (Specify)._
CONTHl,C r ~)PECIAL.I:,;'1 Pf\f'~-l-ICJPA't'IUr',J 114 !:IEGO--j'I/\'j'!ONS:
"'''
r'e:;;
ft."
I'Jo
Thi5 form is to t)f~ sl~JfJed d!ld ();:::tl!d<
i\PPi.:OV[[) HY
[hi,:;' .:-'"
I-::E\jl[~\,-VED BY
\:{t":"
, 't ;:;~ \1 r:,< (~;-
,I
, i-\!-']je~:t r,~allaT:r
~.) 1
/Ll
/ ,
....cJ/ "
/__;J
, C\
[ ; () ! ~-;
__it
,:{ ilD
. <,,_L___
I' 1.[(1
Agenda Item No. 16E6
December 14. 2010
Page 34 of 525:'
1/ /,;}/ /0
- I
I
(li4 rJ0
I
CON1RAC,.IWORK ORDER MODIFICATION
CHECKUST FORM
!
PROJECT II: _NIA_ PROJECT MANAGER:_S1mon ejleveland
POII:_460010:l444 WORK ORDER f:~
CONTRACTORIFIRM NAMe: Ml!iI8.!.4.m....unlclfISoftwafW: Com.
PROJECT NAME: CDES Divlsl"" SoIlworo
BIDIRFP II: 06-3962 110O II: 1 S
DEPMTMErrr:_CDES
R<JviHd ConlmctIWorn Order Amount:
$ 1,996,272.00
(Storting Point)
$ 2,40B,7S8.50
(Last T otalllmoum Appn>ved by tt.. BCC)
$ 2,408,7S8.80
(Including All Cheng.. Prior To Thi> ModiflC8tion)
$ ~.
$ 2,40B,758.80
(Including 111;. Ch..nge Order)
/
OIfg;r1lII Con\nlct Amount
Current acc Approved Amount:
Cun-ent Contract Amount:
Cb_nge lunount:
CUlnulaUv, Oonar V",lu,ft of ChaoQ'ft8 to
till.. C""tnlCtl'I'iork OM" $_412,486.50
Date ofl.Jlet !lCC Approv81_9/29109
A,gOl1do ltom # _16B9
P"I"Ot:nta~ of the Cihnng~ over/uooM current contract 3mount__~0-
Fo/mula: (Revffi.ad Amount I Lnst Bce approved amount}-l
% \,!.
td(?,;/iI \3'
.eh~ II",,"U 11
CURRENT COMPLETION DATE (8): ORIGINAL: __1111(08
CURRENT:
This ch.mOfllord~rwill: 0 Add a n~Talt:k tor $
o Increas. Task Numbllr
by ~--_.~-
00..,
r_cril)e the ehang.($):_Exlend contract completion dete
J
I
Specify tll. """.on.. for the cllangeje)" 1. Planned or Elective (': z. Unfol'll..."n Condlllo"" r 3, Quantity
AdJmtmenll!l r 4. Correction of Errors (PlI!n.., Speelflcatlooe or Scope of Work) r S. Value Added
" 6. S~.h"dul.. AdJUl,trnanlll Nota: One or more may I)e checked, depending on the natul'll of ~e change{.}.
ii?' ....'
Identify L"negati~e Irnpacte to the p',roJect If this e!,snge ord.r were ~ot p~ ed: ....fL!dc;UILU'..wd/-. . I
(1.(;71 j,1Ild.a ,'0' 'ri/a..ltl.i' )',.' , .~... U~
v<.",J.,kC<'/f. .3[1 I p ,to.t!-[LW-<.C F., ,a",!' ,''1 v. ~.'Y' + . L'
TI1IB change ...an m"t.;.ftd by: t11c"l1lractortc'~lSlh'nr ~ "u;?r.r o;;;f'rtmen, L IC ~ j C<-.
CD..f!:lgn f'rofeoSI<lnal nRegulalory Agency (Specify) r Oth.., (SlWcify)
COIITMCT SPECIALIST PARTICIPATION Itl NEGOTIATIONS: x Yes r No
Thle forrn 'a to b" Aill""U m~ dor.d. I!. /
APPROVED BY _ ~(."h1''''~ (fl&df2.Jfjf /
Proj 1rl"ger. ) {
,\p' )- , \,"-: ~ '
REVIEWED BY: -~'tlalll') ({/ {'ft,_ Data --Li. - ,:( - !t.J I
jJfl tVL Ie L)~lwL< ,I.x_()/ (l/1I.dt. (i<!..OI1I- 1'1 f~ i ((.
~~
Date:
4~
,
Agenda Item NO.1 GE6 c-
lJ~('~mhClr 1L1 70-10
Pa,gl 35l'f 52
/3 t''t.b11j ,},-/ /0
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: MKY Apron & EXDansion PROJECT #: 56018/46034
PROJECT MANAGER: Bob Tweedie
BID/RFP #: 09'.Q?~__ MOD #: 5
PO#: 45001-12451
WORK ORDER #: N/A
DEPARTMENT: 6imort Authori))!
CONTRACTOR/FIRM NAME: DeAn .elis Diamond Construction
Original Contract Amount:
$. 645,207.63
(Stalling Point)
,,'...;,.,
Current Bee Approved Amount:
$
7-ll8,m..a '114 /f;!3- (.,3
(Last Total Amount Approved by the BCC)
zas~,,- '7 (f S; '1" 150 (", ~- ~
(Including All Changes Prior To This Modification)
Current Contract Amount:
$
Change Amount:
$
$
13,603.00
Revised ContrnctfWork Order Amount:
802,569.63
(Including T!lis Change Order)
Cumulative Dollar Value of Changes to
this ContracUWork Order:
$
157,362.00
--,._-_.~------ -~_.~.
Date of Last Bee ^pprov~I_~g,?}lQ_._ Agenda Item it ~_~
Percentage of the change over/under current contract arnollnt_~"Cr:? {,)t'lt)
Formula: (Revised Amount I Last GCe approved mTlounl)~'l -
-=---------
,/_., ~,
ClJRREN( 12J1HJ1L_ "~
'--~'~
Ii] Add a new Taslcs for $'13.693.00__1] Increase Task Number __ by $
[~:J Other _Ext~-.Lld sch~du~y 30 ~ays
CURREIH COMPLETION DAlE (S): ORIGINAL: ~_Jiil/1D
Tili.!~ change order '..viI!:
Describe the change(s): .i._Add 11andrails. 2. r~ernOV(~U2.!Danic growth; IJJ.l1I fence: install rT)irafi. stone. rip raD: c1ean-uD
2[ld disJ2Q",e_QLdebris._~3~1!1:::.Li:1U-""9.~L_Ql~ler a'lcLQrQ~idel'mds"~m)inq. 4. Add new 208 volt - 2 pole circuit breakers in
!,xistinu MLJP. 5, Extend sch~dule bv 30.day"'i~
Specify the reasons for Ihe ehange(s) r 1. Planned or Eleetive I~ 2. Unforeseen Conditions r 3. Quantity
Adjustments (' 4. Correction of Errors (Plans, Specifications or Scope of Work) \0 5. Value Added
r.' G. Schf,dule Adjustmont3 Note: Olfe or more may be checkcd, depending on the nature of the change(s).
Identify all 1H.lgative iOlpf-lcts to the project if this change order wera not processed: Proiect will not pass
f2~_[r nLtL9E2.=J9...fD.5J?.....2ctLQJJ5 :Jr.\.9J.;lI_J~~c:QEQ. n1~lut~.J.).,!_~)i~_ C021} .'i111 be b.iilllEi.~
This cfHHlge ".vas rcqu!.'str.~d by; P'IContraclor/Corrsultant r';l Owner rr Using Department r CDES
['Design Plofcssion~1 FIRey<:latory Ayency (SpccifY)_(~QW!.'L COU!!ty__~. 1- Othcr (Specify)
COfH RACT SPECIALIST PARTICIPAIIOfJ IIJ NEGOTIATIOloJS:
,
r-,
) es
r- No
1 his form is to be ~~~6'd and da~g.;;> /
:/:://,/ ///.
A.PP f\OVFf) [3'(; 'L;"'?:::.,c--.~::L...:>~),i'::c.&d~::.
{/I Project Manaqer
F,EVIEWED BY_L;S'~'~L2LC ;!'(
Ccihtrl"ifl'cCniiSI .
____...m_......._
l".,.(
u:. (,~
Dole
, I
/..i2l) riA oJ1J
I!! S\/I (/'
Date:
r;:\!\hd tiS rdKY '\I\\'lJI,';:j'."J..i,:~~, F:':',;:ls",.'l.';uc':
Agenda lIem NO.1GE6
I~,w,,, ,~,. '.,"'.~",,, :.::, '~:.~ '::::~:::::::~:~::::".. ''''0 ,,:::::~;~ :~:1 ~~
PROJECT MANAGER; Maro.ret Bishop. __.__.____.__
-7
,
CONTRAcr #; 10.5198 MOD #: L_POII: 4500116298
WORK ORDER #;
DEPARTMENT; TECM
CONTRACTOR/FIRM NAME: Gu rnann Construction Corn an
.'.----.---.---
Original Contract Amount:
$ .622,517.50
(Starting Point)
Current BCe Approved Amount:
$622.517.50_____
(Lasl Total Amounl Approved by Ihe BCC)
$7211G8.T1 ./
.._._._L.:..__.___..___._.____~___"__
(Including 1\11 Changes Prior To This lv1odification)
Current Contract Amount:
Change AmOtHlt:
$:1.n~_________
v"
Revised ContractlWork Order Amount:
$725,D35,2,Z
(Including 'This CI18nge Or-der)
CUlIlulatrve Dollar Value of Changes to
this ContraGUWork Onhlr:
$1Q1,417.77 J,/
Date of Last Bee ApprOVe'll Fe-l-L!1-g!Yf! 201Q._~.___
Ayenda Item #1 OA
Percentage ot tIle cllange over/under currellt cont.ract amount 16.61 _%
hmnula: (nE:','i~j~'d /\mount f Last nee ~lpprov'?d !ClIllount).-l
CUI~HEr~T C()fv1PI_ETION U/'d E (S): ORIGINAL ~~J~ten!.l~9J~_Q.,_?_O_10____~~__.__~~__CURRENT: !!.ovemQer 8.2010
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This chal1W~ OI'clor will: ['J Add a now T<1sk. fm
!~~r:re.1.f;~ Ta::;!-;: Numbs, lli2..iTiS 12 &. 25 uy $12.435.50
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Other _Q~',9L~~~Q..ltcl11sJl,-9 & 1-5 hy $1~&?B.O(~
Describe the change{s): !\_udi!iol1af timo is reguired f9L ceasl!..!iLQ.umpinq operation due to hiah upstream
~aterlevers durtQflJ}e~.2_L.@.J~Y smwon. Revi~_ed rocls.....guantit.ies due to bottom desian chanaes. Deducted
P?oweb maintefliHH:..Q.Joad due to unsuitab!9 subbase.
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Specify the reasons for the cl1ange(G) C 1. Planned or Elective C 2. Unforeseen Conditions C 3. Quantity
Adjuslments e 4. Correction of Errors (Plans, Specifications or Scope of Work) C. 5. Value Added
CO fL SGlw.dule I\djw:>tlllcnt;; Noto: Orw or more Illay' be chcclwd, depending 011 the nature of the challge(s).
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Identify all ncnative inlpad~3 to tho project jf this c!1<.l11ge order were not processed: If the qcoweb maintenance
~i-) ~~ (Lis !~!J~_'.I~!!,\L_~.l.~~.t~:?Ig!_!.'c)!JJ~.Q. ro~iL is !]_~tE2.d e_~t
f'his C!l,)Il~Je ..vas requested by: r-!Contractor/COllStJlfanl 1"'1 Owner r.'1 Using DepartrnPllt r. COES
r- Dcsiql1 Profc::.sional 1-'IRcuulatory Agcncl{ (Specify)... . _ '-Other (Specify)
CONTRACT SI'[,CIAIIST I'ARJ ICIPATION IN Ni:GOTIA liONS:
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December 14, 2010
Page 37 of 52
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Agenda Item No. 16E6 -n
Page 38 of 52
CONTRACTIWORK OIWEI, MODI:'iCi,IION
CHECKLIST FORM
PROJECT NAME: LASll'_LeIY Maf]gL<;anal West Outfall (South section) see NIP dated 4/12/10 PROJECT #: 51101
PROJECT MANAGER: Marqarct Bishop
CONTRACT #: 10-5198 MOD #: 3
PO#: 4500116298
WORK ORDER #:
J.l.EPAB!MENT:TECM '__'_~~__~~_n___~OIHRACTOR/FIRM NAME: Guymann Construction Corn an
Original Contract Amount:
$J,293,31'?clL ./
(Starting Point)
Current BCe Approved Amount:
$1,293,312.J2
. (La~' Total Amo7ved by tile BCC)
$.L?JU....QJcLL__..
(Including All Changes Prior To HlIs Modification)
Current Contract Amount:
Chanqe Amount:
$1 h.50~\!11_
Revised Contract-Work Order Amount: vi'i)01, 1 07.,')?
(Includinq This Change Order)
Cumulative Dollar V;1]UC of Changes to
this ContracUWork Order:
!.. -------..-------.----..--
$IJ9S.~~__
Dale of Last Bce Approval I:.~.~1)JJ!..<:D'~__~201V_._~~.
Agenda Item # _El~~_._."__.____
Percentage of the change ovcritll1der curmnt Gontract amount :SO__%
r~()nnu!a: (!?e'Jised /\nlOlmll Lasl UCC ;{pprovcd ,111IOUI1() 1
CUr.PEiJT COl-:1PLF1IOH D/\1"[: (:3): ORIGlrD\l: :s.<,:-'?J:::J.llt)_Q!_G'-f.9JQ_____~____.____CURRENT: ~Ialluarv 4.2011
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This chail~jt: oi'd8r will. [J Add iJ f1UW Tu'3kfor $~___.__._ [j increase -lask Number IterU2..~J 18. 26 & 27 by $49.994.24
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Otller !)cc~~~_"Jl:;:.!}l~__.t~Lj~~_1Q..___~....1.Q__I~1.._S33,390AD and add additional time (see attached
D(~scl'ibe the Ghallg(~(~;): L\l_lQ.~lioJ.!i!..L.!:ock eXCil\{_~.uQ!'! rerl!!!red to construct Canal C..~.II #4. (see attached rock
y.2.Junl..~_9,~~:.!lJi!.llil!1.~l~_Q.Q..UtlGLL~~dwoJ1Ul!L.<!!!!JJics-I!ue ..iQ.J)_~_ailltel1ance road width re-,~lesiqll. Additional time
rcql!Cs!ed Jar rg_f;_tLcxcav!1tlQIL,!.lId ce<lsJi!fLJ2~!!}JliliuLQ1~!iltiOl!~~C to IliClh water levels durinq the peak rainy
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~;pncify tile reasons for tllf! c!lanne{:-;) r- 'T. Pf<:lI111Cd or Elective (-. 2, UnfOrC5'1en Conditions ('"" 3. Quantity
Acijuslnwllb (0 'L efn t<-,ctio!l of Enors (Plan:.;, SpeCIfications or S(;ope of Vior") ('" 5. Value Added
Co G. Scll{~duJc I\djustrnent; f'-lote: One or morC! may be dwelled, depending on the nature of tile change(s).
Identify all IWglltiVU irnpaGt;; 10 tlw project if this clian~le older Wf...'le f1ut processed: If the additional rock is not
QlS.. c fl V~!t~fJ-=-.lJl.QJgq!J3!!; S.tVQ!~I1H~SLQQJlJll~" (1./1 ~f..~l(.j~~~?_~o U llU!91 1)0 }.!!2t.
This cll<1l1ge \V;:1"j requC'sted JJy:,k:icolltractor-rcow;ultallt r'! Owner rl Using Dcpariment j- CDES
r--DCSi~J11 Professiollal rrl~f;~iJu!alory Aycllcy (Slll)cifYL___
J- Other (Specify)_
cor; r RAG r Sf'l'CII\LlS r PAPTICli'l\ mm 11< I!EGOl iAI lONCi:
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This form is to bf; :3i~pled and dated.
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AgellclCl Item No. 16E6 7 c
December 14, 20'10
Page 39 of 52
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CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item_j\ln 1 RFR
December 14, 2010
Page 40 .01 52
<0;>
,1
PROJECT NAME: ARRA Green li~hts- Ea<lle lakes PROJECT #: PROJECT MANAGER: Vickv Ahmad
BID/RFP #: 10-5561 MOD #:
1
PO#: 4500123229
WORK ORDER #: 45gPl1l22~ ;.;/A-
DEPARTMENT: Parks & Recreation
CONTRACTOR/FIRM NAME: Electrical Contractin<l Services. Inc.
--~-._-----_._----
Original Contract Amount:
$ _ 276,096,00
(Starting Pain I)
$_276,096,00
(Last Total Amount Approved by the BCC)
Current Bee Approved Amowlt:
Current Contract Amount:
$_276,096,00
(Including All Changes Prior To This Modification)
Change Amount:
$_1,500,00
$_277,596,00
(Including This Change Order)
Revised ContractJWork Order Amount:
CUlnulative Dollar Value of Changes to
this ContractrWork Order:
$_1,500,00
-------~. .--.- - ---_..__._--~-----------_.__._--_._.__..~------~,--~--~
Date of Last BCC Approval__9/14/10___
Agenda Item # _1602__
.9f
%
Percentage of the changp. over/under current completion date ___~
Formula: (Revised Amount f Last Bee approved amount)-1
CUHRENT COMPLETION DATE (S): ORIGINAL: _--"'Pril19. 2011
CURRENT:
April 19 2011
This change order will: . Add a new Task for $_1,500.00_ LJ Increase Task Number _by $_
Other.
Describe the change(s): Three conlractorSlill!lltied two - 40' lonu construction storaoe containers containinu
108 liuht fixtures, 11 wirinu boxes, 23 mountinu bands, 8 boxes hardware, 16 lioht racks, 24 ballast boxes. 216
cardboard box supports, 216 cardboard fixtures supports, etc.. then relocated the two storaoe containers away
from t1J~ark r~stivaland, ,re-stored,alLfixtures backtoUle, ,storaQe.,containers. The par~ f""tl"~! ,..__
.~!:'J!?_:,~-Q.~!.:~,!,~!}D10l~!.~~L~~!!Q!!~.~,.'=?~E.~~.~.t?.ff:
Specify the reasons for the change(s)' 1, Planned or Electivo 2. Unroreseon Conditions (' 3. Quantity
,^.djus,tm'tH'ts (., ,1. CQrT9('Ue!~ ".:f Er!'~!'s (P!E'!ns. -SpPcif!c~t!ons or Sf.'.opr! of VV'.)rk) X S. V:-!!:,:~ .^-~!::!~::.!
6. SI_~!wdl}'0 Adjustnwnts Noh~: One or more may be checked. depending on the nature of the change(s).
identify all negaf.ive impacts to tho project if this change order we~n !lot processed: Park festival would have
h0_~?!.!:! c:h~~.?~.!PJiH~r.~~_!.!I(Hli!:!!! fh~~~~~~!.:~!.!!H~:.
Thrs chan~1e V'l?S !'eqHcst8d by: Contractor/Consultant X Owner [-I Using Department r- CDES
Deskm Professional r.IR(~~w!atory Agoncy (Specifyl '_______.____.______ r- Other (SpecifYL_,____~_
G0~'!TR_h_CT 8-P~G!.ll.!JS.T PART!G!f'll,T!O!'! !!'-! ~E=r:;OT!.l\.T!(lNS:
r'
Y,,:-',?
i;;;-
fl.!,-=-,
This form is to b0 signed 2nJ! date(,!:; /
(- )l ,/,/( _ l
APPR(}\!F=n FW 't1{)~JI}~.,-~7'r~if7, ';Jl~--, '_. ,_~'~'"
,"E\I!F\!VF[l RY J':=::tfl:f)i&LLLt(l~b r'~I"
!';c':'::cd" ,,' i,{\onda Cummings, Contract S7(1)lliSj'
\,~//
/111/;/;0
---(-,'- ---,-
1!~2;i O.
Agenda Item No, 16E6 Ct
December 14. 2010
Page 41 of 52
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: l1omobuvor Ed & Coun.olin" P,OQmm PROJECT #: SH09-02 PROJECT MANAGER: R. Munoz
CONTRACT #: # CSFA #52.901 MOD #:
1
PO':
4500120279
WORK ORDER #:
NIA
DEPARTMENT: Housina. I-Junta" & Veteran Services
l'ASf
CONTRACTOR/FIRM NAME: Emoowennent Alliance of SW FL
I~~:g~:~~nt~ct=ounl~------- $
I
I
I Curront Bee Approved Amount:
35.000.00
(Starting Point)
$
35,000.00
(Last Total Amount Approved by tile BCC)
Current Contrnct Amount:
$ __~..Q!LO~QQ..__
(including Ail Cllfll1ges PriOI To This Modification)
Change Amount;
$
uQ
F~ovised Contr3ctfWork Order Amount: $ _____~g..Jl90,Q.'O
(InC'..Iuding lllis Crlange Order)
Cumulative Dollar V81uo of C!J;U1Um; b
this ControctJWorl: Order:
,.0 _________,_
Da10 of Lm;:t BCe Approval .._,__~15-2G.:.1JL___~
A~Jenda ltern # 1605
I'Nccnt~uf.> of the change ovnr/under cunellt contract anwunt
ForOlull;l: (R('JviGed Amount! L"lsl BCe appro\ied afll':lullt}-l
o %
CUI~REI>Jr COMPLETION D/\TF ($): OmGINA'-:
!liL;iQ:?PJJ .__
CURRENT: _ 00-30-;'9.11..
1 hi!'. chvnfJe orO'H will: [] {,del a new Task for $ ___ [J Increase Task Number
by $
Of her __ To fH'O'I'idc a chnnce ill JaDt!uUl!C in the nruicct scooe: of the contract. This revision
lyjU.N/~.tch[!:ll!.e (he ori!!iuull.nbtl budeeted RlUount for' this State HonsiuJ! Initiatives Partncrshin J)l'oeram (SHIPl
!llliuelmvIT. E.1.l!Sl,tion and CouI18elilll! I)r~:t:.. ~ rcvi~('.d work scbedule has been submitted to the Housinf!,
Jl!!!!![H Hilt! Vc1r-'rnn ~f.':rYicc{; OlHVS) l)CJUlrtmclIl:.
Specify the r9'<~iiOlm tor the Clli:Hlue{sl k~J 1. Planned or Elective (' 2. Unforeseen ~onditions r 3. Quantity
,f'.djllstments. (-' 4. (;orrectiofl of Enol'S (Plans, SpN;ifications or Scopn of Work) r 5. Valuo Added
~(;J 6. S(~Il(!dule lcdjustme-nts Noto: One or more may be checked, depending on the nature of the change(s).
Identify an negativf.' impact.s t,:, the projoct if'this chal1ge order were not processed: Jhe neaaUve imoact for this
J?rQJflt;J.J,m!Y~_r!~~ult_llLP1!llt~lJ1l'!lJ~.....lJQ.t.Jt~J.rr.q_abtlJ to be 3.ssistad thl'ouah this arant. thereby not meetina the
Q!:1Jf9m^y_fr)fJ,t1is fundif1Cl:
l:ii~~, Cltal10~ W'1S f'0ql!~StC:1 by: [-:JGontractoI'/Gonsultant fJOwner
[3JUsillg Department DeDES
[]Oe-sigll Pn;fm,sjof1<.l.l L.IHcgulalory l..gnlH:Y (!:i-pe:;if'{)
[IOther (Specify)___
COHTRACT Sf'ECIAUST PARTICIP AIION IN f~EGOTIA liONS;
[]Yes
~SJNo
Tllic form i~~ to be Gign~d :alu dated. /;e' /,/
!\I'PHOV[D IW, ___Jl""@M~IW;.J~~~_~".I~ _~:- )
, Grants Coordinntor
Date: _1...1,:16-10
HEVIEWED BY:
/
'\:?;.':"/,,, i!l' ,-"/i .t_, , .(
_..-o.-,__~...,;..,i..-.~.-,-_ __..I...!;w.:..-L-._
. COfltract Specialist
,
Dato: ii - ,I 7 -'
Revi.':::cd 4 I (}
l~ ~'
__""""""y:grmml.'t"ent-.~.llIl"t'I1.1r"JrI:1~~>r.;"...~;~
nu;lO,M~~'..lt"'..:I~.n",-"
Agenda Item No, 16E6
December 14, 2010
Page 42 of 52
Ie;
EXHIBIT A-I Contract Amendment # I
"Empowelillcnt Alliance of SW Florida Community Developmcnt Corporation (EASF)
Stale Housing [nitialives Partnership Program (SHIP)
Homcbuycr Education and Counseling Program"
111;S amendment, dated ';) i'{' /2 ,2010 to the referenced agreement shall be by and between the
parties to the original A'greement, Empowennent Alliance of SW Florida Community Development
Corporation (EASF) ("Subrecipient") and Collier COtU11y ("Owner"), a political subdivision of the
state of Florida,
Stalemenl of Understanding
RE: Contract CSFA #52,9U I SIl09-02, "Empowerment Alliance of SW Florida Community
Dcvelopment Corporation (EAS!') -, HOlTIcbuyer Education and counseling Program,"
In order to continue the services provided for in the original Contract docwnent referenced above, the
Subrccipient agrees to Hmclld the above referenced Contract in order to allow for reimbursement to be
made to this subretipicnt. This revision will not change the original total budgeted an10uut of
$35,000,00 for this State Housing Initiatives Partnership Program (SHIP) project.
Exhibit A
AMEND: Exhibit A-Scope
Nole: W ords l!!ld~Ilin,ed have been added, Words 5tfHfk-tfrr-eugh have been ddeted,
The FHlp~lwt'nllt~llL /dJiaIJ\..:.l;: CWVlnathm u[ SlJuthwest fk,rida ("SPONSOR") prGposc:; to ...:;>:;: State
j-lDmiing Initiatives Partnership funds for horllebuyer education and onc-on~one counseling to
i11dividuals se'..:hing to purchase a home, or whu already own a home and arc concerned about
foreclo~;url: or predatory lendillg practices, ^pproximately 200 individuals will benefit from nineteen
(19) hOlll.-=buyer educalioll classes 9-'_LQ!lg__QL.JI!.urI.~~_fu.JJowi.ng_t.Qpics..;.._liomeb!!y-er Education.
h~.J\-lg~.1i!W,__(:'~..s':.1l1~-,_J.H!.QL9_Lf9H;S:.JCl.~JJr~_p.rcvcnti()Q. This funding will also provide approximately fifty
(SO), 01le"Oll-OIlC coullseling sessions, snpplies and training. The SPONSOR is certified by the
Ncighhc)f WorLs Ccnt-.:r of l'lomeO\vllership Education and Counseling (NCHEC). 'nle SPONSOR is
alSt; a u.s. HOllsiug and Urban Development Approved Counseling Agency operating in an area
d'.::;ig.o<1tcd h.l' :;nid :lgency.
II\.using and t 111iH<ln Sorvkcs is using State Housing Initiatives Partnership Program funds in the
,~!n(\\llll ()r)JJjJ:tyJjy_t;''-:JJH.m:::.[lmJrlJ.l~iJ1Q!JQQj)..Qlhl".~_Chli.,j!sH)JliD for this project.
'!lle SI'ONS(JI( agrees to complete the J{)lIl)wing:
d. "!Ovid,.: lwicknce of U.S. I lousing and Urban Dcvclormcllt Approved Counseling Agency
~,lal.u5; and
I." Cl)llduct flillcLecll (19), IJitw-4:H....}-ioHWPWHef4+tl H!2!!.t9.b~LEduc.,,:ujQ!! classes. 'I'he IntnJ-4o
f4oHlf:U\Vnt.H'f:-ihip-^Il()tllCbuycr Education class will cover QlL..91JfLQL1U..oIC or tQUowinu lonics:
th~IJl.~hu.Y~T. f.d!J.vinj~m,Jnl.Qg~J..iHg.__9LQ.flH--,.J!!.]91QLjl_'J~~n,5JJJ!LI2[~yell tion. 'I'he class wi II be
olTcred ;It val'iou~ locations in Eastern C(1l1i~r Counly including Immoka!ee, and the Collier
(~\)lHlty F.~sension o.llicc ill Nupll:~;.
c. Conduct approximately iiHy (50) one-OIl-one counseling sessions.
d. Reach ;lpproxilllatdy 250 aHclIdct,s per year.
e, Frovide post home purchase follow-up counseling.
I
In.lllm_
".
~4;1;1I~~~.--__...-,..r<:"I'>...w5~i1FJi,'i",_
("'~...il<""..._"",.v..."",,,_
Agenda item No, 16E6 (/; I:,
December 14, 2010
Page 43 of 52
ExhIbit 1\.-] CQntrnclAmeotlmem #1
Empowerment Alliance of SW Florida Community Development Corpormlon (HASl')
SHIP lIomebuyer EduenLion "lid Coun.eling l'roBmm
Page 2 of2 '
IN WITNEGS Wlll!,REOl', the Sub-Recipient <Iud \lle County have each, respectively, by an
fimhorlwd porson or ogent, h(\raunder seL their lumds and ."lIls oHule <lalc(S) indlctUe<l below,
Ac.copt~d: ~j'-./.~ I '.'/ ---/20)(}
f;t,II~Recipient:
OWNER:
Empowerment ,'>Ili.oo" of SW Florida
Commwllty Devclopmcllt COI1l01atioH
[bAS!') /'-"" /
/ ~~ ,'....F ~ ,1,/' J
,/........~";' ''''': ,~..:::~~v~f.P// t'I, _ '
, 'r /:Jf"// .//"''1 ~.-.-
',/ ..;'<~/ ./,,'4/,-".J,._....,
,,." ...-.~~~^~ ,.. L':"'--'-"
r) " ,(,;"'tl'~~.,~... ,.....:.- _y..-;v :.;;.' ,/ / ..
~ 3;.-.:.-..."..x-" ",.__~....~,_~......._,....:..-...,,______~....,.
. Edr'<.ti'illl.. OIi'\lll~yl'Chrdnmm
BOARD or COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
I} ~ .
--DEI'AR' liNT OUlliCTO
By: 7f-"::'~-;fr~ ;"0;;0----2
GRANT~.59~INATOR./ ___
, ...,. ,L.-.~------
H": (__::'.lc4J-;;::;r':T'\-- /~ / J _. ..
.. -'- Ro'siI Muno:t l7--~-'-'--'-
CUNTRAC'J,: SPECIALIST '
~ ",l '\', \_.;/~. ,',. I
11' .. ., .. " I 'L f:.. I ,~ '/,',
" ,,__,...,',"',". i .., ,/ '.'
.' _'_~'---;'';-W,_J~ ~-
..! '-'1'11 (H)U
r:JHC1!l\Sj~JC/CS DJH_ECIDH.
1\'/ :
/1/ , I l / ..'
---~~~..iL~~_~.__~--"-~_:'..LL~_,L:J~__..
, ",' J]!
S~'f_~t~,\!K-~'l 'r. Cnnl~~",_. ..
i I.
,-- ~=~=~---~~.~::=~:~""~=~._" :._J
L-
.
Agenda Item No, 16E6 ((J
December 14,2010
Page 44 of 52
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Homebuver Ed/Credit Reaalr Proaram PROJECT #: COBG-R 09-05 PROJECT MANAGER: R. Munoz
CONTRACT #; # B-09-UY-12.o016 #14.253 MOD #:
1
PO#:
4500111604 WORK ORDER #: NlA
DEPARTMENT: 1I0uolno, Human & Veteran Sarvlces
gASF
CONTRACTORIFIRM NAME: Emll?wennent Alliance of SW FL
Original Contract Amount:
$ 34.500.00
(Starting Point)
$ 34.500.00
(Last Total Amount Approved by Ihe BCC)
$ 34,500.00
(Induding All Changes Prior To Thio Modification)
Current Bce Approvod Amount:
Current Contract Amount:
Change Amount:
$ 0
Revised CootractlWork Ordor Amount: $ ---.l4.!100.00
(Including This Change Order)
Cumulative Dollar Valuo!l of Changes to
this ConlractIWork Order: $ 0
Date of Last ace Approval
03-09-10
Agenda Item # 1606
Percentage of tho change over/under current contract amount
Formula: (Reviserj Arntl\Jnt I L;Jst nee approved amount)-1
o
%
CURRENT COM!~'LET!(.'N DATE (S): OR!G!N.^,L: __JL1~~_Q:2Q11_.____CURRErH:
n.. "" "n....
V...-....V-4U. ,
This change order will: LJ Add a new Task for $ ____ 0 Increase Task Number
by $
Oth~r. To l\rovid(~ a chnn1!c hmn:uaf!c in the Dl'oicct SCODe of the contract. This l"Cyjsion will
Nnt cbul1f!e Ow orh!inal totn] budl!cted nmount for this Community Ilevelooment Uluck Grant-Itecoverv Pro!!ram
fQH1G-.ill Credit COlln~clin!! and Foreclmmre Prevention J)roiect. A revised work schedule hns been submitted to
the Housing, H lima" ami Y c(crftn Services fllIIVS) l>clJartmcnt
Specify the rODSOnG for the change(s} [S]1. Planned or Electiye (~ 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correction of Errom (Plans, Speciflc.lions or Scope of Work) r 5. V.lue Added
[gJ 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change(s).
Idnntify all nQgative impacts to the project if this change order were not processed: The neuative impact for this
l!.miz;t mav result in participants not belna able to be assisted throu"h this grant. thereby not meeting the
outcome for this fUltdinq,:
This chango was roquested by: rJContractor/Consultant []Owner
[8JUsing Department DCDES
i.]Design Professional []Regulatory Agency (Specify) __,___ DOther (Specify)
CONTHACT SPECIALIST PAHTICIPATION IN NEGOTIATIONS:
DYes
0No
This fon11 ir. to be signed and dated. /<?~ //
APPROVED BY' __-------Bose !,1UJJPV;;..z-$/C '/:_-;;1-
, Graflts Coordinator ~, ': c: ./
'teA"Ll] ( / i/l,;!
, cO,ryi act Specialist
Date:
11-16-10
/l1-/,,!
REVIEWED BY:
Date:
Revised 4.1 0
-
~if"".
",-
...._,-
-
~~'-'-
-
_.~'"-'--'--~__'__~_"~_~_~__,___,__'_'n__"__
A~lenda I[em No, 16E6
December 14, 2010
"E'_gg~AQQLQ2
loc,
EXHIBIT A-I Contract Amcndment # I
"Empowerment Alliance of SW Florida ComnllUlity Development Corpornuon (EASF)
Community Development Block Grant-Recovery Program (CDBG-R)
Credit Counseling and Foreclosure Prevention Program
HOIllebnycr Ed/Credit Repair"
This nIneudmenl, dated1ltLLJ:~i_, 2010 to the referenced agreement shall be by and between
the parties to the original Agreement, Empowerment Alliance of SW Florida Community
Development Corporation (EASI') ("Subrccipient") and Collier County ("Oymer"), a political
~mbdivjsion of the state of Florida.
Statement of Understanding
RE: Contract II B-09-UY-12-0OJ6#J4253 CDBG-R-09-05, "Empowerment Alliance of SW
Florida Conu11unily Development Cmporation (EASF) - Homebuyer Ed/Credit Repair Program."
[I] order to c011linu(, I.he services provided J{)f in Ihe original Contract document refereueed above,
the Subreciphmt agrees to amend Hie above referenced Contract in order to allow for reimbursenlcnt
to be made to this suhrecipiell!. This reyision will not change the original total budgeted amount of
$34,500,()O [elf (hi" COllullunily Development Block (,nUlt-Recovery Program (CDBG-R) project.
Exltibit A
^ /lAT:'l"lI). U.,l~a,:/ A (.:',...n.',,'"
i 'I-l~J_'.A '.L<. .l..'/"J.H'.)H. .l.).-._''"'uJ:;......
Note: Words JHL'LgJin,,-<! have been added, \Vmlls st-fu~ktJ"'mgft have been deleted,
A, rHO,lEeT SCOl'.e:
The ElllpO'A"'nllCllt Alliance Corporation of SW Florida (EASF) proposes to use
COlllmunity Development. Jjlqck Grant-Recovery Act (CDBG-It) funds lor credit and
hudget education, and onc-on-OIle (;~Ieuit Q.QJJD-l>elJng to low and moderate income families.
1 :,\SF is ecr(llic,l by the Neil~hbor Works Center of l-!mneowllersltip Education and
('''(lIlSelilll~ (NCJlEC), EASF is also a Him certified counseling agency and operates in an
:t!e:~ d(;~dglJnterl hy HUD.
\ :uJlicr County [)cpartllle/lt of I iousiJlg and l1uman Services is using (:DHG-R funds in the
'U110Ulll pI' Tl llRTY FOUP TIIOUSAND FIVE IllJNDlUOD DOLLARS ($34,500) for this
I 'D1J(1-I( I,,"je-ct,
1 he ';UllIU,CIl'IFNT "P'''';; 10 CO/lipide the fdlowing, III addition 10 other CDBG-R
1 i~'(Jt; iJC'~.II'~:n r <::
:). Provide proof of bcing a j IUD Certified Counseling Agency_
I,. 1,~J(}:i~: '.:-',,'uluati!.)ll .':Ul1IUlaric'"l musl be suhmitted to HHS with a. monthly monitoring
rcporL
c, (,<,,,dud twelve (-I?~-22) c10sses covering OllC JlLLUOfe of the following topics:
!!.".!.'lcl)llj'~Lf-,lh,~,-,liQ!!, crcdit, Wid budgct!n..g edooatien and/or foreclosnre prevcntion,
___..~J.i,~1i\.":'€t...I~_.."".,,,,,
'l'lIl......_
Agenda Item No, 16E6 I 0 I
December 14. 2010
Page 46 of 52
Exhibi! A. J Comfllcl ^m~udmentltl
Empawerrnen\ AIU.nee ofSW Florida ComDlunity Development Corporation (BASP)
CDDG.R Homcbuyer EdlCreditRel',.;r
I'nge20f2
TN WITNESS WHEltEOF. the SUb-Recipient Il!Id 1I1e Cuun!y have e""h, respeolively, by an
l1ulnori7.ed petson or agent, herelluaer .et their hallds and sew on the d.le(s) indicated below.
e.....'I. " 4' / /7
Aoceptad: /,."[ ,:' , L--,2010
Sub-Recipient:
Empowennel11 Alliance of SW Florida
ComlllUllity Development COTJlol'Allon
(EASF) '"'
__:H:Y':~'l'r:~'1
.~~;;~~'~~,,~~~~/.,
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, ~lid:;.-;d fl.:''(';i;j~kY ~,_.
.
11,._
-
--
OWNElt:
BOAR!) 01' COUNTY COMMlSSIONIlRS
COLLIER COUN1Y. PLORIDA
D. L>1;tAIlT 'T DIRECT R, j
By: f .__ !..-----.
Morey K un bill"
OMN~~RmN~TO , ...._..'..'
/ ,....'?-,~.. 6)
131/:& /(:;...,
. -""^-","- Ros!!. Munoz
CONTiL'\ct}lPECIALlST
"../ J)"
..-<( -, ,"
By: ','" /).'(',1'1/' .l _ J
--- "', ;Lyn Wood
/ / I)...,,'.
,/
FUHt1II\SING/GS DlJi.ECIDR
-I
~
~
j
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By :l/~"{l~!~{0;::'>Y;;l'" i L!.::L......._
St\?f,l1en, ~j Camell / ,
!- CI,
--
ULd!
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
l\gellcJa Item No, '16E6
December 14, 2010
Page 47 of 52
( I
PROJECT NAME: Collier County Website Hosting and Maintenance PROJECT #: NIA PROJECT MANAGER: _Janet Curran
CON1RACT #: 09.5335
MOD #: 2
PO#:
WORK ORDER #:_NIA
DEPARTNI.EtlT:_,~()mmu_nica!iO!'.!.Cust(JI11Cr Helation"" __ CONTHACTORlFIRM NAME: Vision Internet Providers Inc.
Original Contract Amount:
$ 9,000,00
(Starting Point)
Current Bee Approved Amount:
$__N/A
(Last Total Amount Approved by the BCC)
Current Contract Amount:
$_9,000,00
(Illcluding All Changes Prior To This Modification)
Change Amount:
$_900,00
Revised Contract Amount:
$_9.900,00
(Inclucjinq This Chanoe Order)
.. - .
Cumulative Dollar Value orehanges to
this Contract:
$_9UO.00
Date of Lasl. BCC Approval: _____,_,_~_NIA__,
Agenda Item # t-.J/A
Percentage of th"-, change over/under current contract amotll1t_~10 ~IO)
Formula: (Hcviscd Amount I Last Bee approved amount).1
CURHENT COMPLE1IOI>J CATE (:::-;): ORIGINftJ~~ J!Lili~Y:;J~~)P_~._J2t[fJ_c(ive ~t~~~~fSll?"lliJ.\?~J)n;t~_CURRENT:~_
This change order will: [] Add new Tasks for $_9UO.OO_~__ [J Incroase Task Number
by$
Other~" .__'"________.'_.'.
Describe the change(s):__Atld Google search services for Collier County Website and Sheriff's Office Website.
Specify the reasons for the change(s) X '1. Planned or Elective (- 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) r 5. Value Added
r 6. Schedule Adjustments Note: One or more may be checlced, depending on the nature of the change(s).
Identify all negative impacls t.o tho (u'oject if this change order were not processed: Community would not be
aule to conduct a. searcillo locate specific information on the wehsites.
This challge was requested by: r-rContractoriCunsultant X Owner ,j Using Department r CDES
[Design Prolessional 1-'IJcE9ul~(ory Agency (Speclfy),__________,_,__,____ ,- Other (Specify)
CONTP.f\CT BPECIALlST PAF<1 ICIPA1ICHl If, I'EGO! lATIONS:
r- ,
'y(;-S
x: No
TtllS form is to fH~ signed and dated.
APPHOVED i3Y _ _~(~.'. P:1((;{~,_ ,(:lUt_,'[,'~. :,.1L
Pre)' ...:t)v1anaqer .,'
,.' >"/, t (.' ./1 ,.
Rl:VIEWED BY l.c5 ,cd:' ' , 'I /. ,(
(~or~tT;;Z~t 7\t~~~i~~(;tGr~ r;Aa~~~;I:~-----~.-
/ ] -
Dal~:::
,/_O~3Ift__
1/ / I?! /0
Date:
Rcvi::::('d (i l,c: ()[-)
.~~f~i~:t~~:;r:t?,~.~~~,~t,l~~u;~r,'"'<;t'~~:~(",~"'?" \";11>1' ~.:~~ ~f"~r~''W~~ ,~"\,:~':'t')':s H! '1!~:q
., ',~""l!I
"':-~":~~<"~:">.~:.::~:7'~\~',;;,<~.:',~,:r;:x,;:':}:~t.~iJ?\~~;.~~~:Tr"r:~,,:" :;; 'i
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
f~~~~~(;,Vl'~A:7 )
. Page 48 of 52 1t'0
(~
PROJECT NAME: MKY Apron & Expansion PROJECT #: 46018/46034
PROJECT MANAGER: Robert Tweedie
BIO/RFP #: 09-,,_2.45
MOD #, ~ PO#: 4500112451
WORK ORDER #: N/A
",'.;,. ~.
DEPARTMENT: Air ort Autllorit
CONTRACTOR/FIRM NAME: DeAn elis Diamond Construction
Original Contract Amount: $ 645,207,63
(Starting Point)
Current BCC Approved Amount: $ 774.423.63
(Last Total Amount Approyed by the BCC)
Current Contract Amount: $ 802.569.63
(Including All Changes Prior To This Modification)
Change Amount: $ 10.256.00
Revised ContractIWork Order Amount: $ 812.625.63
(Including This Change Order)
Cumulative Dollar Value of Changes to
this Contract/Work Order: $ 167.618,00
Date of Last Bee Approval_6j22/10_
Agenda Item # H>G2
Percentage of the change over/under current contract amount 4,96
Formula: (f~evised Amount I Last BCe approved amount)-1
"
>.
CURREIH COMF'LETION DATE (5): ORIGINAL:~J)/1L1Q_CURRENT: .12/04/HL.......
This change order will: [8] Add new Tasks for $ 10,256.00 ._ 0 Increase Task Number
by $
Describe the change{s): 1. Pro'lide nrevailing_ -~eti!iuneet grgnt a~~el1CV req!direments 2. Instali conduit and
ground bQ.,'{cs ji,r camera(s): 3, Illstallllndergl:ollm]l1hone cable imd conduit: 4, Provide additionallandscaDing.
Specify the reasons for the changers) (~ 1. Plan lied or Elective (0' 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) \0 5. Value Added
r 6. Schedule Adjustments Note: One or 1Il0re may be checked, depending on the nature of the change(s).
Identify all negative impacts to the project if this change order were not processed: Proiect will not meet arant
8qency conditions/relli!ll:ements: security call1era.lliLY:iill be inoper~ble, and landscape maintenance costs will be hiqher.
This chang. was requested by: r71Colllractor/Consultant 171 Owner n Using Department c: COES
COnsign Professional ["Ineuulalory Auency (Specify)
__ r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
/~"
This form is 10 be/~3iia da::::<~/ /
APPROVED BY(~ ,/(-,~Z~c/J;7<--c~1 _
'-Project Manager "
(I '" L/ ) Ii
f,EVIEWED IJY__1i... ,f.lL.1 n (J; {/-~'d::
Contr~3ilt ,1{Jecialist
';
r
Yes
r No'
Date:
{Iii .?/;5 0 ( 0
11- /7 --/t)
Date:
Y:\Work Orders-C'onlpds Misr.;\DeAngelis DiJj)H_'1PJ'.Mod #6 MKY Apron&Parking Expansion.docx
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