Backup Documents 05/10/2011 Item #10E
10 E:
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. lfthe document is already complete with the
exce tion of the Chairman's si ature, draw a line through routin lines #1 throu #4, com lete the checklist, and forward to Sue Filson line #5 .
Route to Addressee(s) Office Initials Date
ist in routin order
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who createdlprepared the c:x.ecutive
summary. Primary contact information is needed in the event one of the addressees above, including Sue Filson, need to contact stafffor additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.
Name of Primary Staff Debbie Armstrong
Contact
Agenda Date Item was May 10, 2011
A roved b the BCC
Type of Document
Attached
1. Judy Puig
GMD Planning &
Regulation! erations
2.
3.
4.
5 Ian Mitchell, Supervisor, BCC Office
Board of County
Commissioners
Clerk of Court's Office
S!t((H
6. Minutes and Records
Phone Number
Agenda Item Number
Change Order
Number of Original
Documents Attached
252-5874
, o. ~.
1
Yes
(Initial
1.
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark .~/ A" in the Not Applicable column, whichever is
a ro riate.
Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and ossibly State Officials.)
All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
The Chairman's signature line date has been entered as the date ofBCC approval of the
document or the final negotiated contract date whichever is a licable.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si ture and initials are re uired.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Ian Mitchell in the BCC office within 24 hours ofBCC approval.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of our deadlines!
The document was approved by the BCC on 5/1012011 (enter date) and all changes
made during the meeting have been incorporated in the attached document. The
Coun Attome's Office has reviewed the chan es, if a Iicable.
9f
l: Forms! COWlty Forms! BCC Forms! Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
2.
3.
4.
5.
6.
lOE
:MEMORANDUM
Date:
May 12, 2011
To:
Debbie Armstrong, Project Mgr.
Transportation Engineering/Construction Mgmt.
From:
Teresa Polaski, Deputy Clerk
Minutes and Records Department
Re:
Change Order #4 to Contract #08-5006
Attached for your records, is a copy of the agreement referenced above
(Agenda Item #10E), adopted by the Board of County Commissioners May
10,2011.
The Original is being kept by Minutes and Record's Department as part of
the Board's Official Records.
If you have any questions, feel free to contact me at 252-8411.
Thank you.
Attachment
CtO()~ 0 @
CHANGE ORDER 1 0 E
CHANGE ORDER NO.4 CONTRACf NO.08-5006
BCC Date: 1/15/08
Agenda Item: 16B 12
TO: Aim Engineering & Surveying, Inc.
5802 Breckenridge Parkway, Suite 100
Tampa, FL 33610
DATE: April L 2011
PROJECT NAME: 175 IJR
PROJECT NO.: 60060
Under our AGREEMENT dated January 15, f8.
You hereby are authorized and directed to make the following change(s) in accordance with terms and
conditions of the Agreement: See attached Supplemental Scope of Services.
FOR THE Additional Sum of: One hundred twenty five thousand one hundred and ten dollars and no
cents ($125,110.00).
Original Agreement Amount
$639.819.50 /"
,
$ 34.175.00
Sum of Previous Changes
r
This Change Order add
$125.110.00
./
Present Agreement Amount
$799.104.50
The time for completion shall be increased by 552 calendar days due to this Change Order. Accordingly, the
Contract Time is now 4 years 10 months (1767) calendar days. The final completion date is November 30,2012.
Your acceptance of this Change Order shall constitute a modification to our Agreement and will be performed
subject to all the same terms and conditions as contained in our Agreement indicated above, as fully as if the
same were repeated in this acceptance. The adjustment, if any, to the Agreement shall constitute a full and final
settlement of any and all claims of the Consultant arising out of or related to the change set forth herein,
including claims for impact and delay costs.
Accepted: -Apn. \. \ \.
CONSULTANT:
AIM Engineering & Surveying, Inc.
,2011.
BY:S~
Mr. Sean Donahoo, P.E. Vice President
OWNER:
BOARD OF COUNTY COMMISSIONERS
o . COLLIER COUNTY, FLORIDA
)
-
By:! )
Debbie Armstrong, Project Mana er
By: g\/s:;;>
Michael Greene, P .E.,
Transportation Planning Manager
"
10E
~ i.
{by:
DIVISION DEPUTY ADMINISTRATOR
Nick Casalanguida, Deputy nistrator
Growth Management Division
By:
Date: ~} (~~~ll
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A36istant County Attorney
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BOARD OF COUNTY CO!\.1MISSIONERS OF
COLLIER COUNTY FLORIDA
BY: 'ju.L w. r ~ ~("~
Fred W. Coyle, Chairman ~