Backup Documents 06/22/2010 Item #16G 1ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 G
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 fa teE the Board has taken action on the item_)
ROUTING SLIP
Complete routing lines # I through #4 as appropriate for additional signatures, dates, and /or information needed. If the document is already complete with dte
exception of the Chairman's signature, draw a line throng routing lines # I throw h #4, complete the checklist, and forward to Sue Filson (line 45)
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
1.
appropriate.
(Initial)
Applicable)
2.
June 22, 2010
Agenda Item Number
16G1
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4. Jennifer B. White �_r
ounty Attorney
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Ulil244 �`l
5. Ian Mitchell, BCC Office
Supervisor
Board of County Commissioners
Documents Attached
(t(24I�p
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
- - -- - (The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created /prepared the executive
summary. Primary contact information is needed in the event one of the addressees above, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC ofrce only after the BCC has acted to approve the
item.)
Name of Primary Staff
Debbie Brueggeman
Phone Number
(239) 642 -7878 Ext. 35
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
June 22, 2010
Agenda Item Number
16G1
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Change Order
Number of Original
3
Attached
resolutions, etc. signed by the County Attorney's Office and signature pages from
Documents Attached
INSTRUCTIONS & CHECKLIST
I: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip WINS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9. 18.09
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
I.
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 possibly State Officials.)
2.
All handwritten strike - through and revisions have been initialed by the County Attorney's
N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
`` "g-
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
)
5.
In most cases (some contracts are an exception), the original document and this routing slip
N/A
should be provided to Ian Mithchell in the BCC office within 24 hours of BCC 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 your deadlines!
6.
The document was approved by the BCC on 6/22/10 (enter date) and all
changes made during the meeting have been incorporated in the attached document.
I,
The County Attorney's Office has reviewed the changes, if applicable.
`
IML
I: Forms/ County Forms/ BCC Forms / Original Documents Routing Slip WINS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9. 18.09
16G1
MEMORANDUM
Date: June 25, 2010
To: Debbie Brueggeman, Operations Coordinator
Collier County Airport Authority
From: Ann Jennejohn, Deputy Clerk
Minutes and Records Department
Re: Change Order No. 1 to Work Order #4500116918
with Passarella & Associates, Inc.
Attached are two (2) original copies of the document referenced above,
(Item #16G1) approved by the Board of County Commissioners June 22, 2010.
The third original document will be held with the Board's Official Records in
the Minutes & Records Department.
If you have any questions, you may contact me at 252 -8406.
Thank you.
Attachments (2)
CHANGE ORDER 101 TO WORKORDER # 4500116918 16G 1
TO: FROM:
Passarella & Associates, Inc. Collier County Airport Authority
13620 Metropolis Avenue, Suite 200 2005 Mainsail Drive, Suite 1
Fort Myers, FL 33912 Naples, FL 34145
Proiect Name: Phase II Environmental Project Number: 50073
Immokalee Regional Airport
Work Order Dates: February 8, 2010 Work Order No: 4500116918
Change Order No: 1 Date: September 14, 2009
CCAA Tracking No: PAS -FT- 4168 -10 -03
Change Order Purpose:
This Change Order is to amend the rp ice, and tasks as follows.
Original agreement amount ................................ ............................... $78,700
This Change Order No. 1 Amount (add) ............ ............................... $13,600
RevisedAgreement Amount .............................. ............................... $92,300
Scope of Services
Work Order is amended to add the following tasks as specified below and in the attached
proposal dated May 25, 2010:
13.0 Collier County Site Development (SDP) Approval for Phase II
14.0 Gopher Tortoise Survey for Phase II
99.0 Additional Reimburseables
Compensation
Pursuant to Article Five of the Agreement, OWNER will compensate CONSULTANT in
accordance with the following method: Negotiated Lump Sum, as provided in the attached
proposal.
Task
Description
Cost
13.0
Collier County SDP Approval
$6,300
14.0
Gopher Tortoise Survey
$7,100
99.0
Additional Reimbursables
$200
TOTAL FEES
$13,600
C: (Documents and SettingslkristafLocal SettingslTemporary Internet FilesIOLKMUPAS WO 10-03 IMM Phase BERT CO kl (June
2010).docx
e Order No. I to Work Order # 4500116918 (PAS -FT- 4168- 10 -03)
3
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 said Agreement
indicated above, as fully as if the same were repeated in this acceptance. The adjustment, to this
Agreement shall constitute a full and final settlement of any and all claims arising out of or
related to, the change set forth herein, including claims for impact and delay costs.
ATTEST:
Sign �e-
�rr57(�-
Print Name
ATTEST:
DWIGHT E,,BROCK CLERK
tf�� 9
1i l•
Approval for form and legal Sufficiency
Jennifer B. White
Assistant County Attorney
CONSULTANT:
PASSARELLA & ASSOCIATES
JWK4 -
Kefineth C. Passarella, President
COLLIER COUNTY AIRPORT AUTHORITY
OF COLLIER COUNTY, FLORIDA
By:
FRED W. COYLE, CHAIRMAN
Item# &L-