Agenda 11/10/2009 Item #16E 3
Agenda Item No. 16E3
November 10, 2009
Page 1 of 50
EXECUTIVE SUMMARY
Report and Ratify Staff-Approved Change Orders and Changes to Work Orders to Board-
Approved Contracts.
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 which are less than or equal
to $200,000 (Section VII.C, Collier County Purchasing Policy), and changes to work orders for
all other contracts (Section XV.G, Collier County Purchasing Policy) which are not greater than
10 percent of the current Board Approved amount or $100,000 (whichever is greater). The
Administrative report identifies the percentage changes to contracts or work orders that have
occurred since the prior BCC approved amount which are below the threshold limits as
referenced above.
The plan calfs for staff to submit a monthly report listing these 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 period September 24, 2009,
through October 21, 2009.
FISCAL IMPACT: The total change to contracts is $1,045,725.65. The total change to work
orders is $22,862.93.
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact associated with
this action.
RECOMMENDATION: That the 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 to work orders
PREPARED BY: Diana De Leon, Contract Technician, Purchasing Department
_.
-1 at;\w 1 V-1 1
Agenda Item No. 16E3
November 10, 2009
Page 2 of 50
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
Item Number:
Item Summary:
16E3
Report and Ratify Staff-Approved Change Orders and Changes to Work Orders to Board-
Approved Contracts.
11/10/20099:00:00 AM
Meeting Date:
Prepared By
Diana Deleon
Administrative Assistant
Date
Administrative Services
Purchasing
10[26[2009 3:49:08 PM
Approved By
Steve Carnell
Purchasing/General Svcs Director
Date
Administrative Services
Purchasing
10/29/2009 9:40 AM
Approved By
Skip Camp, C.F.M.
Facilities Management Director
Date
Administrative Services
Facilities Management
10/29[2009 11:10 AM
Approved By
OMB Coordinator
OMS Coordinator
Date
County Manager's Office
Office of Management & Budget
10[29/20093:45 PM
Approved By
Randy Greenwald
ManagemenU3udget Analyst
Date
County Manager's Office
Office of Management & Budget
10[30[200910:10 AM
Approved By
John A. Yonkosky
Director of the Office of Management
Date
County Manager's Office
Office of Management & Budget
10[30[2009 12:53 PM
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Agenda Item No. 16E3 (
~~ovember 10, 2009
Page 7 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
hd tJ/Jw':/J
PROJECT NAME: Santa Barbara Boulevard from Davis Boulevard to Copper Leaf Lane PROJECT #: 62081
,
BIDlRFP #: 06-4042
~I~
MOD #: .J!!
PO#: 4500100465
WORK ORDER #:
DEPARTMENT: ~
CONTRACTORfFIRM NAME: Astaldl Construction CorDOratlon
$ 62,051 ,879.48
(Starting Point)
o C 'Ii
$ 62 07~.58 (.;,;)./ C S l( fJ'11- "1.
(Last T?tal Amount Approved by the BCC)
Current Contract Amount S 62.074,018.58
(Including All Changes Prior To This Modification)
Original Contract Amount:
Current BCC Approved Amount:
Change Amount $ 644.094.46
Revised Contract/Work Order Amount: $ 62.718.113.04
Cumulative Dollar Value of Changes to
this ContractlWOft Order: $ 666,233.56
Date of Last BCC Approval November 14. 2006 Agenda Item # 1 DE
Percentage of the change overlundercurrent contract amount j,oJf%
Formula: (Revised Amount / Last BCC approved amount)-1
CURRENT COMPLETION DATE (8): ORIGINAL: 08/24/09 CURRENT: 08/24/09 (See Sec. 5.C PaQe GC-
CA-3) of the Main Contract.
Describe the change(s): Final Adjustment for Overruns of Contract Quantities. (See attached backup for this
CO))
Specify the reasons for the change(s) r 1. Planned or Elective Ie 2. Unforeseen Conditions Ie 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:
Unable to complete final payment for authorized extra work.
This change was requested by: PIContractor/Consultant rl Owner rI Using Department C CDeS
COeslgn Professional r1Regulatory Agency (Specify)
r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
r
Yes
W No
This fonn is to be signed and dated.
-r;:; -/ _ ~/.J _ _
APPROVEDBY: L~ ~
Project Manager
REVIEWED BY:))
Date:
?/Zf't/1
q/~ 1//09
J I
Date:
Revised 11.1 9.2007
J
r
r-
~
CONTRACTJWORK ORDER MODIFICATION
CHI:CKUSTFORM
Agenda Item No. 16E3
November 10, 2009
~~d q/~~J?80f5~
u):1.J
PROJECT NAME: Collier County Seven storY Addition Coorthou!!le Annex PROJECT ':52533 PROJECT MANAGER:Hank
Jpnes
BID/RFP #: ~MOD it; ~POtI:4500100675 WORK ORDER it;-----!lf.b.--
DEPARTMeNT: F8ClI-..CONTRACTORIFIRM NAME: Krd Construction
Original ContnIct Amount: $ 20,841,800.00
(starting Point)
Current ace Approved Amount: $38,481,122..74
(La&t Total Amount Approved by the BCC)
Current Contract Amount: $38,257,765.25
(Including All Changes Prior To This Modificelion)
Change Amount: $ 11,928.90
Revised ContractlWork Order Amount: $38,2f18,flN.15
(Including This Change Order)
Cumulative Dollar Val... of Changes to
thl. Contrac:tlWork Order: $17,822,894.15
Olrie of l.a8t ace ApPmv8l1 nl?WOO7 Agend. Item '# 10 F
PeIceI.... 01 the chIInge ovet1under CUInNIt COIdrc:t tmOUnt -.3,'0 5 'It
Fnr:n1J1l'!' .(R!!YI!!!!d Amount 11l'!!rt Rf-e BpprnYAd l'tmollnt)-1
CURRENT COMPLETION DATE (5): ORIGINAL:
CURRENT:
.0 Incre.:uoe T:zsk _ by $
Thl& CI1~iiiije o.-der will: 0 Add.3 new TOISk for $
other DMP Rllimbur..".1t ..- -.,.. Bulldout
Describe the change(s): DMP Reimbursement
Spec:ify the reasons for the change(s) cz.. 1. Planned or Elective r 2. Unfona...n Conditions r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specmc:ations or Scope ofWor1t) r 5. Value Added
r 6. Schedule Adjustments Note: One or rnona may be chec:ked, depending on the nature of the c:hange(s).
Identify all negative impacts to the projec:t If this chBnge GRIer were not processed:
f./~ /'Y~ /ldarn~, ~~-:t:
.
This change was requested by: ~rlConsuJtant ~r
L.nesign Professional r1Regul8tory Agency (Specify)
rr Using Department r- CDes
r other (specify)
CONTRACT SPEClAUST PARnClPATION IN NE:G011AnONS: r Yes r No
Date:
r~;-Ior
{j /1 t/-ft? 9
REVIEWED BY:
Date:
,--
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item ~~o. 16E33
/J Novem02r 10, 2g~
{(,l. C!- cJ0 p-f~~*po/J
~
PROJECT NAME: Collier County Seven StOry Addition Courthouse Annex PROJECT #:52533 PROJECT MANAGER:Hank
Jpnes
BIDIRFP #: ~MOD #: ~PO#:45001 00675 WORK ORDER #:
~{~
DEPARTMENT: Facilities CONTRACTORJFIRM NAM E: Kraft Construction
Origh,al Contract Amount: $ 20,646,800.00
(Starting Point)
Current BCC Approved Amount: $39,491,122.74
(Last Total Amount Approved by the BCC)
Current Contract Amount: $38.269,694.15
(Including All Changes Prior To This Modification)
Change Amount: $ 258,835,47
Revised ContractlWork Order Amount: $38,528,529.62
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractJWork Order: $17,881,729.62
Date of Last BCC ApprovaI10123J2007 Agenda Item # 10 E
Percentage of the change over/under current contract amount -2.44%
Formula: (Revised Amount / Last BCC approved amount)-1
CURRENT COMPLETION DATE (5): ORIGINAL:
This change order will: 0 Add a new Task for $
CURRENT:
o Increase Task _ by $
other OMP Reimbursement Annex Rebid
Describe the change(s): DMP Reimbursement
Specify the reasons for the change(s) ~1. Planned or Elective (" 2. Unforeseen Conditions r; 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) (" 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 to the project if this change order were not processed:
!AVJL?' ~ ~~c.;:..
,
~~
This change was requested by: ry:lcontractor/Consultant f)(owner rI Using Department C CDES
Coeslgn Professional r1Regulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: ryes
r No
APPROVED B .
Date:
'1/s/0r
t( 12 tllt}f
REVIEWED BY:
Date:
Revised 6-15-09
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3
j) _ IJ f\Wye~,bi'11)j), 2009
!U (J eJ( 'fl'a~rM:710 of 50
. ~
~
PROJECT NAME: Collier County Seven StOry Addition Courthouse Annex PROJECT #:52533 PROJECT MANAGER:Hank
Jpnea .
BID/RFP #: 04.3576MOD.: 40 PO.:4500100675 WORK ORDER tI:~
DEPARTMENT: FacilltiesCONTRACTORIFIRM NAME: Kraft Construction
Current Contract Amount:
$ 20,646,800.00
(Starting Point)
$39.491.122.74
(Last Total Amount Approved by the BCe)
$38.528,529.62
(Including All Changes Prior To This Modification)
Original Contract Amount
Cummt BCe Approved Amount:
Change Amount:
ReviaedContraetlWork Order Amount:
$ (4353.42)
$38,524,176,20
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order:
$17,877,378.20
Date of Last BCC Approval 1 012312007
Agenda Item # 10 E
Percentage of the change over/under current contract amount -2.45%
Formula: (Revised Amount I Last BCC approved amount)-1
r-'
CURRENT COMPLETION DATE (S): ORIGINAL:
CURRENT:
o Increase Task _ by $
This change order will: 0 Add a new Task for $
Other Cancel Order for 3 AED unIts.
Describe the change(s): Cancel Order for 3 AED units
Specify the reasons for the chllnge(s} ~ 1. Planned or elective r 2. Unforeseen Conditions r 3. Quantity
Adjustments (" 4. Correction of Errors (Plans, 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 to the project if this change order were not processed:
~{.cuM .~ ~,.~o- ~
This change was requested by: ~ontractor/Consultant riJ.- Owner n Using Department C CDES
Loesign Professional rlRegulatory Agency (Specify) rOther (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes
r No
APPROVED BY.
Date:
'1/I~/01
t?(24j07
REVIEWED BY:
Date:
Revised 6-15-09
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Aoenda Item ~~o. 16E3
~ November 10.2009
n,"",,,,~,,,,, '" r1 -.~ r::0
~.~do/j~)?-
~
~
PROJECT NAME: Collier County Seven StOry Addition Courthouse Annex PROJECT #:52533 PROJECT MANAGER:Hank
Jpnes
BIDlRFP #: 04-3576MOD #: ~PO#:4500100675 WORK ORDER #:~
DEPARTMENT: FacilitiesCONTRACTORlFIRM NAME: Kraft Construction
Original Contract Amount: $ 20,646,800.00
(Starting Point)
Current BCC Approved Amount: $39,491,122.74
(Last Total Amount Approved by the BCG)
Current Contract Amount: $38,524.176.20
(Including All Changes Prior To This Modification)
Change Amount: $ (5,804.56)
Revised ContractJWork Order Amount: $38,518,371.64
(Inchlding This Change Order)
Cumulative Dollar Value of Changes to
this ContractJWork Order: $17.871,571.64
Oate of Last BCC ApprovaI10/2312007 Agenda Item # 10 E
Percentage of the change overfunder current contract amount -2.46%
Fonnula: (Revised Amount I Last BCC approved amount)-1
CURRENT COMPLETION DATE (5): ORIGINAL:
CURRENT:
This change order will: 0 Add a new Task for $
o 'ncr..s8 Task _ by $
Other Cancel Order for 4 AED units.
Describe the change(s): Cancel Order for 4 AED units
Specify the reasons for the change(s} ~ 1. Planned or Elective r 2. Unforeseen Conditions (' 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 cheeked, depending on the nature of the change(s).
Identify all negative impacts to the. project if this change order were not processed:
t t.lJLt '/te;-- fd a nee C!?yIILcCL. C
This change was requested by: iilcontractor/Consultant 'iZLowner rI Using Department r CDES
COGsign Professional r1Regulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: ryes
r No
APPROVED B .
'f;)~
Dale:~
Date: CJ / :) L/ I fJ9
I I
REVIEWED BY:
Revi sed 6-15 -09
JI
"."'-~
/!.l ad
(p
CONTRACTIWORK ORDER MODIFICATION
CHECKUSTFORM
oJiJ
PROJECT NAME: Santa Barbara Boulevard from Davia Boulavard to CODDer Leaf Lan. PROJECT #: 62081
BIDIRFP.: ~ MOD #: ...u POt: 4500100465 WORK ORDER #:
O~~TMENT: ~ CONTRACTORIFIRM NAME: AstaIdI Consbuction Col'DOl'lltlon
.....
Origlna' Contract Amount $ 62.051.879.48
(Starting Point)
Current BeC Approved Amount:
$
82.716.113.84 62.../05/,7 79. f-o
(Last Total Amount Approved by the BCC)
62.718.113.04
(Indudlng All Changes Prior To This Modification)
Current Contract Amount:
s
Change Amount:
-97.865.02
62.620.248.02
Revised Contract/Wortt Order Amount:
$
$
Cumulative Dollar Value of Changea 10
this ContractMlork Order: $
....Q7.886.e2- S" fi 36 fl. 5~
Date of Last BCC Approval November 14. 2006 Agenda Item # ~
Percentage of the change over/under current contract amoun~
Fonnula: (Revised Amount I Last BeC approved amount)-1
CURRENT COMPlETION DATE (5): ORIGINAL: 08/24/09 CURRENT: 08/24/09 (See Sec. 5.C Paoe GC-
CA-3) of the Main Contract.
Describe. the change(s): Change Order #5 is to remove the remaining balance allocated to Countryside
r. OptionButton1
Specify the reasons for the change(s) Ci' 1. Planned or Elective r 2. Unforeseen CondlUone r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) r 5. Value Added
(' 6. Schedule Adjusbnents 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:
This change was requested by: r1contractorlConsultant PI Owner r! Using Caparbnent C CCES
Coeslgn Professional r1Regulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
r
Yes
~ No
Thill fonn 18 to be signed and dated.
APPROVED BY: ~ ~
Project Mana er ~ I. If ,.-
REVIEWED BY: t-1/ 1ft-(:(
Date:
~/II!09
?ld~/t79'
Date:
RECEi'-'JD
SEP 2 4 2009
II Cl\ Uilponatton
l5ugil..nng Depsri'nef\\
-~
- --AgeMa Item"No. 16E3-
November 10, 2009
Page 13 of 50
1
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Naples Station Museum Phase IV PROJECT #: 50401
BIDIRFP #: 09-5242 MOD tJ: 1
PO#: NIA
PROJECT MANAGER: Gary Vincent
WORK ORDER #: N/A
DEPARTMENT: Museum
CONTRACTORIFIRM NAME: Professional Building Systems Inc. of SWF
Original Contract Amount S 98,238.00
CutTent Bee Approved Amount S 98,238.00
Current Contract Amount $ 98,238.00
Change Amount: $ 9,748....9
Revised ContractJWork Order Amount $107,986.49
Cumulative Dollar Value of Changes to
this ContractJWork Order: S 9,748.49
Date of Last BCC Approval: June 9, 2009
Agenda Item # 16014
Percentage of the change over current contract amount +9.92%
Formula: (Revised Amount I last BCC approved amount)-1
CURRENT COMPLETION DATE (5): ORIGINAL: November 30, 2009
CURRENT: March 9, 2010
this change order will: 0 Add a new Task for $
o Increase Task Number
by$
Other: Increase lump sum contract amount by $9,748.49
Describe the change{s): Change the size and location of the underground utility work required to install the fire
suppression system in the Naples Depot Museum. These change were required by the City of Naples Building
Review Department and the Fire Inspector.
Specify the reasons for the change{s) r 1. Planned or Elective x 2. Unforeseen Conditions r 3. Quantity
Adjusbnents r 4. Correction of Errors (Plans, Specifications or Scope of Work) r S. 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: Renovations to the Naples
Depot Museum could not be completed and it would never open as a Museum.
This change was requested by: rlcontractorlConsultant rI Owner rI Using Department r CDeS
r Design Professional x Regulatory Agency (Specify) City of Naples r Other (Specify)
CONTRACT SPECIALIST PARTICI;2ATIO IN NEGOTIATIONS: ryes
This tonn is to be sig and dated.
APPROVED BY: Date:
r No
REVIEWED BY:
1/~'1/tJ/
Date:
q.2-" .09
.
Date:
q /2'1 j(fj
I I
Q.t:01l
Revised 6 18 09
Agenda Item No. 16E3
N,io/embeJ 1JJ 2009
,'t1 &e)e ..j+~J{}f'
...;
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: ~~"'1 A-lf\ ~~A-tA'-PROJECT#: Sot;J[,.J_PROJECT MANAGER: ~~
BID/RFP #: C:>'1.-?lCo9MOD #: '3 PO#: ~-lcG5>o WORK OROE:R #: ~/4-
DEPARTMENT: C -Z-M CONTRACTORIFIRM NAME: ~i3C- CQ...!s.~~
Original Contract Amount: .
$ L ~ 0_ Oz.-a z, 8
(StartYng Point) I
$ L h q 0 0'2,.. o. -z....8
(Last7otal Amount Approved by the BCC)
$ L '"+0=f( 3-@q. &>3
(Inclu8ln9 All Changes Pnor To This ModIficatIon)
$ , .~ t 39 .'::'9 / 'l; ~ (p s 7'1
$ ..1-., =;;; e~ ;:;~J . 2. 2.. /, 1~6/05S. 3 7
(IncluJfng T~is Change Order)
$ q'?~<1 ~ E:> g. ~ :Z1~ J ~ 35", elf
"1-.' o. oq
Agenda Item # \ ro ..E..
'5/~3 %
5,7~
Current BCC Approved Amount:
Current Contract Amount:
Change Amount:
Revised ContractfWork Order Amount:
Cumulative Dollar Value of Changes to
this ContractlWork Order:
Date of Last BCC Approval
Percentage of the change over/under current contract amount
Formula: {Revised Amount I Last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: ~CURRENT: {, .lB. Dcr
This change order will: 0 Add a new Task for $ 0 Increase Task _ by $
Other
Describe the change(s): . 'fZt-..lAA~C{zM~ f=O(2.... At<C>.F..A:) \./1"+Lt!E
)
-=S~ C:-O,-iDt...-lLL>r-ts.;:" Af--iD ~~~ Ib ~~_
I ~
Specify the reasons for the change(s) r 1. Planned or Elective" 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work). 5. Value Added
r 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the ~hall_~e(s).
Identify all negative impacts to the project if this change order were not processed: A-f)\lB\Z-S'iZ'. ~
C/O hi CYOinrN. <::: ,. ~ eN PrDeQI1"r1~ ('" ..,.",7I2->.n::\1-lDJ 1'1 ~ll-\DDS .
This change was requested by: . ontractor/Consultant n Owner rl Using Department r CDES
tA~~A~
<Di=- tili~,.
rDesign Professional rJRegulatory Agency (Specify)
r Other (Specify)
~ rNo
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
This form is to be signed and dated.
APPROVED BY:
Date:
~, lb. O'L
q - 3() -(,J7
REVIEWED BY:
Date:
Revised 6-1 5-09
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
~~&l,Qrl()tqt"iE3 ~
'/Nove~ber 1 (J, 2'OD9 '
Page 15 of 50 q
PROJECT NAME: ImprovinQ the Accuracy and Resolution of FDEM Orthophotos for Collier County and for Additional UDAR
Break lines. DIM. contours and Orthophotos for Additional Portions of Collier County
PROJECT #: None
PROJECT MANAGER: Robert Wilev
BIDIRFP #: State Contract
MOD #: .2
PO#: 4500102993 WORK ORDER #: Woolpert 08-01
DEPARTMENT: EnQineerina and Environmental Services
CONTRACTOR/FIRM NAME: Woolpert. Inc.
Original Contract Amount:
$ 1.052.259.00
(Starting Point)
$ 1.052.259.00
(Last Total Amount Approved by the BCC)
$ 1,052.259.00
(Including All Changes Prior To This Modification)
Current BCC Approved Amount:
Current Contract Amount:
Change Amount:
$
0.00
Revised ContractIWork Order Amount: $ 1.052.259.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractlWork Order: $ 0.00
Date of Last BCC Approval 2-7-08
Agenda Item # Approved bv PurchasinQ Director
Percentage of the change over/under current contract amount
Formula: (Revised Amount I Last BCC approved amount)-1
o %
CURRENT COMPLETION DATE (S): ORIGINAL: 9-30-08
CURRENT:
10-30-09
Describe the change(s): Time extension of 133 days to account for work product delivery delays from difficulties the
County had in aettinq the Quality Assurance/Quality Control review contractor (Jones Edmunds) on board, alonq with time
to make corrections found durin!:! the QNQC reviews
Specify the reasons for the change(s) 0 1. Planned or Elective 0 2. Unforeseen Conditions 0 3. Quantity
MJustments 0 4. Correction of Errors (Plans, Specifications or Scope of Work) 0 5. Value Added
T"-G. 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: Clerk's office (Finance) will
not pay the invoice.
This change was requested by: DlContractor/Consultant [lJ Owner 01 Using Department )( CDES
OOesign Professional n1Regulatory Agency (Specify) rJOther (Specify) Clerk's office
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes J?<.NO
This form is to be signed and dated.
";;ROVEDBY: ~~~
Project Manager
REVIEWED BY: 1
t Specialist
Date:
'1-3-01
Date:
It) -s: (/)
Revised 11.19.2007
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
~~~b~~~~~
Page 16 of 5J D
PROJECT NAME: Utility Payment Assistance
PROJECT #: CD09-08 PROJECT
MANAGER:
Rosa Munoz
BIDIRFP #:
B.o9-UC-12-0016
MOD #:
1
PO#: N/A
WORK ORDER #: NIA
DEPARTMENT: Houslna and Human Services CHHSl CONTRACTOR/FIRM NAME: HHS-UTILlTY PAYMENT ASSISTANCE
Original Contract Amount
$ 50.000
(Starting Point)
Current sec Approved Amount:
$ 50.000
(Last Total Amount Approved by the BCC)
Current Contract Amount:
$ 50.000
(Including All Changes Prior To This Modification)
Change Amount:
$ 0
Revised Contract/Work Order Amount: $ 50.000
(Including This Change Order)
Cumulative Dollar Value of Changes to
this Contract/Work Order: $ 0
.
Date of Last BCC Approval
Seotember15.2009
Agenda Item # 10D
Percentage of the change over/under current contract amount
Formula: (Revised Amount (last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: 09-30-2010
o
%
CURRENT:
09-30-2010
This change order will: 0 Add a new Task for $
o Increase Task Number
by$
Other Will adiust maximum benefit amount and line Item amount.
Describe the change(s): To Drovlde a chanae in Exhibit A. Scooe of Services Prolect SCODe (Al. to allow for an
increase In maximum household benefit to $300 This revision will not chan~e the original total budgeted amount for
this Community DeveloDment Block Grant (CDBG) Droiect.
Specify the reasons for the change(s) r 1. Planned or Elective r 2. Unforeseen Conditions rgJ 3. Quantity
Adjustments ('" 4. Correction of Errors (Plans, Specifications or Scope of Work) ('" 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 to the project if this change order were not processed: A decrease in number of clients
assisted if this chanae were not Drocessed.
This change was requested by: r1ContractorlConsultant [8J Owner
rDesign Professional r1Regulatory Agency (SpeCify)
rI Using Department r CDES
DO~ (Specify)
ryes ^No
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
This form is to be signed and dat~
APPROVED BY: Rosa Munoz ~~ ~;-,,-7"\.- /'
APPRO~ BY: ~ser
REVIEWED BY:. 'rYt
C . '~~peCialist
Date: 10-02-09
'/U :4-
Date: y-
Date: / b .- S - () f
-
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 'E3 / /
r'>lovember 10.' 09
Page 17 50
PROJECT NAME: Rattlesnake Hammock Road (Polly - Collier Blvd. ICR-951l
PROJECT MANAGER: Bob Petersen
PROJECT#: 65021.1
BIDIRFP#: 09-5190
MOD #: Q1
PO#: 4500106681 WORK ORDER #: ,J i A
,
CONTRACTOR/FIRM NAME: Hannula LandscapinCl. Inc.
DEPARTMENT: Transportation. ATM Depl Landscape
Original Contract Amount: $ 327.140.53
(Slarting Poinl)
Current BCC Approved Amount: $ 327.140.53
(Last Tolal Amount Approved by the BCe)
Current Contract Amount: - $ 327,140.53
(Including All Changes Prior To This Modification)
Change Amount: $ 25.172.29
Revised ContractlWork Order Amount: $ 352.312.82
(Including This Change Order)
Cumulative Dollar Value of Changes to
this Contract/Work Order: $ 25.172.29
Date of Last BCC Approval
03/1012009
Agenda Item # 16-8-5
Percentage of the change overlunder current contract amount
Formula: (Revised Amount I Last BCe approved amounl)-1
CURRENT COMPLETION DATE (S): ORIGINAL: November 03.2009
7.69
%
CURRENT:
November 03. 2009
This change order will: 0 Add a new Task for $
o Increase Task Number
by $
Other
Describe the change(s): - Add & remove olant materials due to redesiGn based on Traffic Ooeration reviews.
- Chanae DUma station to meet A TM IrriGation standard eauioments.
- Add bores due to conflicts with existina utility lines.
- Temoorarv ootable water meters whr7e awaitina reuse line to be bOUGht on line.
- Additional irriGation Darts due to realianment of mainlina because of conflict with utilities.
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 ofthe change(s).
Identify all negative impacts to the project if this change order were not processed:
This change was requested by: P"lcontractor/Consultant II Owner PI Using Department C CDES
EDesign Professional nRegulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
ryes
r No
This form is to be signed and dated.
APPROVEDSY ~ p~
ob Petersen, Project Manager
Date:
i-iT-Or
REVIEWED BY:
Date:
7-1107
~J
APPROVED BY:
Date:
Revised 6 18 09
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
1:;1-
Agenda Item No. 16E3
t'>lovember 10,2009
Page 18 of 50
PROJECT NAME: Naoles Depot Phase 3
PROJECT #:
50401
PROJECT MANAGER: Gary Vincent
BID/RFP #: 08-5114
MOD #: 2
PO#: 4500107294
WORK ORDER #:
NIA
DEPARTMENT:
Museum
CONTRACTOR/FIRM NAME:White General Construction
Original Contract Amount:
$ 440.000.00
(Starting Point)
Current BCC Approved Amount:
$ 440.000.00
(Last Total Amount Approved by the BCC)
$ 473.172.00
(Including All Changes Prior To This Modification)
Current Contract Amount
Change Amount:
$ 10.421.00
Revised ContractIWork Order Amount: $ 483.593.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractJWork Order: $
43.593.00
Date of Last BCC Approval
3/24/09
Agenda Item #
16.D.8
Percentage of the change over/under current contract amount
Formula: (Revised Amount 1 Last BCe approved amount)-1
9.91
%
CURRENT COMPLETION DATE (5): ORIGINAL: 1/27/2010
This change order will: ~ Add a new Task for $ 10,421.00
CURRENT: 3/8/2010
o Increase Task Number
by$
Other
Describe the change(s): Add additional tile and Iiqhting to both restrooms. install ADA accessible sidewalk to public
riqht-of-wav sidewalk. install vapor barrier. repair deteriorated structural cross beams.
Specify the reasons for the change(s) r 1. Planned or EI9ctiveX 2. Unforeseen Conditions r 3. Quantity
Adjustments~4. Correction of Errors (Plans, Specifications or Scope of Work) r 5. Value Added
r 6. Schedule A(Jjustments 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: It would close the proiect down
because it would result in an unsafe buildinQ condition.
This change was requested by: r1Contractor/Consultant rI Owner r/ Using Department r CDeS
~Sign Professional rlRegulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes
r No
APPROVED BY:
.>
Date: /0 17 I~ 7
(O. 01. 09
-APPROVED BY-
Date:
REVIEWED BY:
l{ j) I /'2...GC-'T7> R...
. ~-4A a--=-':' V 0 cI!-~
Contradt Specialist
Date:
I()'- P-09
Revised 6 18 09
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3
r'>lovember 10,2009
Page 19 of 50
13
PROJECT NAME: Pump Station Improvements-302 PROJECT #: 725456 PROJECT MANAGER: Sandy Sridhar
BI DfRFP #:
08-5078
MOD #: 1
PO#: 4500102705
WORK ORDER #:
nfa
DEPARTMENT: PUPPMD
CONTRACTOR/FIRM NAME:
DouQlas N. HiQQins Inc..
Original Contract Amount: $ 1.887,800
(Starting Point)
Current BCC Approved Amount: $ 1.887.800
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ $1.887,800
(Including All Changes Prior To This Modification)
Change Amount: $ $135,549.25
Revised ContractIWork Order Amount: $ $2.023,349.25
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $ $135,549.25
Date of Last BCC Approval
October 14. 2008
Agenda Item # 10 D
Percentage of the change over/under current contract amount
Formula: (Revised Amount I Last Bee approved amount)-1
7.1ft
%
CURRENT COMPLETION DATE (S): ORIGINAL: January 4.2010
CURRENT:
March 23.2010
Describe the change(s): Bypass flows changed from 10,000 gpm to 19,000 gpm and add time to the contract.
Specify the reasons for the change(s) r 1. Planned or Elective ~ 2. Unforeseen Conditions r 3. Quantity
Adjustments CX:-4. Correction of Errors (Plans, Specifications or Scope of Work) ~ 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: The residents living closer to
the pump station demanded a higher screening to the pump station and a decorative type gate as opposed to the
traditional chain link fence gate. Extra work at the manhole will decrease the odor.
This change was requested by: r1Contractor/Consultant .RI Owner rI Using Department r COES
!t.Design Professional r1Regulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
Steve Carnell and Kelsey Ward negotiated the terms.
This form is to be signed nd d ted.
r
Yes
!l" No
APPROVED BY: Date: /0/13/0'7
APPROVED BY. Date: lo{\~/09
REVIEWED BY: Date: /D! /3 /oq
f)~ge.n ncJ a Jt~fP. No. :l.I3~~~. I j
p c!JtlvtfrOt~r3I!l';fOU{J!JU/
Page 20 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Underground Storage Fuel Tanks PROJECT #: n/a_ PROJECT MANAGER: Bob Pierce
BIDfRFP #: 09-5237
MOD #: 1
PO#: 4500109275_ WORK ORDER #: n/a
DEPARTMENT: FacHities Mgml CONTRACTOR/FIRM NAME: Surge Solutions GrouD, Inc. .
Original Contract Amount: $ 447,884.00
(Starting Point)
Current BCC Approved Amount: $447,884.00
(Last Total Amount Approved by the BCC)
Current Contract Am ount: $447,884.00
(Including All Changes Prior To This Modification)
Change Amount: $ (1.e-:63&.OO)C!O, 9& 1, -)
Revised ContractIWork Order Amount: $431,943.00 1f.J~1 9/7, -
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $ (~18as.8C)~ r'61-)
Date of Last BCC Approval_5/23/09 Agenda Item # -,16E2_
Percentage of the change over/under ~urrent contract amount_(-2.~1\ %
Formula: (Revised Amount / Last BCC approved amount)-1 I
CURRENT COMPLETION DATE (5): ORIGINAL: 12/31/09_CURRENT: 12/31/09_
This change order will: 0 Add a new Task for $
o Increase Task Num ber
by $
Other_ Decrease in scope or work
Describe the change(s):_(1)Delete piping from J to tank at K (2) 68;rFel\ l;~ J ~ . I 1:;;1
Specify the reasons for the change(s) ~ 1. Planned or Elective C 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: No cost savings.
This change was requested by: rlContractor/Consultant rl Owner PI Using Department r COES
r Design Professional r1Regulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
This form is to b&eig and d~."
APPROVED BY:. ~cP Date:
. Pierce,' Project Manager
K
rYes
17: No
APPRO~Y:
Date:
/tP/!z,P/
y-
/ol/tfjtJi
I
. REVIEWED BY:
Date:
c
Revised 6 18 09
,s CONTRACTIWORK ORDER MODIFICATION
~~ CHECKLIST FORM
PROJECT NAME: Collier County Fleet Facilities PROJECT #: 52009, PROJECT MANAGER: Claude Nesbitt
Agenda Item r'~o. 16E3
November 10, 2009
Page 21 of 50
/0
BID/RFP #: 06-3914 MOD #:
5
PO#: 4500100673'
DEPARTMENT: Facilities Management CONTRACTOR/FIRM NAME: Wriaht Construction
.'
Original Contract Amount: $ 9,272,848.00
(Starting Point)
Current BCC Approved Amount: $ 9,272,848.00
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 8,831,160.58'- ~ r 11../1 tJtf~,Sl}
(Including All Changes Prior To This Modification)
Change Amount:
$
o
Revised ContractIWork Order Amount: $ 9,272,8-48.00 . t; 6:1. ~ c> St' $( .50
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractJWork Order: $(451,803.50)
Date of Last BCC Approval 03/28/2006 Agenda Item # 10 0
Percentage of the change over/under current contract amount -4.87%
Formula: (Revised Amount / Last BCC approved amount)-1
$I!~(/.odl
CURRENT COMPLETION DATE (S): ORIGINAL' 11 g CURRENT: 1/24/2010
Describe the change(s): Extend time of the contract.
Specify the reasons for the change(s): To improve the generator at the BCC fleet from only life safety to full building
capacity. The work has been delayed in permitting.
Identify all negative impacts to the project if this change order were not processed: The project would incur
demobilization and remobilization costs for the contractor to return to accomplish the additional alternatives.
This change was requested by: VContractor/Consultant ~wner 0 Using Department 0 CDES
o Design Professional 0 Regulatory Agency (Specify)
o Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: 0 Yes
DNa
This form is to be ~iy'{e~ dated. <-:'\J\
APPROVED BY: \j~ ~ ~
Project Manager
REVIEWED BY:
Date: lo l'1-l '2~~
Date:
(t/ /1 tf/~ (]7J 9
I I
Revised 5.21.2007
Agenda Item No. 16E3 10
November 10, 2009
Page 22 of 50
CONTRACTJWORK ORDER MODIFICATION
CHECKUSTFORM
PROJECT NAME: Management Services for Pelican Bav Services PROJECT '" ~ PROJECT MANAGER: Kyle
Lukasz
B1DfRFP f#: 09-5174
MOD#:
1
PO#:_NA
WORK ORDER #:_NA
DEPARTMENT: PeDcan Bay Services
CONTRACTORlFlRM NAME: Dortill Management Group, tne
Original Contract Amount:
$ _42. 300.00
(starting Point)
$_42,.300.00
(Last Total Amount Approved by the BCC)
$_42,300.00
{Including All Changes Prior To This Modification)
$_0
$---..::9:: L("2-, 300
(Including This Change Order)
Current BCC Approved Amount:
Current Contract Amount:
Change Amount:
Revised Contrac:tIWork Order Amount:
Cumulative Dollar Value of Changes to
this ContracttWork Order: $ 0
Date of Last BCC Approval_June 23, 2009
Agenda Item #- _16F7
Percentage of tbe change over1under current contract amount 0 %
FOlTT'lula: (Revised Amount I last Bce approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: Co ( 30 ( (b CURRENT: to 130 \ lO
This change order will: 0 Add a new Task for $ 0 Increase Task Number by .$
OtherL Correct mOnthlv compensation amount from $3.3533.00 to $3535.00
Describe the change{s): Correctina contract lanauaqe to reflect correct neaotiated monthlv compensation
amount from $ 3.533.00 to $ 3.525.00
Specify the reasons for the change{s) r' 1. Planned or Elective 2. Unforeseen Conditions " 3. Quantity
Adjustments. 4. Correction of Errors (Plans, Specifications or Scope of Work) r'. 5. Value Added
." 6. Schedule Adjustments Note.: One or more may be checked. depending on the nature oftrle change(s).
Identify all negative impacts to the project if this change order were not processed: _The Consultant would be
compensated more than the negotiated contract amount.
This change was requested by: r Jcontractor/Consultant I Owner
~esign ProfessionallRegulatory Agency (Specify)
I Using Department ,'"' CDES
..fuher (Specify) -:f'~s 1>
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
Yes
No
REVIEWED
Date:
10/;'1-/09
I I
(O(('1! 0 I
Date:
Revised 6 I 8 09
.~i?,\J\;).,;.';", . "
< EXHI!JITj\,4 Contract Amendment No.1 to
"Management Services for Pelican Bay Services"
Agenda Iten} No. 16E3, It?,
November 10. 2009
Page 23 of 50
This amendment, dated 9- /~ ,2009 to the referenced agreement shall be by and
between the parties to the original agreement, Dorrill Management Group, (to be referred
to as "Consultant") and Collier County, Florida, (to be referred to as "County").
Statement of Understanding
RE: Contract #09-5174 "Management Services for Pelican Bay Services"
The following change to the above referenced Agreement has been mutually agreed to by the
Consultant and the County. The additions to the existing language in the Agreement are shown
herein by underlining; deletions from the Agreement are shown by strikcthroughs.
3. THE CONTRACT SUM. The County shall pay the Consultant for the performance
of the Agreement the sum of ($42,300.00) (forty two thousand three hundred dollars) for
the period of time commencing on July 1, 2009 and ending on June 30,2010, payable at
the rate of (three thous;:md fin hundred thirty three dolbrs) ($3,533) three thousand five
hundred twenty five dollars ($3525.00) per month, subject to Change orders as approved
in advance by the County. This price shall be fixed and firm for the first year duration
but will increase to fifty six thousand four hundred dollars ($56,400.00) for subsequent
years of the contract Any pre-approved travel expenses shall be paid at actual cost with
no markup for travel outside of Lee and Collier County. Payment will be made upon
receipt of a proper invoice and in compliance with Section 218.70, Fla. Stat., otherwise
known as the "Local Government Prompt Payment Act".
All other terms and conditions of the agreement shall remain in force.
IN WITNESS WHEREOF, the Consultant and the County have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date(s) indicated below.
Accepted:
C;-/t
,2009
By:
BOARD OF COUNTY
COMMISSIONERS
COLLIER COUINTY. FLO
B'
.-:'
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME:
LASIP Phase 1 B eN & S) PROJECT #:
51101
PROJEC"rIMANAGER:
BID/RFP #:
DEPARTMENT:
09-5142 MOD #: LPO#: 4500104719
WORK ORDER #: N/A
Agenda Item No. 16E3
November 10,2009
Page 24 of 50
fI
Shane Cox
CONTRACTOR/FIRM NAME:
Road Maintenance / Stormwater Mat
Mitchell & Stark
Original Contract Amount:
$ 3.530.719.90
. (Starting Point)
$ 3.530.719.90
(Last Total Amount Approved by the BCC)
$ 3.530.719.90
(Including All Changes Prior To This MOdification)
$ 45.095.05 { f~ t^- (.on+1 ~5L"'C'j )
$ 3.575.814.95
(Including This Change Order)
Current BCC Approved Amount:
Current Contract Amount:
Change Amount:
Revised ContractIWork Order Amount:
Cumulative Dollar Value of Changes to
this ContractIWork Order:
$ 45.095.05
Date of Last BCC Approval
Agenda Item # 10 E
December 16. 2008
Percentage of the change over/under current contract amount
Formula: (Revised Amount I Last BCC approved arnount)-1
1.~
%
CURRENT COMPLETION DATE (8): ORIGINAL:
November 18. 2009
CURRENT:
. This change order will: 0 Add a new Task for $
IXJ Add / delete the following materials and labor items:
PART 1
Describe the change(s):
ITEM QUANTITY DISCRIPTION
1 Electric se/Vice to existing lift station
1 Relocate a" forcemain
'1 Modify Forcemain connection
-1 Connect to existing 20" force main
t 1 Remove excess soil from under US 41 bridge
1 Additional 1 an fitting
1 Purchase & install Hydro cones under pumps
o Increase Task Number
November 18. 2009
by$
UNIT COST
LS $ 12,529.00
LS $ 12,500.00
LS $ 6,675.00
LS $ 5,320.00
LS $ 34,865.00
LS $ 2,500.00
LS $ 6.364.00
TOTAL
$ 12,529.00
$ 12,500.00
$ 6,675.00
$ (5,320.00)
$ 34.86~.OO
$ 2.500.00
$ 6,364.00
Specify the reasons for the change(s) r 1. Planned or Elective ~ 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) (" 5. Value Added
r 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change{s).
.' Identify aU negative impacts to the project if his change order were not processed+Re~cJ\/;:1j ..Jiv l'VIa-fp";,,,,1
., 1" . . - I' IJ r~ _ .
This change was requested by: r1Contractor/Consultant f71 Owner n Using Department r CDES
Coesign Professional rJRegulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
ryes
T7 No
Revised 6 18 09
.
".
Agenda Item No. 16E3
~Jovember 10, 2009
Page 25 of 50
17
PART 2
Describe the change(s):
1 Viburnum hedge @ Hibiscus Golf Courst
1 Provide Limited access Gates
LS
LS
$ 3,995.25
$ 11.120.00
$ 3,995.25
$ 11,120.00
Specify the reasons for the change(s) r 1. Planned or Elective r 2. Unforeseen. Conditions r 3. Quantity
Adjustments ("" 4. Correction of Errors (Plans, Specifications or Scope of Work) (i' S. Value Added
r 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change(s).
Identify all negative impac~he project if this change order were not process. ed: ~, 5~ ~e;f ~d4~1
5f!(lJr-.'ty at s;m.-ty to -t '~(t~t nt itbcrhDoa," i~e. t.dJj~ l../iH: fad of il IJ.I ra ~ cs. jof;a+wn.
This change was requested by: rJContractorfConsultant w( Owner rl Using Department r CDES
r Design Professional rJRegulatory Agency (Specify)
r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
rYes
r7 No
PART 3
Describe the change(s):
9 -250 1 1/2" Type 511I Asphalt SY $ 20.00 $ (5,000.00)
10 -250 6" Umerock Base SY $ 10,00 $ (2,500.00)
11 -250 12" Stabilized Subgrade SY $ 2.00 $ (500.00)
18 -200 36" RCP LF $ 75.00 $ (15,000.00)
20 -2 Triple 36" RCP Mitered end sections EA $ 4,700.00 $ (9.400.00)
24 3457 Solid Sod SY $ 1.65 $ 5,704.05
30 -3 Air Release Valves EA $ 5,900.00 $ (17,700.00)
46 80 Emba~ment Fill (turn around) CY $ 8.00 $ 640.00
48 180 6" Lirnerock Base Maint Road (turn around) SY $ 8.00 $ 1 ,440.00
61 2 12" ADS Yard Drains EA $ 940,00 $ 1,880.00
68 -3 Lock Down Removal Ballards EA $ 1,100.00 $ (3.300.00)
69 -1 Guardrail Modifications LS $ 2,000.00 $ (2,000.00)
70 l' Install "0" curb along Maple Road LS $ 5,602.75 $ 5.502.75
Specify the reasons for the change(s) ("" 1, Planned or Elective r2. Unforeseen Conditions ~ 3. Quantity
Adjustments r 4. Correction of Errors (Pians, Specifications or Scope of Work) ("" S. 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 pro-ect if this change order were not processed: -r;
. k \J 'f: "e./' ;: '.f.<!s
This change was requested by: fV'IContractor/Consultant n Owner r! Using Department r CDES
rDesign Professional rlRegulatory Agency (Specify) COther (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes
f7 No
APPROVED BY:
Dale: .1 0/9'/01
APPROVED BY:
Date: {O-,-Ocr
D,te ,of 15/ if(
REVIEWED BY:
Revised 6 18 09
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
&- ~njt<tlif~~E1rA. I
c~ovember to,l200~
Page 26 of 50 ~
PROJECT NAME: Immokalee CRA Master Plan F'ROJECT #: --$- PROJECT MANAGER: Penny Phillipoi _
BID/RFP #: 08-5073 MOD #: 5 PO#: 4500101492 WORK ORDER #: N/A
DEPARTMENT: Immokalee CRA
CONTRACTOR/FIRM NAME: RWA. Inc.
Original Contract Amount:
$ 386.175
(Starting Point)
$SS1.675 ..5 ~3 , t, '7 S"
(Last Total Amount Ap'proved by the BCC)
Current BCC Approved Amount:
Current Contract Amount:
$ 623,675
(Including All Changes Prior To This Modification)
Change Amount:
$ 4.605
$ 628.280
(Including This Change Order)
Revised ContractIWork Order Amoant:
Cumulative Dollar Value of Changes to
this ContractIWork Order:
$ 242.105
Date of Last BCC Approval
12/16/08
Agenda Item #
16.E.13 & 16.G.1
Percentage of the change over/under current contract amount ~ ~....~ %
Formula: (Revised Amount / Last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL:
11/17/09
CURRENT:
5/17/2010
This change order will: [gI Add a new Task for $ 4,605.00
o Increase Task Number: _ by_
Other $4.105 Fixed Fee. $500.00 Reimbursables per RWA Proposal Dated 9/26/09
Describe the change(s): The Collier County Community Redevelopment Aqencv (CRA). Immokalee, is seeking an
outside consultant to conduct an Operation Plan Workshop with CRA staff and the CRA Advisory Board in order to
oenerate a Fiscal Year 2010 Operation Plan for CRA execution.
Specify the reasons for the change(s) C. 1. Planned or Elective c;: 2. Unforeseen Conditions 0 3. Quantity
Adjustments 0 4. Correction of Errors (Plans, Specifications or Scope of Work) 0 5. Value Added
o 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: The Collier County Community
Redevelopment Aqency (CRA), Immokalee, would not have an operational plan for fiscal year 2010.
This change was requested by: DIContractor/Consultant r?'1 Owner ['I Using Department C CDES
CDesign Professional rlRegulatory Agency (Specify) ["Other (Specify)
This form is to be
n Yes
v-
,.,- No
APPROVED BY:
Dat~~ 1.' 2Q? q
I /
Date: IIJ//(p,loi
REVIEWED BY:
Revised 6 18 09
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PROJECT NAME: East Sewer Force Main
PROJECT #: 73132
PROJECT MANAGER: Phil Gramatoes
WORK ORDER #: 4S -/ OtiS//)
I I
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3
Novemb. er 10--tc..-~?9
~gqrn~o
BID/RFP #: 05-3785 MOD #: 1
PO#:45-104810
DEPARTMENT: Plannino and Proiect Manaoement
CONTRACTOR/FIRM NAME: Greelev and Hansen LLC
Original Contract Amount: $ 53.410.00
(Starting Point)
Current BCC Approved Amount: $ N/A
(Last Total Amount Approved by the BCG)
Current Contract Amount: $ 53.410.00
(Including All Changes Prior To This Modification)
Change Amount: $ 0
Revised ContractIWork Order Amount: $ 53.410.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $ 0
Date of Last BCC Approval: N/A Agenda Item #
Percentage of the change over/under current contract amount 0
Formula: (Revised Amount / Last BeC approved amount)-1
%
CURRENT COMPLETION DATE (8): ORIGINAL: 9/1012009
CURRENT: 12/31/2009
This change order will: 0 Add a new Task for $
o Increase Task Number
by$
Other: Extend the completion date
Describe the change(s): Extend the completion date to allow for adequate start-up time to ensure
that all operational compliance is met.
Specify the reasons for the change(s) (":. 1. Planned or Elective C 2. Unforeseen Conditions (': 3. Quantity
Adjustments C 4. Correction of Errors (Plans, Specifications or Scope of Work) C 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: The proiect could not be
completed.
This change was requested by: r1Contractor/Consultant PI Owner n Using Department C CDES
r Design Professional rlRegulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
rYes
P No
REVIEWED BY:
Date: 9/22/2009
APPROVED 8
APPROVED B
Date: 9/22/2009
Date: cr / :J5 / Ocr
-~
Revised 7-14-09
CONTRACTJWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3-)
November 1 0, 200~
/J. Pag~2 of 50
pt!-d 9j.;7:>7d?
J;$J
Curbln
PROJECT#: 4500107120 (dated 0511912009)
PROJECT MANAGER: Danvl Richard. RLA. Proiect Manaaer. ATM OeDartment
BIDlRFP#: 08-5060 MOD': 01 (onel POt: 4500107120 WORK ORDER t: 4500107120
DEPARTMENT: A TM De l CONTRACTORIFIRM NAME:
Original Contract Amount:
$ 73.401.00
(Starting Point)
$ n/.
(last Total Amount Approved by the BCC)
$ 73.401.00
Oncluding All Changes Prior To This Modification)
Curnnt Bee Approved Amount:
CUl'nnt Contract Amount:
Change Amount:
Revised ContractIWork Order Amount: $ 86.651.00
(Including This Change Order)
Cumulatlw Dollar Value of Changes to
this ContractJWork Order: $ 13.25D.00
Dsta of ....t BCC Approvel_N/A Agenda Item # _N/A
Percentage of the change over1und.r current contract amount 18.05%
Formula: (Revised Amount I Last Bee approved amount)-1
CURRENT COMPLETION DATE (5): ORIGINAL: September 19.2009 CURRENT: Julv 31.2010
this change order will:
~ Add. newT..k 1.1.5 for $2.'736.00
~ Add. newT_k 1.1.6forS10.514.00
~ Tatallnc...... Task Number -1:L by $13.250.00
Other
Dacribe the chang.(.):
ADD Task 1.1.5 (Base Plan Development - Survey; Planning-Prime Consultant: McGee)
Professional Unit
PrincipaVSenior LA 1
AutoCAD Technician 4
Administrative 2
TOTAL ADD-TASK ITEM 1.1.5 (Prime)
Rate
$128.00
$62.00
55.00
Cost
$128.00
$248.00
11 0
$486.00 (prime)
ADD Task 1.1.5 (Planning-Engineer Sub-Consu1tant)
TOTAL ADD -TASK ITEM 1.1.5 (Sub-Consultant)
TOTAL ADD 1.1.5 =
$2,T36.oo (TOTAL 1. .5 ADD)
111I111/1111I1/
ADD Task 1.1.6 (Roadway Survey; Planning-Prime Consultant: McGee)
..,~
Professional
PrincipaVSenior LA
Revised 6 18 09
Unit
2
Rate
$128.00
Cost
$256.00
AutoCAD Technician 4 $62.00
Administrative
TOTAL ADD-TASK ITEM 1.1.5 (Prime)
$248.00
110.00
$614.00 (prime)
Task 1.1.6 (Planning-Engineer Sub-Consultant)
TOTAL ADD -TASK ITEM 1.1.6 (Sub-Consultant)
TOTAL ADD Task 1.1.6 =
.I\qsnda Item No. 16E3
~ November 10. 2009 dq
Page 33 of 50
Explanation for Time Added: Additional time is added to contract for completion of survey wori< s added in task 1.1.5 and
1.1.6; staff review of project Indicates that Task 6.0 Contract Administration req uires additional t added for project
bidding and consultant services during construction.
Specify the re&eon. for the change(.) -i. Planned or Elective r 2. Unfo....een C ndltlons 3. Quantity
Adjustments C 4. Correction of Errors (Plana, Specifications or Scope of Work) -S. Va . Added
C 6. Schedule Adjustments Note: One or more may be checked, depending on the nat re of the change(s).
Identify all negative Impacts to the project If this change order were not processed: Native im act would be
that the ro'ect Desi n Hunter & Coronado would not benefit from onsultant sarvi s that are necessa in
order to ensure successful construction of the project.
This change was requested by: - Contractor/Consultant - Owner n Using Oepartm nt r: COES
- Design Profesaional nRegulatory Agency (Specify) rOther (Specify
CONTRACT SPECIAUST PARTICIPATION IN NEGOTIATIONS: rYes - No
Date:
q j?:>M
,
~/:J$/oCj
r
APPROVED BY:
Con
Date:
Revised 6 18 09
Agenda Item No. 16E3 3
November 10, 2009
Page 34 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLJST FORM
PROJECT NAME: SCADA uograde
BIDIRFP#: q:;r;3h8~OD#: 1
DEPARTMENT: PUPPMD
PROJECT#: 71024.7.73964.10.74033.10
PROJECT MANAGER: Tom Chmelik
PO#: 4500102645
WORK ORDER #:
.N< '-I S; 00 ( 0 "2..Cc4 S-
CONTRACTOR/FIRM NAME:
Hazen and SaWYer. P.C.
Original Contract Amount: $ 12.540.00
(Starting Point)
Current BCC Approved Amount: $ NA
(Last Total Amount Approved by the BCG)
Current Contract Amount: $ 12.540.00
(Including All Changes Prior To This Modification)
Change Amount $ 0
Revised ContractIWork Order Amount $ 12.540.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractlWork Order: $ 0
Date of Last BCe Approval
NA
Agenda ftem #
NA
Percentage of the change over/under current contract amount ~ 0 -.IlJ1( % over
Formula: (Revised Amount / Last BCC approved amount)-1
,- CURRENT COMPLETION DATE (S): ORIGINAL: 3/18f09
CURRENT:
10/31109
This change order will: 0 Add a new Task for $
o Increase Task Number
by $
Other Increase time
I f:
Describe the change(s): Time extension only to allow for coordination with operational and budgetary constraints.
Specify the reasons for the cha!lge(s) (" 1. Planned or Elective r 2. Unforeseen Conditions (" 3. Quantity
Adjustments r_ 4. Correction of Errors (Plans, Specifications or Scope of Work) (" 5. Value Added
U' 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change(s).
.:j~~ntii{ all negative impacts t.o tha. rOject if this chan, e order .wete nOJP,roesse : Time extension only.......1h OCl()~
M~tJ:f CUJ-dcn !z! cZ' l.:!(/.:!; ,~-k2.AL~ 4.rl1-d 11-c:t-<.~ .
This change ~as requested by: rlCon actor/Con ultant i Owner rl Using epiutmeri1 r CDES .
UOesign p/ofessional ClRegulatory Agency (Specify)
r Other (Specify)
r Yes ~NO
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
APPROVED BY:
Date:
1/&1 #J
4fY/Cft.
q/st>/tJf
I
Date:
EVfEWED BY:
Date:
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3 't
November 10, 2009
Page 35 of 50
PROJECT NAME: CC Sewer Swap PROJECT#:52005 PROJECT MANAGER: Sandy Sridhar
BID/RFP #: Or".. 2f1lD" MOD #: 1 PO#: 4500105396 WORK ORDER #: Li'5DO I 05 3 q(p
DEPARTMENT: P & PM
CONTRACTOR/FIRM NAME:
ABB inc.
Original Contract Amount:
$
24.000.00
(Starting Point)
24..D<ltf.OO tv I A
(Last Total Amount Approved by the BCC)
Current BCC Approved Amount:
$
Current Contract Amount:
$
24.000.00
(Including All Changes Prior To This Modification)
Change Amount:
$_0.00
Revised ContractIWork Order Amount: $ 24,000.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $ 0.00
Date of Last BCC Approval
N/A
Agenda Item #
NIp..
Percentage of the change qver/under current contract amount
Formula: (Revised Amount I Last BCC approved amount)-1
o
%
CURRENT COMPLETION DATE (S): ORIGINAL: June 9.2009
CURRENT:
December 9, 2009
This change order will: 0 Add a new Task for $
0.00
o Increase Task Number
by $
Other
Describe the change(s): Extension to contract time to complete record drawin~s
Specify the reasons for the change(s) r 1. Planned or Elective <1. 2. Unforeseen Conditions (' 3. Quantity
Adjustments ('" 4. Correction of Errors (Plans, Specifications or Scope of Work) ~ 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:
This change was requested by: r1Contractor/Consultant fit I Owner rI Using Department r CDES
r Design Professional rlRegulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes
fV No
APPROVED BY: Date: I eJ{~/rY}
APPROVED BY: Date: IO/s!09,
REVIEWED BY: Date: IOf5"'Jo~
Revised 6 18 09
.A.genda Item No. 16E3 S
November 10, 2009--
Page 36 of 50
CONTRACTIWORK ORDER MOOIFICATION
CHECKLIST FORM
PROJECT NAME: Golden Gate MSTU "Master Plan"; Work Order TLO-MA-3614-07-04: (PO 4500100242 FY-09
PROJECT #: 4500100242 (dated 10/09/2008)
PROJECT MANAGER: Darryl Richard. RLA. Project Manaaer. ATM Defr.n1ment
oc.(-3laI'f .
BID/RFP #: 08.5d60 MOD #: 01 (one) POI: 4500100242 WORK ORDER #: TLO-MA-3614-07-04
,
DEPARTMENT: A TM Dept. CONTRACTOR/FIRM NAME: McGee & Associates
Original Contract Amount: $ 4.800.00
(Starting Point)
Current BCC Approved Amount: $ nla
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 4.800,00
(Including All Changes Prior To This Modification)
Change Amount: $_-0-
Revised ContractIWork Order Amount: $ 4.800.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractlWork Order: $ -0-
Date of Last BCe Approval_N/A Agenda Item # _N/A
Percentage of the change over/under current contract amount 0% .
Formula: (Revised Amount I Last BCC approved amount)-1
CURRENT COMPLETION DATE (5): ORIGINAL: February 8. 2008 CURRENT: January 8. 2010
This change order will: Add Time to Work Order
Describe the change{s):
Change is to ADO TIME ONLY. Additional time has been deemed necessary to allow for sufficient staff review of
proposed changes to the "Golden Gate Beautification Master Plan" document as referenced in Collier County
lDC.
Specify the reasons for the change(s) e1. Planned or Elective r 2. Unforeseen Conditions 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) e5. Value Added
C 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: NeQative impact would be
that staff and consultant would not have additional time to revise the "Golden Gate Beautification Master Plann
per comments received bv Staff/Community/and third party consultant(s).
ThIs change was requested by: - Contractor/Consultant - Owner n Using Department r CDES
· Design Professional L1Regulatory Agency (Specify) LOther (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes . No
This fonn Is to be signed and dated.
APPROVED BY:
Date:
1Ft/o!
(o!1-ltfJ
l ' l
Date:
Agenda Item No. 16E3
November 10. 2009
Page 37 of 50
~
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Work Order MP-FT-3657-0B-01/PO 450009B565 Project Name: Field Inspection and Construction Services for the
Forest Lakes MSTU Bond Issue Projects - Phase I (Projects Nos. 2,3, and 4) (old PO 4500091398 FY-08)
PROJECT #: 4500098565 (10/04/2008)
PROJECT MANAGER:_Darryl Richard, RLA, Project Manager, A TM Department_
BID/RFP #: 05-3657 MOD #: 02 (two)nndudes previous C0#2 'Zero Dollar Change')
Pot: 4500098565 WORK ORDER #: MP-FT -3657 -08-01
DEPARTMENT: ATM Dept. CONTRACTOR/FIRM NAME: Malcolm Pimie Inc.
Original Contract Amount: $ 85.000
(Starting Point)
Current BCC Approved Amount: $ n/a
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 85,000
(Induding All Changes Prior To This Modification)
Change Amount: $_-0-
Revised ContractJWork Order Amount: $ 85.000
(Including This Change Order)
Cumulative Dollar Value of Changes to
this Conb"actlWork Order:. $ -0-
Date of Last BCC Approval_N/A Agenda Item # _N/A
Percentage of the change over/under current contract amount 0% (no chanqe)
Formula: (Revised Amount I Last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: Auaust 10. 2008 CURRENT: October 31.2009
This change order will: Add Time to Work Order
Describe the change(s):
Change is to ADD TIME ONLY. Additional time has been deemed necessary for completion of project activity
per Work Order MP-FT-3657-08-01/PO 4500098565 for services from Malcolm Pirnie, Inc.
Specify the reasons for the change(s) e1. Planned or Elective (" 2. Unforeseen Conditions 3. Quantity
Adjustments C 4. Correction of Errors (Plans, Specifications or Scope of Work) es. Value Added
(" 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: NeQative impact would be
that staff and consultant would not have additional time necessary for pro;ect completion.
This change was requested by: - Contractor/Consultant . Owner n Using Department r CDES
· Design Professional nRegulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes . No
1/1-~1 0'
, (
/~ ! 9-/07
I I
Agenda Item No. 16E3
November 10, 2009
Page 38 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: PO 4500098563; Field Inspections and Construction Services for the Forest Lakes MSTU
Bond Issue Projects -Phase II (Project Nos. 1 b, 1 c and 6)
PROJECT #: 4500098563 (10/09/200B)
PROJECT MANAGER:_Darryl Richard, RLA, Project Manager, ATM Department_
BIDIRFP #: 05-3657 MOD #: 02 ttwo>nncludes previous CO#2 'Zero Dollar ChanQe')
PO#: 4500098563 WORK ORDER #: 4500098563
DEPARTMENT: ATM Dept. CONTRACTOR/FIRM NAME: Malcolm Pirnie Inc.
Original Contract Amount $ 70.000
(Starting Point)
Current BCC Approved Amount: $ nla
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 70.000
(Including All Changes Prior To This Modification)
Change Amount: $ -0-
Revised ContractIWork Order Amount: $ 70.000
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractJWork Order: $ ..()-
Date of Last BCC Approval_N/A Agenda Item # _N/A
Percentage of the change over/under current contract amount 0% (no chanoe)
Formula: (Revised Amount /last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: September 6.2008 CURRENT: October 31.2009
This change order will: Add Time to Work Order
Describe the change(s):
Change is to ADD TIME ONLY. Additional time has been deemed necessary for completion of project activity
per Work Order PO 4500098563 for services from Malcolm Pimie, Inc.
Specify the reasons for the change(s) e1. Planned or Elective ('" 2. Unforeseen Conditions 3. Quantity
Adjustments C 4. Correction of Errors (Plans, Specifications or Scope of Work) es. Value Added
n 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: Neoative imoact would be
that staff and consultant would not have additional time necessary for proiect completion.
This change was requested by: · Contractor/Consultant . Owner n Using Department r COES
· Design Professional f'1Regulatory Agency (Specify) ["Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes . No
/-
This form Is to be signed and dated. A
APPROVED BY: Date:
proj ct Mana~er, DW1 Ri rd
APPROVEDBY:~ ~t~_ ~"v-t ,f,,~-"-'--Date:
. Conlract Specialist, Rhonda CummingS, 0
ReVIsed 6 18 09 '" .
'ij1/iIM
;O(~/O~
.t,genda item r'~o. 16E3 a
, I .' 1_. _ _ A ,,r,, ,.-, ,""'_~\f'.
i>':vV::;;iljL.i'__1 ,-"", .......V'-''-'
Page 29 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Forest Lakes MSTU Bond Issue Projects Field Services & eEl Services P. O. #4500104940 (dated 02117/2009)
(Bond Issue Projects F-43. F-45, F-53 and F-53A)
PROJECT #: 4500104940 (02/17/2009)
PROJECT MANAGER:_Darryl Richard, RLA, Project Manager. ATM Department_
BID/RFP #: 05-3657 MOD #: 01 (one)
PO#: 4500104940 WORKORDER#: 4500104940
DEPARTMENT: A TM Dept. CONTRACTORIFIRM NAME: Malcolm Pirnie Inc.
Original Contract Amount: $ 47.500
(Starting Point)
Current BCC Approved Amount: $ nla
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 47,500
(Including All Changes Prior To This Modification)
Change Amount: $_-0-
Revised Contract/Work Order Amount: $ 47.500
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $ -0-
Date of Last BCC Approval_N/A Agenda Item # _N/A
Percentage of the change over/under current contract amount 0% (no change)
Formula: (Revised Amount I Last BCC approved amount)-1
CURRENT COMPLETION DATE (8): ORIGINAL: AUQust 19.2009 CURRENT: October 29. 2010
This change order will: Add Time to Work Order
Describe the change{s):
Change is to ADO TIME ONLY. Additional time has been deemed necessary for completion of project activity
per Work Order/PO 4500104940 (02117/2009) for services from Malcolm Pimie, Inc.
Permitting negotiations with SFWMD required additional time allotment for project.
Specify the reasons for the change{s) 01. Planned or Elective r 2. Unforeseen Conditions 3. Quantity
I
Adjustments C 4. Correction of Errors (Plans, Specifications or Scope of Work) 05. Value Added
C 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change{s).
"\
Identify air negative impacts to the project if this change order were not processed: Neqative impact would be
~
that staff and consultant would not have additional time necessary for project completion.
-,
. .
This change was requested by: - Contractor/Consultant . Owner
- f '.
r Design Professional ORegulatory Agency (SpeCify)
n Using Department r CDES
COther (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes - No
This form is to be signed and dated.
Q-.
'"
Agenda Item No. 16E3 1
November 10, 2009
Page 40 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJeCT NAME: Work Order TLO-MA-3614-05-17 Immokalee MSTU Phase IV Roadside Tree Plantina and Street Liahtlna
Project PO 4500100243 FY'()9 (PO 4500043411 FY'()6)
PROJECT #: 4500100243 {dated 10/09/20081
PROJECT MANAGER: Darrvl Richard. RLA. Proiect Manaqer. A TM Department
c)q-~ fQ(<I
BIDIRFP #: O~MO'o #: 02 (two) PO#: 4500100243 WORK ORDER #: TLO-MA-3614'()5-17
---
DEPARTMENT: A TM Dept. CONTRACTOR/FIRM NAME: McGee & Associates
Original Contract Amount: $ 76.944.00
(Starting Point)
Current BCC Approved Amount: $ n/a
(Last Total Amount Approved by the BCC)
Current Contract Amount $ 76,944.00
(Including All Changes Prior To This Modification)
Chiange Amount: $ -0-
Revised ContractJWork Order Amount: $ 76.944.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractlWork Order: $ .()_
Date of Last BCe Approval_N1A Agenda Item # _N/A
Percentage of the change over/under current contract amount 0% (no chanoe)
Formula: (Revised Amount / Last BCC approved amount)-1
CURRENT COMPLETION DATE (8): ORIGINAL: March 22. 2006 CURRENT: November 10. 2009
This change order will:
o Total Increase Task Number _ by $_
other
Describe the change(s):
Change is to add time only. Invoice 2291 'Final' was received on September 24, 2009 for $2,199.61; staff has reviewed
the invoice and associated 'back-up' documentation provided and found the request for payment to be within terms of
ContractIWork Order (see attached Invoice 2291 and back-up documentation
ContractIWork Order time-line extension is necessary in order to process payment for services rendered.
Original Work Order was for 1 year (365 days) with March 22, 2006 completion date;
Zero dollar change #1 added 1057 days to Work Order
This change #2 adds 272 days to Work Order for revised completion date of November 10, 2009
Specify the reasons for th~ change(s) e1. Planned or Elective (" 2. Unforeseen Conditions 3. Quantity
Adjustments C 4. Correction of eiTorS (Plans, Specifications or Scope of Work) e5. 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: Neaative impact would be
,- that payment per invoice 2291 would not be orocessed for payment to consultant for services rendered.
This change was requested by: · Contractor/Consultant . Owner n Using Department r: coes
Revised 6 18 09
IJ
Ie)
,^, a. to ..-.~
hg~nda L~m NO.1 0_
November 10. 2009
Page 41 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Immokalee MSTU - Landscape Architecture and Landscape Maintenances services (REVISED
PROPOSAL DATED 1-30-09)
PROJECT #: .P. O. #4500]05395 (dated 03/06/2009)
PROJECT MANAGER: Darryl Richard, RLA. Proiect Manaqer, ATM Department
BID/RFP #: 08-5060 MOD #: 01 (one) PO#: 4500105395 WORK ORDER #: 4500105395
DEPARTMENT: ATM Dept CONTRACTOR/FIRM NAME: JRL Desion
Original Contract Amount: $ 19,676.00
(Starting Point)
Current BCC Approved Amount: $ n/a
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 19.676.00
(Including All Changes Prior To This Modification)
Change Amount: $ 9,742.00
Revised ContractIWor1< Order Amount: $ 29,418.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractlWork Order: $ 9,742.00
Date of Last BCe Approval_N/A Agenda Item # _N/A
Percentage of the change over/under current contract amount 49.51 %
Formula: (Revised Amount! Last BCC approved amount)-1
CURRENT COMPLETION DATE (8): ORIGINAL: March 12,2010 CURRENT: March 12. 2010
This change order will:
[g:] Total Increase Task Number ~ by $3,404.00
[g:] Total Increase Task Number ~ by $3.680.00
[g:] Total Increase Task Number ~ by $2,658.00
Describe the change(s):
Other
ADD to Task 1 Monthly Services
Professional
Principal/Senior LA
Landscape Architect
Technical Staff
Administrative
TOTAL ADD Task 1
Unit
12
8
4
12
Rate
$128.00
$120.00
$62.00
$55.00
Cost
$1,536.00
$960.00
$248.00
$660.00
$3,404.00 (TME)
ADD to Task 2 Required Limited Design Services
Professional
Principal/Senior LA
Landscape Architect
Design Associate
Technical Staff
Revised 6 18 09
Unit
10
8
8
10
Rate
$128.00
$120.00
$75.00
$62.00
Cost
$1,280.00
$960.00
$600.00
$620.00
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3
r\Jovember 10, 2009
P8je 42 of 50
( /
PROJECT NAME: Work Order PO 4500098727 Forest lakes MSTU - Easement ACQuisition Phase 1/ _ Roadwavs and Drainaae
PO 4500098727 FY -08
PROJECT #: PO 4500098727 (dated 10/04108)
PROJECT MANAGER: Darryl Richard. RLA. Proiect ManaCler. ATM Deoartment
. BID/RFP #: 06-3944
MOO #: 01 (one) PO#: 4500098727
WORK ORDER #: Work Order RWA-FT -3944-08-09; PO 4500098727
DEPARTMENT: ATM Dept. CONTRACTOR/FIRM NAME: RWA Consultina
Original Contract Amount: $ 15.550.00
(Starting Point)
Current BCC Approved Amount: $ nla
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 15.550.00
(Including All Changes Prior To This Modification)
Change Amount: $ -0-
Revised ContractIWork Order Amount: $ 15.550.00 (no chanae)
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $ -0-
o
Date of Last BCC Approval_N/A
Agenda Item # _N/A
Percentage of the change overlunder current contract amount O%(no chanqe)
Formula: (Revised Amount! Last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: Julv 4.2008 CURRENT: October 31.2009
This change order will:
Add 484 days to contract time period
o Total Increase Task Number _ by $_
Other
Describe the change(s):
Change is for Time Only. Additional time is required for project completion; Review of proposed
easement acquisition by Transportation Division ROW Acquisitions indicated additional survey
services were/are required to complete the legal description for easement acquisition in
preparation of Board of County Commissioners approval. Change will Add 484 days to contract
time period for revised completion date of: October 31.2009
Specify the reasons for the change(s) 81. Planned or Elective (" 2. Unforeseen Conditions 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work) 85. 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: Neoative impact would be
that the necessary easement descriptions would not be completed per Work Order PO 4500098727 Forest .
Lakes MSTU - Easement Acquisition Phase /I - Roadwavs and Drainaqe (PO 4500098727 FY-08)
,'-
/his change was requested by: · Contractor/Consultant . Owner n Using Department r COES
Revised 6 18 09
· Design Professional nRegulatory Agency (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS:
This fonn is to be signed and dated.
~
APPROVED BY:
Revised 6 18 09
Agenda Item No 1eE3
r'>lovember 10. 2009
['Other (Specify) Pa08 43 of 50
r
Yes
-No
Date: (o-{ OJ
Date: 10 I~ 00-
~
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3/;I-
November 10, 2009
Page 44 of 50
PROJECT NAME: Work Order RWA-FT-3944-08-11; PO 4500099678 Forest Lakes MSTU -Forest Lakes Condo and (F-521 Mira
Vista - Related to Bond Issue Prolect (RWA File No. 070190.02.00) (PO 450094110 FY-oS)
PROJECT #; 4500099678 (dated 10/08/200B)
PROJECT MANAGER: Darryl Richard. RLA. Proiect Manaaer. ATM Deparbnent
BIDJRFP #: 06-3944
MOD '#: 02 (two) rinc/udlna previous C01 Zero Dollar Time Extensionl PO#: 4500099678
WORK ORDER #: Work Order RWA.FT -3944-08-11: PO 4500099678
DEPARTMENT: ATM Dept CONTRACTOR/FIRM NAME: RWA Consultina
Original Contract Amount: $ 19.050.00
(Starting Point)
Current sec Approved Amount: $ nla
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ 19.050.00
(Including All Changes Prior To This Modification)
Change Amount: S -D.
Revised ContractIWork Order Amount: $ 19.050.00 (No Chanae)
(Including This Change Order)
Cumulatrve Dollar Value of Changes to
this ContractlYVork Order: S .0-
Date of Last BCC Approval_N/A Agenda Item # _N/A
Percentage of the change over/under current contract amount 0%(00 chanQe)
Formula: (ReVised Amount / Last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: April 7. 2009 CURRENT: October 31. 2009
This change order will:
Add 269 days to contract time period
o Total Increase Task Number _ by $_
Other
Describe the change(s):
Change is for Time Only. Additional time is required for project completion; Review of proP9sed
easement acquisition by Transportation Division ROW Acquisitions indicated additional survey
services were/are required to complete the legal description for easement acquisition in
preparation of Board of County Commissioners approval. Change will Add 207 days to contract
time period for revised completion date of: October 31.2009
Specify the reasons for the change(s) .1. Planned or Elective (': 2. Unforeseen Conditions 3. Quantity
Adjustments C 4. Correction of Errors (Plans, Specifications or Scope of Work) .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: Neqative impact would be
that the necessary easement descriptions would not be completed per Work Order RWA-FT-3944-08-11: PO
4500099678
fhls change was requested by: · Contractor/Consultant . Owner n Using Department r CDES
Revised 6 18 09
· Design Professional rlRegulatory Agency (Specify)
r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: rYes . No
APPROVED BY:
Revised 6 18 09
lo-h-1 ,
1(}/8/~
,';genda Item No. 16E3
November 10, 2009
Paoe 45 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: Emergency Bridge Management Program PROJECT #: _66066_ PROJECT MANAGER: Marlene Messam,
P.E._
. BID/RFP #: ,08-3969'
>
MOD #: 1
PO#:_ 45-101570_ WORK ORDER #: SC-FT -3969-08-03
DEPARTMENT:_ TECM
CONTRACTOR/FIRM NAME:
Stan lev Consultants. Inc.
Original Contract Amount:
$ _157,420.00
(Starting Point)
$_CLQ((. tJ (k
(L€St Total Amount Approved by the BCG)
$_157,420.00
(Including All Changes Prior To This Modification)
Current BCC Approved Amount:
Current Contract Amount:
Change Amount:
$
0.00
Revised ContractIWork Order Amount:
$_157,420.00.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order:
$_0.00
Date of Last BCC APproval~ Agenda Item # ~
Percentage of the change over current contract amount, 0_%
Formula: (Revised Amount I Last BCC approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: March 6.2009
CURRENT:
Januarv 14. 20tl()
This change order will: 0 Add a new Task for $
o Increase Task Number
by $
Other
Describe the change(s): Time is beinQ extended to allow the consultant to provide post desian services on an on-
eall basis durina the construction. The oriainal 63 days desian contract was completed on time: however. the
start of construction was delaved due to elevated water levels at the bridaes and construction material delavs.
The construction is expected to end In Januarv.
Specify the reasons for the change(s) Co 1. Planned or Elective r- 2. Unforeseen Conditions C 3. Quantity
Adjustments C' 4. Correction of Errors (Plans, Specifications or Scope of Work) C 5. Value Added
o 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:
This change was requested by: DContractor/Consultant VI Owner r! Using Department D COES
rDesign Professional CIRegulatory Agency (Specify)
L Other (Specify)
~ ';;:N
J; Yes l~' 0
APPROVED B
Date: 10 -5'.... 07
REVIEWED BY:
Date, ~
.-
Revised 6 18 09
-AIIIll
CONTRACTMlORK ORDER MODIFICATION
CHeCKLIST FORM
!\genda Item r'>lo. 16t::3
~~ovembc;r 10, 2009
Pad. 7of50
I?-
PROJECT #: ODC.FT-3887.04.10 PROJECT MANAGER: Steve Lanq
45001081~
WORK ORDER l::4S[l{)106157
CONTRACTOR/FIRM NAME: Divl>rsilied Drillina Corp
OrigInal Contract Amount:
$ 24,610.03
Current BCe Approved Amount: $ ~ III A
Current Contract Amount: $ 24,610.03
Chang. Amount: $ 1222.52
Revised ConlractIWorlt Order Arno nt: $25,832.55
Cum"l.tlw Dollar Valu. of Chllrige to
thi. Contr'llctIWork Oreler. $ 1222.52
Dat. of Lot BCC Api>rovlIl AEll>nda Item tI ~
. Percentage oflhe change overtun r current contract amount ~ ~ .q') Dlo
CURRENT COMPLETION Df,TE ~): ORIGINAL: -=21nlt:J '1 CURRENT: 1 \ ~\ \ oq
Describe the changels): When e pump was pulled it was discovered that the 8" S.S. check valve was broken
due to normal wcm- and tClI!'.
SpecIfy the Nlasone lor the ch nge(s) r. 1. Plann~ or Elective r. 2. Unforeseen Conditions r. 3. Quantity
A.dJustments (' 4. Corroctlon Errors (Plana, Spoclflcatlons or Scopa of Work) ('. 5. Value Added
. (' 6. Schedule Adjustments ote: One or more may be ch'eckecl, depending on the nature of thechange(s).
, '.
Identify ell negative Impacts 'to tho project if this change ordor were not processed: The check valve stops the
ilow of water from the supply line to the pump. If the pump is spinning in the wrong direction BIld the pump
starts it will either run backw ds or create a power surge that will destroy the pump and motor respectively.
This is non-negotiable proto
This change was requested by: rJcontractorfConllultent n Owner P1 Using OeP<irtment C CDES
r Other (Spoclfy)
CONTRACT SPECIALIST PA~ CIPATlON IN NEGOTIATIONS: rYes
P' No
APPROVED BY:
Da1e:
'1/?/Ccj
,
Dale 4!lS/OCf,
1-/7-01
Date:
17 _ AOOr}9,:tI+?/p~ ~ ........
IV etf r-fo'V'emlSer ~ 0, 2009 I':)
Page 48 of 50
PROJECT NAME: Watershed Manaqement Plans
05 - 3~'51
BID/RFP #: MOD #: 1
CONTRACT/WORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT #: .~ PROJECT MANAGER: Mac Hatcher
PO#: 4500102994 WORK ORDER # URS-FT-3657-07-fl
DEPARTMENT: EnqineerinQ &Environmental Services
CONTRACTOR/FIRM NAME: URS Corporation Southern
Original Contract Amount: $ 198.840
(Starting Point)
Current BCC Approved Amount: $ 198.840
(Last Total Amount Approved by the BCG)
Current Contract Amount: $ 198.840
(Including All Changes PrlorTo This Modification)
Change Amount: $ 0
Revised Contract/Work Order Amount: $ 198.840
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $ 0
Date of last BCC Approval September 25. 2007
Agenda Item # 10.E
Percentage of the change over/under current contract amount
Formula: (Revised Amount / Last BCC approved amount)-1
o
%
CURRENT COMPLETION DATE (8): ORIGINAL: February 28.2009 CURRENT: December 31.2009
Describe the change(s): Add Planned Phase 2 tasks to prolect.
Specify the reasons for the change(s) X 1. Planned or Elective 0 2. Unforeseen Conditions 0 3. Quantity
Adjustments Co 4. Correction of Errors (Plans, Specifications or Scope of Work) Co 5. Value Added
o 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: Growth ManaQement Plan
reaulred studies would not be completed.
This change was requested by: D1Contractor/Consultant 01 Owner 01 Using Department X CDeS
UDesign Professional OIRegulatory Agency (Specify) nOther (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: D Yes X No
This form is to be signed a~~ drfetf,
APPROVED BY: /!IJ\~~ ~~
Project Manager
AP~DBY: y..
REVIEWED BY:
Date: J 0 II f(J I rYj
D~/V
Date: /0 --1M- () 7'
Revised 2-22-08
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
Agenda Item No. 16E3
~~r1J~eL ~t~~n?
I 'fia 9 '-' -.1J ~ j .../jIJ v;
~~c~ 1&
PROJECT NAME: Justice Center Wastewater Grinder PROJECT #: _N/A PROJECT MANAGER:_John Clements
BID~: 08-5011 MOD #: % 2. PO#:_ 4500105992 WORK ORDER #:_4500105992
DEPARTMENT: Facilities Management CONTRACTOR/FIRM NAME: D. N. Hiaoins
Original Contract Amount: $ _142,920
(Starting Point)
Current BCC Approved Amount: $_N/A
(Last Total Amount Approved by the BCC)
Current Contract Amount: $_142,920
(Including All Changes Prior To This Modification)
Change Amount: $_($1,351.59)
Revised ContractIWork Order Amount: $_141,568.41
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractIWork Order: $_($1,351.59)
Date of Last BCe Approval
,J!~
Agenda Item #
tJ{/\
Percentage of the change over/under current contract amount_(.95)
Formula: (Revised Amount / Last BCC approved amount)-1
%
CURRENT COMPLETION DATE (S): ORIGINAL: 6/30/09
CURRENT:
9/16/09
This change order will: 0 Add a new Task for $ 0 Increase Task Number by $
Other_l2."l..~'-C-ce Qt~-lJ/'u T -t II ~,---+~b\. 'SNt p')~ ~
Describe the change(s):_Design of bid alternate 1 could not be completed as designed so alternate methods of
accomplishing necessary work were designed as evidenced by the backup attached to this Change Order.
Specify the reasons for the change(s). 1. Planned or Elective 0 2. Unforeseen Conditions C 3. Quantity
Adjustments 0 4. Correction of Errors (Plans, Specifications or Scope of Work) 0 5. Value Added
o 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: _Severe damage to
underground piping, particularly the sanity sewer system, chiller lines, fire mains, etc
This change was requested by: CIContractor/Consultant (YOwner 01 Using Department n CDES
CDesign Professional CIRegulatory Agency (Specify) COther (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: 0 Yes x No
APPROVED
Date (Of /1 (iJ 7
/tJ/!1t)/o9
I .
REVIEWED BY:
Revised 6 18 09
Agenda Item No. 16E3 I 'J
November 10, 2009 I
Page 50 of 50
CONTRACTIWORK ORDER MODIFICATION
CHECKLIST FORM
PROJECT NAME: NCWRF Real-time flow diaQram
PROJECT #: 73968 PROJECT MANAGER: Tom Chmelik
BID/RFP #: 05-3785 MOD #: 1
DEPARTMENT: PPMD
PO#: 4500107448
WORK ORDER #:
4500107448
CONTRACTOR/FIRM NAME:
Hole-Monies
Original Contract Amount:
$
Current BCC Approved Amount:
$
25.400.00
(Starting Point)
..ft N I A:.
(Last Total Amount Approved by the BCC)
25.400.00
(Including All Changes Prior To This Modification)
Current Contract Amount:
$
Change Amount:
$
o
Revised ContractIWork Order Amount: $ 25.400.00
(Including This Change Order)
Cumulative Dollar Value of Changes to
this ContractlWork Order: $ 0
Date of Last BCC Approval
NA
Agenda Item #
NA
Percentage of the change over/under current contract amount
Formula: (Revised Amount 1 last BCC approved amount)-1
NA % over
CURRENT COMPLETION DATE (8): ORIGINAL: 6/3/09
CURRENT:
8/29/09
This change order will: 0 Add a new Task for $
o Increase Task Number
by $
Other Increase time to 12/31/09 Schedule was adiusted to coincide with the laroer CAP
Expansion Proiect. allowina for more efficient Implementation. The interface of this profect with the NCWRF expansion
proQram reauired an aliqnment of the two schedules that was not previouslv anticipated. This scope will include all of
the CAP revisIons.
Describe the change(s): Time extension only to allow for coordination with operational and budgetary constraints.
Specify the reasons for the change(s) 0 1. Planned or Elective 0 2. Unforeseen Conditions C 3. Quantity
Adjustments (': 4. Correction of Errors (Plans, Specifications or Scope of Work) () 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 to the project if this change order were not processed: Time extension only.
This change was requested by: r1Contractor/Consultant "5<( Owner r! Using Department r COES
nDesign Professional OIRegulatory Agency (Specify)
r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: 0 Yes '6(No
APPROVED BY:
Date:
10/ W/OJ
Jo/wlo,
[DIdO! 09
APPROVED BY:
Date:
REVIEWED BY:
Date: