Backup Documents 12/01/2009 Item #16B4
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 B 4
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 b~ hand delivered to the Board On-ice. The completed routing slip and original
documents are to be forwarded to the Board Otlice only after 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. Irthe document is already complete with the
exec tion afthe Chairman's si nature, draw a line thrall h routin lines #1 throu h #4, com letc the checklist, and forward to Ian Mitchell line #5 .
{The primary contact is the holder of the original document pending Bee 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 Ian Mitchell, need to contact staff for additional or missing
information. All original documents needing the Bee Chairman's signature arc to be delivered to the Bee oflice only alter the BCe has acted to approve the
item.
Name of Primary Staff
Contact
Agenda Date Item was
A roved b the BCC
Type of Document
Attached
Route to Addressee(s)
(List in routin order
1.
Office
2,
---------
..---
3.
---------
4,
-------,---
-
5. Ian Mitchell, BCC Supervisor
Board of County Commissioners
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
Phone Number
Agenda Item Number
Number of Original
Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is
a ro riate.
1. 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 ofthe 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 Jossibl State Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exec t the BCC Chairman and the Clerk to the Board
3. The Chairman's signature line date has been entered as the date ofBCC approval of the
document or the final ne otiated contract date whichever is a licable.
4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si nature and initials are re uired.
5. 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 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 our deadlines!
6. The document was approved hy the BCC on (enter date) and all changes
made during the meeting have been incorporated in the attached document. The
Count Attorne 's Office has reviewed the chan Jes, jf a Iicable.
PLEASE scan under in the BMR Real Property Folder. Thank you
Initials
Date
)..
,/ '-/ -
I'll> OJ
Yes
(Initial)
N/A(Not
A licable)
It
-;K
-r
~
-t
*
168 4
CHANGE ORDER
CHANGE ORDER NO.
2
CONTRACT NO. 08-5135
BCC Date: 3/24/2009
Agenda Item: l6B5
TO:
Kellv Brother Inc.
15775 Pine Ridge Rd
Ft Mvers. FL 33908
DATE:
November 4th. 2009.
PROJECT NAME: Bridge Repairs (Chokoloskee. Green Boulevard. And Oil Well Road)
PROJECT NO, 66066
Under our AGREEMENT dated: April 13th. 2009
You hereby are authorized and directed to make the following change(s) in accordance with terms and
conditions of the Agreement:
Reference to the recommendations of Cardno TBE, Collier County Design Engineers and the Engineer
of Record on the project:
1.0 Install a 4"Thick layer of 4000 PSI concrete between the edge of asphalt and the ABM.
This layer of concrete should extend underneath the bridge between the abutment and the
ABM and round the area between where the water pipe penetration in the ground,
2.0 Place#57 stone in the space between blocks of the ABM to provide additional UV
protection to the filter fabric underneath the blocks.
3.0 Provide non-erodible backfill from the edge of pavement down to the end ofbulliead.
4.0 Additional Turbidity Barrier at Oilwell Road bridges.
5.0 Pressure grouting underneath the bents on Oilwellroad Bridge (Per EORMemo) includes
drilling on top of approach slab. arrange rubble riprap and patch drilled holes.
6.0 Additional crack repair of Chokoloskee Bridge.
400-135 Clean & repair cracks overruns.
FOR THE (Additive) (Deductive) Sum of:
Original Agreement Amount $ ~-~-- .__ 771.546.00
Sum of Previous Changes $ 57.720.00
This Change Order Add $ 44,302.00
Present Agreement Amount $ 873.568.00
The time for completion shall be increase by _90_ calendar days due to this Change Order. Accordingly,
the Contract Time is now December 7th. 2009 (210) calendar days. The substantial completion date is
November nnd. 2009 and the final completion date is December 7th. 2009, 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
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.L6J 4
claims of the Contractor arising out of or related to the change set forth herein, including claims for impact and
delay costs.
Accepted:
CR-L.
"
,200'7.
CONTRACTOR: Kelly Brothers, Inc
15775 Pine Ridge Road
Ft, Myers F1. 33908
By:
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
. ~~.~ /'J~
By:
Eddie Martin, Project Manager
TECM
By: ~:4~Q~
Steve Ritter
Manager-Road Construction
BY:~ad_' CM~~~ct!
DEP AR ENT DIRECTOR 1/ I? lot 1
Rho da Cummings
CONTRACT SPECIALIST
Date: let-Of -01009
ATTEST:
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Attest 'tie tW ,"
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Apjlrove(rA.~ ToFonDc. '
and Legal StlffiQj~n,~y:, JC'
PrintN~:,~YIR ).4_L
/' [JUiflt8M Coun Attorney
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168 4
TY COMMISSIONERS OF
FLORIDA I
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BY:
Donna Fiala, Chairman