Backup Documents 06/09/2009 Item #16D12
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL-16 D 12
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. HIe completed routing slip and original
documents are to be fOlwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 as appropriate for additional signatures, dates. and/or information needed. If the document is already complete with the
exception of the Chairman's silmature, draw a line through routing lines #1 through #4, cOlllPlete the checklist, and forward to Sue Filson line #5).
Route to Addressee(s) Office Initials Date
(List in routing order)
I.
2. ---
3. ----
4. Colleen M. Greene, Assistant County County Attorney Of\b- 06/30/09
Attorney
5. Sue Filson OMB
6. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending Bce 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 Bee Chairman's signature are to be delivered to the BCe office only after the BCC has acted to approve the
item.)
Name of Primary Staff Clint Perryman Phone Number 252-4245
Contact
Agenda Date Item was June 9, 2009 Agenda Item Number 16-0-12
Approved by the BCC
Type of Document Change Order, Contract/W ork Order Number of Original 1 of each
Attached Modification Checklist Form Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/ A" in the Not Applicable column, whichever is appropriate. Yes N/ A (Not
(Initial) A licable)
I. Original document has been signed/initialed for legal sufficiency. (All documents to be signed by the CMG
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 Office and N/A
all other arties exce t 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 ofthe document or CMG
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 signature and CMG
initials are re uired.
5. In most cases (some contracts are an exception), the original document and this routing slip should be
provided to Sue Filson in the BCC office within 24 hours of BCC approval. Some documents are N/A
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 by the BCe on 06/09/09 and all changes made during the meeting CMG
have been incorporated in the attached document. The County Attorney's Office has reviewed
the chan es if a licable.
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04. Revised 1.26.0S, Revised 2.24.0S
<<matter _ numbem/ <<document_number>>
16D12
MEMORANDUM
Date: July 1, 2009
To: Clint Perryman, Project Manager
Coastal Zone Management
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Change Order to Work Order
Contractor: C3TS
Enclosed please find a copy of the referenced above (Agenda Item
#16DI2), which was adopted by the Board of County Commissioners on
Tuesday, June 9, 2009.
Please forward on for signature and return a fully executed
original document to the Minutes and Records Department.
If you have any questions, please call me at 774-7240.
Thank you.
Enclosure
"~,."~~.'-
, 16D12
CHANGE ORDER TO WORK ORDER
CHANGE ORDER NO. 1 CONTRACT NO. C3TS-4153-08-02
BCC Date:-l().um-'-. z- 3.09
Agenda Item: ( h D /2-
TO: C3TS
3996 North West 9th Avenue
I Fort Lauderdale, FL 33309
DATE: November 26. 2008
PROJECT NAME: Manatee Park Design Criteria Package
PROJECT NO.: 346-80122.1
I
Under our AGREEMENT dated October 23,2007
You hereby are authorized and directed to make the following change(s) in accordance with terms and
conditions of the Agreement: (See attachment)
FOR THE (Additive) Sum of: Fifty Thousand & 00/100 ($50,000.00.
Original Agreement Amount $193,950.00
Sum of Previous Changes $ -0-
This Change Order add $ 50,000.00
Present Agreement Amount $ 243.950.00
The time for completion shall be (Increased) by (540) calendar days due to this Change Order. Accordingly,
the Contract Time is now October, 6, 2010 (776) calendar days. The substantial completion date is September
10. 2010, and the final completion date is October 10. 2010. Your acceptance of this Change Order shall
constitute a modification to our Agreement and will be performed subject to all the same terms and conditions as
contained in our Agreement indicated above, as fully as if the same were repeated in this acceptance. The
adjustment, if any, to the Agreement shall constitute a full and final settlement of any and all claims of the
Contractor arising out of or related to the change set forth herein, including claims for impact and delay costs.
Accepted: Vc e-e#"?lj;('r I ,20~
CONTRACTOR: OWNER:
C3TS BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
/ .
By: By: ~ ____
Jeffrey C . an, CGC, , Project Manager
DEPARTMENT DIRECTOR
By: ~~ Ma~
J. G McA pm, P.E. DIrector
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16D 12
CONTRACT/WORK ORDER MODIFICATION
HAN..vree. p~ CHECKLIST FORM
PROJECT NAME: t::>e.C;;T'LiN c.~~ PROJECT #: 9c:w'Z,::z... t PROJECT MANAGER: GJ.q.Jr ~
BID/RFP#: 1J1'~ 'I1Si/:>D #: ~po#A5'. 9 ~hbOwORK ORDER #:c..~\S-.t.Ilsa.-o8-O.%.
DEPARTMENT: C-z. t.-, CONTRACTOR/FIRM NAME: C.3\"'S
Original Contract Amount: $ ,C{~ Q50.0D
(Starting ~oint)
Current BCC Approved Amount: $ l~ ~, <:1'50.00
(Last Total Amount Approved by the BCC)
Current Contract Amount: $ l q "; c:q 50. 00
(Including 'All Changes Prior To This Modification)
Change Amount: $ t;; CC>~ OC() .00
,
Revised ContractlWork Order Amount: $ "l.. ~ 3.. q5o. 00
(Including This Change Order)
Cumulative Dollar Value of Changes to ~(JDO.OO
this ContractJWork Order: $
Date of Last BCC Approval lO. "Z-- ">. 0 =t- o
Agenda Item #
Percentage of the change over/under current contract amount ~.1'1 %
Formula: (Revised Amount I Last Bee approved amount)-1
CURRENT COMPLETION DATE (S): ORIGINAL: 4. \4.~CURRENT:~JO.IO
Describe the change(s): ~o~ ~r:>PE.. of ~\lc;c..&~-ro .E."5~-t::"SJ.4.
REQu~ ~~:JX)t-14L .De.SJ:~N. ~~ '""'(l:) ~uQpo. ~....;p~.
Specify the reasons for the change(s) r 1. Planned or Elective C 2. Unforeseen Conditions r 3. Quantity
Adjustments r 4. Correction of Errors (Plans, Specifications or Scope of Work). 5. 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: LnSS 1'C)f='" V'~E.
O-e,IA-~eb '"T"l'\v2.u De,..S~ ~. NO ~J+t;;,Q .S1>P ~m-:
,
This change was requested by: r1Contractor/Consultant . Owner n Using Department r CDES
~ign Professional U1Regulatory Agency (Specify) r Other (Specify)
CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: ri Y ~o
es
-- -
l"'-
"- Date: II. p~. 08
APPROVED BY:
REVIEWED BY: Date: 1.)-2 -Of
Revised 11.19.2007
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. 16D12
By:
CONTRACT SPECIALIST
By: Gitfr h1 tU~
Lyn od
Date:J()f~ )J 2t.(R .
ATTEST.:" ... . BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY FLORIDA
BY. "',' ,
"/ . c;.,_<;. ". ..t" ;, ~ "'... '\ > .. ~
Itllltwe,..,!.. ,. Donna Fiala, Chairman"'^
Approved A~ To ftlifu
and Legal Sufficiency:
O~fVl~JL
Print Name: ('j)/ leen rn .GreeJ1-L-
Assistant County Attorney
Page 2 of 2
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