Backup Documents 02/24/2009 Item #16A 3ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO /� t?
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE �1
Print on pink paper. Attach to original document Original documents should be hand delivered to the Board Office. The completed routing slip acid original
documents are to be forwarded to the Board Office only ancr the Board has taken action on the item)
ROUTING SLIP
Complete routing lines #1 through 44 as appropriate for additional signatures. dates, and/or information needed. If the document is already complete with the
exception of the Chairman's signature, draw a line throng orming lines # I through 44, complete the checklist, and forward to Executive Manager on (line #5).
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
1.
(� ! <: <;„ - c v -
(Initial)
fit" k
2.
Original document has been signed/initialed for legal sufficiency. (All documents to be
Agenda Item Number
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
by the Office of the County Attorney. This includes signature pages from ordinances,
Number of Original
5. Executive Manager
Board of County Commissio ere
Documents Attached
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created /prepared the executive
summary. Primary contact information is needed in the event one of the addressees above need to contact staff for additional or missing information. All original
documents needing the BCC Chairman's signature are to be delivered to the BCC office nly after the BCC has acted to so nove the item )
Name of Primary Staff
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Phone Number
N/A (Not
Contact
(� ! <: <;„ - c v -
(Initial)
fit" k
Agenda Date Item was
Original document has been signed/initialed for legal sufficiency. (All documents to be
Agenda Item Number
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
by the Office of the County Attorney. This includes signature pages from ordinances,
Number of Original
Attached
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Documents Attached
INSTRUCTIONS & CHECKLIST
C Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W W S Original 9.03.04, Revised 1 26.05, Reviscd 2.24.05
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
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 of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
t
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
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IX
2.
All handwritten strike- through and revisions have been initialed by the County Attorney's
Office and all other parties except the BCC Chairman and the Clerk to the Board
nJ (A
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
6
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to the Executive Mgr, in the BCC office within 24 hours of BCC
approval. Some documents are time sensitive and require forwarding to Tallahassee within
N 1�
a certain time frame or the BCC's actions are nullified. Be aware of your deadlines!
6.
The document was approved by the BCC on (enter date) and all changes
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes, if applicable.
C Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W W S Original 9.03.04, Revised 1 26.05, Reviscd 2.24.05
16A3
MEMORANDUM
DATE: February 26, 2009
TO: Lyn Wood, Contract Specialist
Purchasing Department
FROM: Teresa Polaski, Deputy Clerk
Minutes and Records Department
RE: Chanfe Order #4 to Contract #45 -88581
Contractor: Van Buskirk, Ryffel and Associates, Inc.
Enclosed, please find an original, referenced above (Agenda Item #16A3)
approved by the Board of County Commissioners on Tuesday, February
24, 2009.
An original Agreement is being held in the Minutes and Records
Department in the Official Records of the Board's
If you should have any questions, you may contact me at 252-8411.
Thank you,
Enclosures
CHANGE ORDER
CHANGE ORDER NO. Four
TO: Van Buskirk. Ryffel and Associates Inc
100 Estero Boulevard, Suite 434
Fort Myers Beach, Florida 33931
DATE: January 15 2009
16A3
CONTRACT NO.45 -88581
BCC Date, _-� - -C/b
Agenda Item: -'ZeA g
PROJECT NAME: Collier County Inter - Active Growth Model (CIGM)
PROJECT NO.:
Under our AGREEMENT dated September 26. 2006 and modified on April 22 2008 and September
26. 2009 .
You hereby are authorized and directed to make the following change(s) in accordance with
terms and conditions of the Agreement: To increase the time frame associated for the CIGM land use
modeling to be utilized by AIM Engineering & Surveying, Inc., the consultants for the Transportation
Divisions to update to the Long Range Transportation Plan (LRTP).
FOR THE Additive Sum of:
Original Agreement Amount
Sum of Previous Changes
This Change Order Add
Present Agreement Amount
BIN
$200,000.00
$54.000
$254.000.00
The time for completion shall be increased by 300 calendar days due to this Change Order.
Accordingly, the Contract Time is now 38 months or 1,140 calendar days. The substantial completion
date is 6 -01 -2009 and the final completion date is 01- 01 -10. 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: January 15, 2009
CONTRACTOR:
Van Buskirk. Ryffel and Associates Inc
Carleton Ryffel, ICP, Vice President
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
By:
Mike Bosi, AICP, Project Manager
ATTEST
J
ffq"A W,* 0410
Approved As To Form
and Legal Sufficiency:
X14 � 14 Ulv
Assistant County Attorney
DEPART ENT DIRE TO l 6 A 3
By:
Randall Cohen
DIVISION INISTRATOR
By: _
Joseph Schmitt
CONTRACT SPECIAL7IS(T_�, %
By: I LC/c'u4'
Lys M. Wood
BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY FLORIDA
By: $,-,. --
Donna Fiala, Chairman