Backup Documents 03/10/2020 Item #16A11 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 Al 1
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 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 through routinglines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office SRT 03/10/20
4. BCC Office Board of County C8S b�
Commissioners %j 1 3' 13 '23
5. Minutes and Records Clerk of Court's Office
3/90X) 5SM
PRIMARY CONTACT INFORMATION
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,may need to contact staff for additional or missing information.
Name of Primary Staff Mall McCleary Contact Information 239-252-8442
Contact/Department htt, -
Agenda Date Item was March 10,2020 Agenda Item Number 16A 11
Approved by the BCC
12G3Type of Work Order to Bonness,Inc.,for Number of Original 1
Document Attached construction of the"St.Andrews Blvd.,at Documents Attached
Wildflower Way"traffic calming project,in
the amount of$244,536.40(Project 60213).
PO number or account N/A
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK N/A
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be MC
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's MC
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the MC
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MC
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip MC
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on 3/10/2020 and all changes made during MC
the meeting have been incorporated in the attached document. The County Iption for
Attorney's Office has reviewed the changes,if applicable. line.
9. Initials of attorney verifying that the attached document is the version approved by the ;. is not
BCC,all changes directed by the BCC have been made,and the document is ready for the ',sp 't ,for
Chairman's signature. •
16A11
DocuSign Envelope ID:A5A3BAD8-D222-4C0B-9476-A5764296E0D1
WORK ORDER/PURCHASE ORDER
Contract# 16-6663 "Roadway Contractors"
Contract Expiration Date: March,3,2021
y4-,;2-7
This Work Order is for roadway construction services for work known as:
Project Name: St. Andrews Boulevard at Wildflower Way
Project No: 60213
The work is specified in the proposal dated January 4,2020 which is attached hereto and made a part
of this Work Order. In accordance with Terms and Conditions of the Agreement referenced above,this
Work Order/Purchase Order is assigned to: Bonness, Inc.
Scope of Work: As detailed in the attached proposal and the following:
Task I: St. Andrews Boulevard at Wildflower Way Traffic Calming
Schedule of Work: Complete work within 90 days from the date of the Notice to Proceed which is
accompanying this Work Order. The Consultant agrees that any Work Order that extends beyond the
expiration date of Agreement# 16-6663 will survive and remain subject to the terms and conditions of
that Agreement until the completion or termination of this Work Order. '
Compensation: In accordance with the Agreement referenced above, the County will compensate the
Firm in accordance with following method: ® Negotiated Lump Sum (NLS) as provided in the
attached Bid Schedule.
Task I: Traffic Calming $ 244,536.40
TOTAL FEE $244,536.40
4-Aik
PREPARED BY: zuAtif e /1.30/Zo2
Mark McCleary, PE, PSM Principa Project Manager Date
Transportation Engineering Division
APPROVED BY: �,� /j`_ x/.30 X0 .10
Ja : hmad, PE, Di 'sion Direc • ate
Tran portation E :ineering D. ision
APPROVED BY:
lift 1. I Ali` :A - � c�,�c)
c Thaddeus Cohen, Depa m nt Head ate
Growth Management Department
Page 1 of 3
I �I'►
16A11
DocuSign Envelope ID:A5A3BAD8-D222-4C0B-9476-A5764296E0D1
By the signature below, the Firm (including employees, officers and/or agents) certifies, and hereby
discloses, that, to the best of their knowledge and belief, all relevant facts concerning past, present, or
currently planned interest or activity(financial,contractual,organizational,or otherwise)which relates
to the proposed work; and bear on whether the Firm has a potential conflict have been fully disclosed.
Additionally,the Firm agrees to notify the Procurement Director, in writing within 48 hours of learning
of any actual or potential conflict of interest that arises during the Work Order and/or project duration.
ACCEPTED BY: Bonness, Inc.
1/22/2020
6446 \go.n n,
Bradley Thornton, Secretary Date
II
Page 2 of 3
Cq
16A1 ji
DocuSign Envelope ID:A5A3BAD8-D222-4C0B-9476-A5764296E0D1
IN WITNESS WHEREOF, the parties hereto, have each, respectively, by an authorized person or
agent, have executed this Work Order on the date and year first written below.
ATTEST: BOARD OF COUNTY COMMISSIONERS
-;y4° "J41-6,1(�of Courts COLLIER COUNTY, FLORIDA
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By: .�' t h ; t AI y: Ae4...,,,444.4._
, Chairman
Dated: # A." .
Atte 1 Chairman
. Bonness, Inc.
Signature only
&Au, dill, By: &a.e �i�o.wbn,
First Witness Signature
Ruan Hill Bradley Thornton, Secretary
TType/print witness nameT
W..wws4, K.or..
Second Witness
Hannely Roque
TType/print witness nameT
Ap ove as to F• Legality:
4474,rrto County Attorney
S.,,y- R 67:ta 4L
Print Name
Page 3 of 3
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