Backup Documents 02/23/2021 Item #16C 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6 C 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
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 routinLlines#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 3/25/21
4. BCC Office Board of County PT by JH/s/ 3/25/21
Commissioners
5. Minutes and Records Clerk of Court's Office l' d..1 to.
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 Peter Schalt/Engineering and Project Contact Information 239-252-81196-
Contact/Department Management 4343
Agenda Date Item was Ku►&9,2021 Agenda Item Number 16CI
Approved by the BCC 1e b a 3 ttR
•
Type of Document $243,969 Work Order on a Request for Number of Original 1
Attached Quotation("RFQ")under Agreement#15-6469, Documents Attached
"Well Drilling,Testing and Maintenance"to
Layne Christensen Company,for the
Rehabilitation of Deep Injection Well 1W-I at
the North County Water Reclamation Facility
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 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 PS
signed by the Chairman,with the exception of most letters,must be reviewed and signed by
the Office of the County Attorney.
All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
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 PS
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 PS
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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 2/23/2021 and all changes made during PS
the meeting have been incorporated in the attached document. The County Attorney's
Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the BCC,
all changes directed by the BCC have been made,and the document is ready for the
CO
Chairman's signature.
16C1
Ann P. Jennejohn
From: Ann P. Jennejohn
Sent: Monday, March 29, 2021 10:17 AM
To: schalt_p
Subject: Item #16C1 (2-23-21 BCC Meeting)
Attachments: Backup Documents 02_23_2021 Item #16C 1.pdf
Good Morning Peter,
An executed copy of Item #16C1, from the
February 23, 2021 BCC Meeting is attached
for your records.
Thank you!
Ann Jennejohn
13MR Senior Deputy Clerk II
` Clerk to the Value Adjustment Board
��� 0.
Office: 239-252-8406
Fax: 239-252-8408 (if applicable)
Ann.Jenv.ejohn@Coll ierClerk.covin
•F'-t. � Office of the Clerk of the Circuit Court
"",,r.• & Comptroller of Collier County
3299 Tawuavvu Trail, Suite #401
Naples, FL 34112-5324
www.CollierClerk.cowt
i
16C �
WORK ORDER/PURCHASE ORDER
Contract#15-6469"WELL DRILLING,TESTING&MAINTENANCE"
Contract Expiration Date:November 13,2021
This Work Order is for professional services for work known as:
Project Name: NCWRF Deep Injection Well IW-1 Rehab
Project No: 70148.8.3
The work is specified in the proposal dated December 10,2020 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:LAYNE CHRISTENSEN COMPANY.
Scope of Work:As detailed in the attached proposal and the following:
* Task I Mobilization& Site Work
* Task II Casing Brushing
* Task III Pre-Acidization Geophysical Logging&Video
* Task IV Conduct Acidization Procedure
* Task V Post Acidization Video Logging
* Task VI Site Restoration&Demobilization
* Task VII Owner's Allowance
Schedule of Work: Complete work within 120 days from the date of the Notice to Proceed which is
accompanying this Work Order.The Vendor agrees that any Work Order that extends beyond the expiration
date of Agreement#15-6469 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(s): Negotiated Lump Sum(NLS)0 Lump Sum Plus Reimbursable
Costs (LS+RC) ® Time & Material (T&M) 0 Cost Plus Fixed Fee (CPFF), as provided in the attached
proposal.
Task I $24,000.00 (NLS)
Task II $17,000.00 (NLS)
Task III $8,200.00 (NLS)
Task IV $162,769.00 (NLS)
Task V $8,200.00 (NLS)
Task VI $5,500.00 (NLS)
Task VII $18,300.00 (T&M)
TOTAL FEE $243,969.00
Gl'�
1 $ CI s .
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
Crystal K.,J Clerk COLL C ,FLORIDA
•
By OC+ By: ai/444,_ -
• I ' Penny Taylor,Chairperson
• (SEAO, t )` ,t•11
Layne Christensen Company ly 45% 41$1:1,t
First Witness f§ignature ,; 0 ; rA:4 ? _
c:
James Bruneio—Area Manage ''
Blake McCullers TType/print signature and titlel
TTvpe/arint witness name
10-
6-77(07,-
Second V1f ness
Miguel Martinez
TType/print witness name?'
Approved as to F and Legality:
Assistaxt'County Attorney
R
Print Name
Item# '
Agenda-1
Date v'
Date
Rec'd �
Deputy CI
s c h a l t Digitally signed by scha►t_p 6 C 1
_p Date:2021.01.05 14:13:27-05'00'
PREPARED BY:
Peter Schalt, Senior Project Manager Date
PajerCraig
Digitally signed by PajerCraig
Date:2021.01.12 14:34:06-05'00'
APPROVED BY:
Craig Pajer,Principal Project Manager Date
C h m e I i kTo m Digitally signed by ChmelikTom
APPROVED BY: Date:2021.01.1416:41:41 -05'00'
Tom Chmelik,EPMD Director Date
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: LAYNE CHRISTENSEN COMPANY
,$1 EN Soft;''., p January 5.2021
. . ohlpies Bruneio- Crea Manager Date
" Cl
BID TABULATION
REHABILITATION OF NCWRF INJECTION WELL IW-I
Layne Christensen Company Youngquist Brothers,Inc. Wells&Water Systems,Inc. FOR Estimate
Mobilization and Site Work $24,000.00 $70,000.00 $100,000.00 $15,000.00
Casing Brushing $17,000.00 $60,000.00 $140,000.00 $20,000.00
Perform Pre-Acidization Geophysical and Video Logging $8,200.00 $16,000.00 $30,000.00 $12,000.00
Conduct Acidization Procedure $162,769.00 $55,000.00 $235,000.00 $120,000.00
Perform Post-Acidization Video Logging $8,200.00 $12,000.00 $12,000.00 $6,000.00
Site Restoration and Demobilization $5,500.00 $18,000.00 $25,000.00 $10,000.00
Owner's Allowance $18,300.00 $18,300.00 $18,300.00 $18,300.00
TOTAL $243,969.00 $249,300.00 $560,300.00 $201,300.00