Backup Documents 09/14/2021 Item #16G 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP ! G 2
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 routing lines#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. County Attorney Office CAO 4) E lj/ i/
j
2. Board of County Commissioners Office BOCC b
Pest t- all
3. Minutes and Records Clerk of Court's Office �fr.//2 � �'"_-_
a1 I.53
4. Send signed copy to Heather Meyer GMD South
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 Heather Meyer/Airport Authority 239-252-5765
Contact/ Department
Agenda Date Item was Sept 14,2021 Agenda Item Number 16G.2
Approved by the BCC
Type of Document Change Order#3 Hole Montes-1MM Runway Number of Original 1
Attached Documents Attached
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 HM
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 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 HM
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 HM
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 Sept. 14,2021 and all changes made HM N/A is not
during the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the t `1,J
, an option for
Chairman's signature. : this line.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
1 6G2
MEMORANDUM
Date: September 21, 2020
To: Heather Meyer, Management/Budget Analyst
Operations Support Division
From: Martha Vergara, Sr. Deputy Clerk
Minutes & Records Department
Re: Change Order #3 to Contract #19-7558 w/Hole Montes, Inc.
Design Services for Immokalee Runway Rehab and
Taxiway Ext. Projects
Attached for your records is one (1) scanned copy of the document referenced above,
(Item #16G2) approved by the Board of County Commissioners Tuesday, September
14, 2021.
If you have any questions, please call me at 252-8411.
Thank you.
Attachment
16C
Procurement Services
Cto tr Country Change Order Form
®Contract Modification ❑Work Order Modification
Contract II: 19-7558 Change#: 3 Purchase Order#: 4500200722(Closed) Project#: 33605
4500200723(Closed) 33650
4500208713 Amend#1
4500208813 Amend#1
Contractor/Firm Name: Hole Mentes,Inc. Contract/Project: Design Services for IMM Runway Rehab&
Taxiway Ext Protects(Amendment#1)
Project Manager Name: Andrew Bennett Division Name: Airport Authority
Original Contract/Work Order Amount $ 680,344.00 11/12/19#16G2 ;Original BCC Approval Date;Agenda Item#
Current BCC Approved Amount $ 754,088.50i 12/8/20#14A2 Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount $ 754,088.50 9/12/2021 1SAP Contract Expiration Date(Master)
Dollar Amount of this Change $ 0.00 10.84% ;Total Change from Original Amount
Revised Contract/Work Order Total $ 754,088.50 0.00% Change from Current BCC Approved Amount
Cumulative Changes $ 73,744.50 0.00% Change from Current Amount
Completion Date,Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed 12/2812020 Original 7/31/2021 Last Approved 9/12/21 Revised Date 12/23/21
Date Completion Date Date (Includes this change)
#of Days Added 102 Select Tasks ❑Add new task(s) ❑Delete task(s) ❑Change task(s) ®Other
Provide a response to the following:1.)detailed and specific explanation/rationale of the requested change(s)to the task(s)and/or
the additional days added(if requested);2.)why this change was not Included In the original contract;and,3.) describe the impact
If this change is not processed. Attach additional Information from the Design Professional and/or Contractor if needed.
1. Extend the schedule one hundred two(102)days to allow time for the consultant to provide post design services through the final
completion of the Runway 18/36 construction and allow days to close out the project.This time extension applies only to the
Runway 18/36 tasks on the contract(PO#4500208713).
2. The construction of Runway 18/36 was placed on a stop work order to allow for the construction of the Taxiway C extension to be
completed first,in order to minimize interruptions to the airport traffic.During this period,the consultant was able to attend
meetings and respond to RFIs.The Taxiway C project reached final completion on 8/12/2021,therefore the Runway 18/36
construction can now continue with a projected construction final completion on 11/25/21.Post design services will be needed
throughout project close out(about 30 days post construction).
3. If this change order is not processed,the consultant will be unavailable to finalize the post design services and any necessary
paperwork for the grant and project closout.
Prepared by: ` - — Date: 8/20/2021
Andrew Bennett,Airport Executive Manager
Acceptance of this Change Order shall constitute a modification to contract/work order Identified above and will be subject to all the same
terms and conditions as contained in the contract/work order indicated above,as fully as if the same were stated in this acceptance.The
adjustment,if any,to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/Vendor/Consultant/
Design Professional arising out or relate to a oh nge set forth herein,including claims for impact and delay costs.
Accepted by: ,y I 7 t�>
Date: f ZU I
Timothy Parker, re' et, anager,Hole Mantes,Inc
Approved by: ShU@GE'ne Digitally signed by ShueGene
Date:2021,08,20 17:47:40-04'00' Date:
Gene Shue,Division Director,Growth Management Department
Approves!q : ScottTri n itY Digitally signed by ScoltTrinity
y Date:2021.08.2310:34:44-04'00� Date:
Trinity Scott,Deputy Department Head,Growth Management Department
Schneeber erSara DgdetrysignedbySchneebergerSara
Approved by: g oate:zozl.Ot1.24092s:1a obar Date:
Sara Schneeberger,Procurement Specialist, Procurement Services
Revised:01/14/2021 (Divisions who may require additional signatures may Include on separate sheet.) PROCUREMENT USE ONLY
Admdn RPM BCC ES
(c.���i
1 6G2
Change Order/Amendment Summary
COST TIME
CO# AMD# Description Days New Justification
Additive(+) Deductive(-)
Added Amount
1 Time extension 60 360 Added days to provide time to
transition to construction phase
Added Post Design Added dollars and time for the Post
1 Services to $73,744,50 215 Design services so the engineer of
contract 225 record could assist with the post
design
Time extension to Days needed to cover post design
Amendment#1 2 43 258 services for construction of Runway
(Post Design 18/36 which was delayed
Services) Y
Time extension to Days needed to coverpost design
3 Amendment#1 Y 9
(Post Design 102 360 services for construction of Runway
Services) 18/36 which was delayed
•
I --
is
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet) PROCUREMENT USE ONLY
Admin Rpt BCC ES
16G2
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K.Kinzel,Clerk of Courts COLL C TY,FLORIDA
&Comptroller
By: By:
envy T r,Chair ers
� ??�� P
Dated: 7 t s7va'
(S•'• L) Attest as o Chairman's
signature only.
Appr ve as o o d gality:
By:
S . eac
Deputy County Attorney
•