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Backup Documents 11/08/2022 Item #16C 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 C 6 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 Iniitiiaalss Date 1. County Attorney Office County Attorney Office 2. BCC Office Board of County Commissioners Chairman it/M/S( ii Z//ZZ 3. Minutes and Records Clerk of Court's Office 11 !mow (MII" 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 Bendisa E.Zela,Facilities Division Phone Number 239-252-8440 Contact/ Department Agenda Date Item was November 08,2022 Agenda Item Number Approved by the BCC 16.C.6 Type of Document Approving administrative Change Order Number of Original Attached No. 3 for a time extension to Construction Documents Attached 1 Agreement No.21-7899 with Haskins, Inc.,on the Hamilton Avenue Improvements Project. PO number or account PleASe Ent.j be„1;54 4Ae number if document is to be recorded f;AA( cloy 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 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 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 BEZ 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 November 8,2022 BEZ N/A is not and all changes made during the meeting have been incorporated in the attached an option for document. The County 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 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 I 6 MEMORANDUM Date: November 21, 2022 To: Bendisa E. Zela, Management Analyst II Facilities Management From: Martha Vergara, Sr. Deputy Clerk Minutes & Records Department Re: Change Order #3 w/Contract #21-7899 "Hamilton Avenue Improvements Project Contractor: Haskins, Inc. Enclosed please find one (1) copy of the original of the document referenced above (Agenda Item #16C6), approved by the Board of County Commissioners on Tuesday, November 8, 2022. The Minutes and Record's Department has kept the original of the agreement as part of the Board's Official Record. If you have any questions, please feel free to call me at 252-7240. Thank you. Attachment 16C 6 Procurement Services y,tip Co ity Change Order Form ❑Contract Modification ©Work Order Modification Contract#: 21-7899 Change#: 3 Purchase Order#: 4500215081 Project#: 50171.1.3 Contractor/Firm Name: Haskins, Inc. ContractlProject: Hamilton Avenue Improvements Project Manager Name: Olivier Sureau Division Name: Facilities Management Original Contract/Work Order Amount $ 3,246,304.75 09/28/21; 11 B Original BCC Approval Date;Agenda Item # Current BCC Approved Amount $ 3,246,304.75 5/24/22; 16E Last BCC Approval Date; Agenda Item # Current Contract/Work Order Amount $ 3,246,304.75 1/18/2023 SAP Contract Expiration Date (Master) Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount Revised Contract/Work Order Total $ 3,246,304.75 0.00% Change from Current BCC Approved Amount Cumulative Changes $ 0.00 0.00% Change from Current Amount Completion Date,Description of the Task(s)Change,and Rationale for the Change Notice to Proceed 01/10/2022 Original 12/06/2022 Last Approved 01/18/2023 Revised Date 03/31/2023 Date Completion Date Date (Includes this chang #of Days Added 72 Select Tasks ❑Add new task(s) El 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 1 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) This change order will add 72 days for the following:a)2 weather days(September 14 and 15); b)25 days for disruption caused by hurricane Ian;c)45 days to repair the damage sustained during the storm. New substantial and final completion dates will be January 30,2023, and March 31, 2023, respectively. 2) The change being requested was not included in the original contract because the occurrence of an act of God(Storm surge/sea water flooding of the site during a major hurricane)was not known at the time the original contract was awarded. 3) If this modification is not processed,the contractor cannot finish the roadway improvements in the time currently remaining. Dailaby waned b/SoreauOWier Prepared by: Su reauOlivier$11 zo22.102015.2027 Date: Olivier Sureau,Senior Project Manager,Facilities Management 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 of or related to the change set forth herein,including claims for impact and delay costs. Ryan MacPhee one01720°o2" "»"Zoao Date: Accepted by: Ryan McPhee,Vice President,Haskins Inc. await/Ppled b/Joshua J Joshua J Hildebrand of 2ozz1o2o1s+ss7u+oo Date: Accepted by: Joshua Hildebrand, CEI Project Manager,Johnson Engineering Inc. McCormickJohn ;zi�a�'a.e ;onnv Approved by: Date: John McCormick,Interim Director, Facilities Management Digitally synod by SchneebergerSara SlM000.ae Sara Approved by: Date.2022.10.2e 11:3 02-OOoe Date: Procurement Professional PROCUREMENT USE ONLY Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) BCC Reviewed AG 10/20/22 Admln RPt BCC ES {�L) lac 6 ATTEST: BOARD OF CO TY COMMISSIONERS Crystal K.Kinzel,Clerk of Courts COLLIER COU r I A &Comptroller 61) By: 1 By: .!� ��► n,, Willi. % . McDaniel,Jr., Chairma Dated: IV E 4 .r 3 2°22 (SEAL) Attest as to Chrairman s signature only. Appr to form and leg ity: By: ---!— Scott R. eac Deputy County Attorney 4/14 0 t 6C 6 Change OrderlAmendment Summary COST TIME CO# AMD# Description Days New Justification Additive(+) Deductive(-) Added Amount 1 Time Extension 43 373 To account for watermain replacement by the City of Naples Use owners To resolve FP[ conflict&comply 2 allowance for work with sponsor requirement directives#2&#3 3 Time Extension 72 445 Disruption and repairs caused by hurricane Ian Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY Reviewed AG 10/20/22 Admin RPM BCC ES