Backup Documents 12/13/2022 Item #16A29 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 ' A Z 9
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
2.
3. County Attorney Office County Attorney Office
Ser /43 ?>
4. BCC Office
Board of County
Commissioners Len by/ON I2/j5/Zt
5. Minutes and Records Clerk of Court's Office
h�lr rairb/9?-- 9!34/
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 Julio Castro/Transportation Engineering Contact Information 239-348-1328
Contact/Department
Agenda Date Item was December 13,2022 Agenda Item Number 16.A.29
Approved by the BCC
Type of Document Change Order#2 for adding additional Number of Original 1
Attached temporary traffic control plan equipment Documents Attached
covered by the allowance and add
additional days to the 11 Bridge
Replacement Project PKG C.
PO number or account 1500211270
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 ✓JC
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 ✓JC
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 V JC
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 ✓JC
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 12/13/2022 and all changes made during V JC N/A is not
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 /hr�oo an option for
Chairman's signature. N" this line.
16A29
Procurement Services
Colter County Change Order Form
® Contract Modification ❑ Work Order Modification
Contract#: 21-7851 Change#: 02 Purchase Order#: 4500211270 I Project#: 66066.12
Contractor/Firm Name: ZEP Construction, Inc. Contract/Project: Bridge Replacement- Bridge Package C
Project Manager Name: Robert White Division Name: Transportation Engineering
Original Contract/Work Order Amount $ 12,992,442.90 5-11-2021, 11E Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount $ 12,992,442.90 5-11-2021; 11E Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount $ 12,992,442.90 1/17/2024 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount
Revised Contract/Work Order Total $ 12,992,442.90 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 7-19-2021 Original 1-17-2024 Last Approved 1-17-2024 Revised Date 2-2-2024
Date Completion Date Date (Includes this change)
#of Days Added 16 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 I 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.
Item A—0102 60 WORK ZONE SIGN, 0102 74 2 CHANNELIZING DEVICE-TYPE III, 6' & 0102 120 TEMPORARY
SIGNALS $1.3 , .27 RP'N! :%:3, 749 6 b Kv!l~4
1. This change order will utilize the Roadway Allowance ($-1-3-7-,6-1-130), the Structures Allowance ($23,749:&3),
Miscellaneous Allowance ($89,686.19) and reallocated funds from Conduit and Junction Box ($19,953.73) to pay
for equipment used for the Temporary Traffic Control Plan (TTCP) for a total cost of$271,000.85
2. The change being requested was not included in the original contract because the construction plan estimated
that each of the bridges' construction phases would be accomplished within estimated durations. The actual
construction phase durations exceeded the plan estimate.
3. If this modification is not processed the equipment would not be available to safely direct traffic through the
construction site per FDOT Standards.
Item B -Decrease Plan Quantity for 0630-2-16 Conduit, and 0635-3-13 Junction Box
1. This change will reduce the original contract amount for Conduit by $18,633.97, and Junction Box by $1,319.76.
The total deduction amounts to $19,953.73.The funds will be reallocated to the Temporary Signals.
2. The change is being requested because the Engineer of Record (EOR) eliminated one half of the conduit and
junction boxes from the plans.
3. If this change is not processed the contract quantities will exceed what is necessary after the EOR modified the
plans.
Item C—Additional Contract Time for Weather and Holidays thru June 3, 2022
1. This change will add three (3) days for inclement weather and thirteen (13) days for holidays for a total of sixteen
(16) days to the original contract time (912 days). This change order is required to meet the requirements of FDOT
Specifications 8-6.4 Suspension of Contractor's Operations— Holidays and Special Events and 8-7.3.2 Contract
Time Extensions.
2. The change being requested was not included in the original contract because the schedule impacts were not
predicted.
3. If this modification is not processed the Contractor would not receive the additional days authorized by the
contract documents.
See Exhibits"A" & "B" for the information and allocation of quantities and dollars
Revised: 01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin BC BCC ES
L6429
A VincentZaliauskas Digitally signed by Vincent A Zaliauskas
Date: 2022.09.20 08:14:51 -04'00'
Prepared by: Date:
(CEI)
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.
Jovan Zepcevski Digitally signed by Jovan Zepcevski
Accepted by: Date: 2022.09.20 08:43:26 -04'00' Date:
(Jovan Zepcevski, President, ZEP Construction, Inc.)
WhiteRobert Digitally signed by WhiteRobert
Approved by: Date: 2022.09,20 10:10:04-04'00' Date:
(Robert White P.E., Project Manager,Transportation Engineering)
ThomasMatthew Digitally signed by ThomasMatthew
Approved by: Date: 2022.09.20 10:16:50-04'00' Date:
(Matthew Thomas P.E., Principle Project Manager,Transportation Engineering)
AhmadJay Digitally signed by AhmadJay
Approved by: Date: 2022.09.20 13:29:38 -04'00' Date:
(Jay Ahmad P.E., Division Director,Transportation Engineering)
Digitally signee by
ScottTrinity g
at t:402it 2.09.27
Approved by: 18:36:02-04'00'
PP Date:
(Trinity Scott, Department Head,Transportation Management Services Department)
Sc h nee be rg e rSa ra Digitally signed by SchneebergerSara
Date:2022.10.13 09:45:36-04'00'
Approved by: Date:
(Sara Schneeberger, Procurement Strategist, Procurement Services)
Revised: 01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin BCC BCC ES
1 6 A 2 9
ATTEST: BOARD OF COU -17 COMMISSIONERS
Crystal K. Kinzel, Clerk of Courts COLLIER CO , FLO
&Comptroller Ce) C.•
By: •
Willi I,. McDaniel,Jr., Chairman
Dated: OP 0/4/-2—
(SE ,)
Attest as to ChairinOs
signature only.
Appyr7Tas to for an legality:
By:
Scott R. 'each
Deputy County Attorney
,CA)
1 6 A 2 9
Change
a ge Order Summary
COST TIME
CO# AMD# Description Days New Justification
Additive (+) Deductive(-) Added Amount
Use allo waao FDOT Spec 7-14 requires owner to
01 fundss t to payy forr p compensate for damage to crash
repair to damaged
cushion.
crash cushion.
Add Additional quantities for each
Utilize Allowance, day TTCP pay items.
02 Reallocate Funds, 16 928 Conduit and Junction Boxes
Add Contract Days reduced quantities
Add days for Weather and Holidays
thru June 3, 2022
Revised. O1/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin Rpf BCC ES
: :
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16429
Bridge Replacement-Bridge Package C-Change Order 02
Additional Contract Days
Project Number: 66066.12
Contract Number: 21-7851
P.0#:4500211270
Weather Days(3)
• 11/05/2021
• 11/18/2021
• 06/03/2022
Holidays(13)
• 11/25/2021
• 11/26/2021
• 11/27/2021
• 11/28/2021
• 12/24/2021
• 12/25/2021
• 12/26/2021
• 12/31/2021
• 01/01/2022
• 01/02/2022
• 05/28/2022
• 05/29/2022
• 05/30/2022