Backup Documents 01/24/2023 Item #16F 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 F 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.
** 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.
2.
3. County Attorney Office County Attorney Office ,) 3
42.4
4. BCC Office Board of County
Commissioners IQ 11/ s/ I�3il e3
5. Minutes and Records Clerk of Court's Office /"f
ME 1-31 la-01
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 Lisa Jacob, Pelican Bay Services Division Phone Number 239-252-1355
Contact/Department
Agenda Date Item was 1/24/2023 Agenda Item Number 16.F.1
Approved by the BCC
Type of Document(s) Change Order Number of Original 2
Attached Documents Attached
PO number or account
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(instead of stamp)? MB
2. Does the document need to be sent to another agency for additional signatures? If yes, MB
provide the Contact Information (Name;Agency; Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legality. (All documents to be signed by LJ
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 MB
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 MB
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 MB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip MB
should be provided to the County Attorney Office at the time the item is uploaded to the
agenda. 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 1/24/23_and all changes made
during the meeting have been incorporated in the attached document. The County an option for
Attorney Office has reviewed the changes, if applicable. *-1-
fir, this lin
9. Initials of attorney verifying that the attached document is the version approved by the N/A iS'i
BCC,all changes directed by the BCC have been made,and the document is ready for the an option for
Chairman's signature. O this line.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04;Revised 1.26.05;2.24.05; 11/30/12;4/22/16;9/10/21
Procurement Services
4 761' County Procurement
Order Form
® Contract Modification ❑ Work Order Modification
Contract#: 20-7680 Change#: 4 Purchase Order#: 4500203324 Project#: 50178.1
Contractor/Firm Name: Agnoli Barber& Brundage, Inc. Contract/Project: Pelican Bay Sidewalk Improvements
Project Manager Name: Darren Duprey Division Name: Pelican Bay Services Division
Original Contract/Work Order Amount $ 314,894.00 4/28/20;16.F.3 Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount $ 338,721.000 2/8/22;16.E.4 Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount $ 338,721.00 10/31/2022 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 7.57% Total Change from Original Amount
Revised Contract/Work Order Total $ 338,721.00 0.00% Change from Current BCC Approved Amount
Cumulative Changes $ 23,827.00 0.00% Change from Current Amount
Completion Date, Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed 5/13/2020 Original 6/17/2022 Last Approved 10/31/2022 Revised Date 12/3/2024
Date Completion Date Date Includes this change)
#of Days Added 764 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.
1.) detailed and specific explanation/rationale of the requested change(s)to the task(s)and/or the additional days added;
This is a request to a) add 764 days to the contract, changing it from 901 days to 1665 days to complete Phase 2 of the project; phase
2 sidewalk construction contract ends 9/3/2024.
2.) why this change was not included in the original contract;
This change was not included in the original contract because of unanticipated contract, supply chain and material delays.
3.) describe the impact if this change is not processed;
If this change is not processed, and the contract would expire prior to all necessary tasks being completed; and design plans would be
inaccurate and out of compliance with established ADA standards, creating a public safety issue and increased liability to the County.
PreparedDupreyDarren Digitally signed by :45:37Darren
p by: Date:2022.08.30 08:45:37-04'00' Date:
(Project Manager Name and Division)
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.
Accepted by: Date:
(Contractor/Vendor/Consultant/Design Professional and Name of Firm, if project applicable)
...AY$p.w b,.inik A.Con,P.E
James A. Carr,
E•pm rrtQ{MYr.cm�.CN•hoes A Can P E'.n•'AanW Br.,{Brundage.hr..',A,Oe•,
P.E. 9ntlie { Date: 08/26/22
Accepted by: OW 2022.25 11 gl]FgfgC
(Design Professional and Name of Firm,if project applicable)
Digitally signed by NeilDorrill
Neil Dorrill
Approved by: Date:2022.08.3010:36:54-04'00' Date:
(Division Director or Designee)
Digitally signed by schneebergersara
Approved by: Sch neebergerSara Date:2023.09.07 10:06:13-04'00' Date:
(Procurement Professional)
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin RpI BCC ES
I6FI
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K. Kinzel,Clerk of Courts COLLIER COUNTY, FLORIDA
&Comptroller
By: By:
Rick LoCastro, Chairman
Dated: 1 - '1 - a'
(SEAL)
Attest as to Chairman's
signature only,
Ap oved s to fo n legality:
By:
S R. etc,
Deputy County Attorney
----- __ _ 1 i F 1
Change Order/Amendment Summary
COST TIME
CO# AMD# Description Days New Justification
Additive (+) Deductive() Added Amount
Remove Seagate Sidewalks on Seagate and VBR
Dr and Vanderbilt are assets of Road&Bridge;need
1 Beach Rd from $10,757 0 for arborist services not anticipated
Scope and add until landscape design phase
arborist services began.
2 Enlisted new $12,927
arborist services Existing arborist sold business.
Repurpose
remaining arborist
3 funds for permit $143 136 901 Compliance with ADA standards
modification and and public safety
design revisions;
add time
Add time to Compliance with ADA standards
4 contract $0 764 1665 and public safety until project
completion.
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin Rpt BCC ES