Backup Documents 05/09/2023 Item #16C 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 C 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.
** 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. N/A
2. N/A
3. County Attorney Office County Attorney Office
4. BCC Office Board of County
Commissioners R( � /1�'j/s/ ,S f t2/Z D'l
5. Minutes and Records Clerk of Court's Office ( 1 1
5 j12(2023
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 Corinne Trtan,PUD—Subregional Utilities Phone Number 239-252-4233
Contact/Department Division
Agenda Date Item was 05/09/2023 Agenda Item Number 16.C.2
Approved by the BCC
Type of Document(s) Change Order& Supporting Information Number of Original One
Attached Documents Attached
PO number or account 4500212570,70145.3.1
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 A o
appropriate. (Initial) ApplicableN/ (Nt)
1. Does the document require the chairman's original signature(instead of stamp)? Yes CrB
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 legality. (All documents to be signed by Yes CBT
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 Yes CBT
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 Yes CBT
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 Please
signature and initials are required. do CBT
7. In most cases(some contracts are an exception),the original document and this routing slip Yes CBT
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_09/13/22 and all changes made Yes CBT
during the meeting have been incorporated in the attached document. The County
Attorney Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the Yes CBT
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature.
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
1 6 C 2
Procurement Services
COy Change Order Form
®Contract Modification 0 Work Order Modification
Contract#: 19-7622- hange#: 1 Purchase Order#: 4500212570 pry g:I 70145.3.1 1
302.25
Pump Station 302.25 Rehabilitation
ContractorlFirm Name: US Water Services Corporation Contract/Project:
Project Manager Name:
Corinne Titan Division Name: Public Utilities Sub-regional Utilities
Original ContracUWork Order Amount $ 435,105.01 7/13/2021;16C8 Original BCC Approval Date; Agenda Item#
Current 8CC Approved Amount $ 435,105.0147/13/2021;16C8 Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount $ 435,105.01 4/27/2024 SAP Contract E piration Date(Master)
Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount
Revised Contract/Work Order Total $ 435,105.01 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 4/13/2022 Original 10/10/2022 Last Approved 10/10/2022 Revised Date
Date Completion Date Date (Includes this change)
#of Days Added 150 Select Tasks ❑Add new task(s) 0 Delete task(s) 0 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.
This contract is currently on a stop work order with 38 days remaining (8 days prior to substantial completion).
Days added (time extensions) for this project, and all future time added to this project, move the substantial
completion along with the final completion.
This change order is adding an additional 150 days to the substantial and final contract time for the procurement
and delivery of the pump station generator. Currently,generators are backordered and the estimate is 1.5 years
for delivery. Our generator was ordered in February 2022. The current delivery date estimate is April 2023.
WD#1
1. This work directive is an allowance draw. The contractor was required to order and install an additional
wet well riser ring due to unforeseen conditions discovered during the demolition of the existing wet
well top in preparation for the new top slab.
2. When the Contractor began to excavate and remove the existing top slab it was discovered that the
existing top portion of the wet well had been constructed using bricks and mortar. It was determined that
the designed wet well riser would not allow the top slab of the station to meet the 100 year flood
elevation requirement. In order to meet the 100 year flood elevation per the County and FDEP
requirements an additional 9-inch riser is required.
3. If this change is not processed,the pump station will not meet the County and FDEP requirement for the
top slab elevation to be at the 100 year flood elevation.
This Change is to use$6,295.00. This Change DOES NOT increase the contract amount.
�► 03022023
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PaOCUalasENTUseONLY
Adrift ( e- 1 BCC ES
16iC 2
WD#2
I. This work directive is an allowance draw. The purpose of this work directive is to direct the contractor to
install a new 4-inch plug valve on the existing 4-inch force main due to the existing 4-inch plug valve
determined to being inoperable.
2. When the contractor began rehabilitation efforts on the pump station it was proposed that a new 6-inch
force main would tie into the existing 4-inch force main and ultimately tie into the existing 30-inch force
main within the county ROW. The existing 4-inch plug valve was believed to be operable during design,
but was deterimined during construction to be inoperable. In order to provide flexibility in isolating I'ti
302.25 and/or flow in the County's wastewater collection system,the inoperable existing 4-inch plug
valve needs to be replaced.
3. If this change is not processed,the County's Wastewater Collection Division will not be able to isolate
PS 302.25 and/or the flow in the County's wastewater collections system.
This Change is to use $3.595.37 from the project allowance. This Change DOES NOT increase the contract
amount.
Beginning General Allowance $ 20,000.00
Allowance Draw WD#I $ (6,295.00)
Allowance Draw WD#2 $ (3.595.37)
Remaining General Allowance $ 10,109.63
Prepares by: 144degentni 742 k. 1a 5u1ee/L " It s Date:. ,7/'
(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 I work order indicated above,as fully as if the same were stated in this acceptance.The
adjustment,if any,to the Contract shall const a full and final settlement of any and all claims of the Contractor/Vendor!Consultant I
Design Professppel rising out of or ted change set forth herein, intluding claims for impact and delay costs.
Accepted by:7 USWC, Edward Mitchell,VP Date: 3/8/2023
(C/ tracts / endor r Consultant/Design Professional and Name of Firm,if project applicable)
,.�. Alexander Dunko, P.E. - Project Manager Accepted Date: 3/3/2023
{e+ ign Professional and Name of Firm,if project applicable)
PajerCraig Digitally signed by PajerCraig
Approved by: Date:2023.04.05 11:01:29-04'00' Date:
(Division Director or Designee)
Do r i a Priscilla Digitally signed by DoriaPriscilla
Approved by; Date:2023.04.05 12:30:47-04'00' Date:
(Procurement Professional)
e/t) 03022023
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROM use ore_ra—
A , Dec t$
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ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K. Kinzel, Clerk of Courts COLLIER COUNTY, FLORIDA
& Comptroller
B B�P ` 7
y: ► �cI y:
26
A I" Rick LoCastro, Chairman
Dated: Kr 4 i Pi!?'
(SEA 6
Attest as Chair+rtan'-s
`signature only
Ap ve s to fo d 1 gality:
By:
Scott R. T ach
Deputy County Attorney
40/
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Change Order/Amendment Summary
COST TIME
COGS AMD# Description - Days New Justification
Additive(+) Deductive(4 Added Amount
Allowance draw+ County and FDEP Code
1 time addition 150 330 compliance;collections system
operations
4
A" 03022023
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PRocu86INt USE ONLY
NCO
Admin BCC ES
1 6 C 2 ,,: .y
Collier County Engineering & Project Management Division
WORK DIRECTIVE CHANGE
CONTRACT#/PROJECT NAME: WORK DIRECTIVE# 1
#19-7622-302.25 Pump Station 302.25 Rehabilitation
PURCHASE ORDER#: 4500212570 DATE OF ISSUANCE: May 2,2022
OWNER: Collier County Board of Commissioners PROJECT#: 70145.3.1
CONTRACTOR: U.S.Water Services Corporation ENGINEER/DESIGN PROFESSIONAL: Q.Grady
Minor& Associates, P.A.
You are directed to proceed promptly with the following change(s):
Detailed and specific explanation/rationale of the requested change(s) to the task(s) and ! or the additional days
added (if requested): The Change is requested to allow the Contractor to install an additional wet well riser ring
due to unforeseen conditions discovered during the demolition of the existing wet well top in preparation for the
tie top slab.
Why this change was not included in the original contract: When the Contractor began to excavate and remove
the existing top slab it was discovered that the existing top portion of the wet well had been constructed using
bricks and mortar. It was determined that the designed wet well riser would not allow the top slab of the station
to meet the 100 year flood elevation requirement. In order to meet the 100 year flood elevation per the Count)
and FDEP requirements an additional 9-inch riser is required.
Describe the impact if this change is not processed: If this change is not processed. the pump station will not meet
the Counts and FDEP requirement for the top slab elevation to be at the I00 year flood elevation.
Attachments: PS 302.25 IE:T Riser Proposal.pdf
If a claim is made that the above change(s) have affected Contract/Allowance Price or Contract Times any
claim for a Change Order based thereon will involve one or more of the following methods of determining the
effect of the changes(s).
Method of determining change in Method of determining change in Contract Times:
Contract/Allowance Price:
❑ Unit Prices ❑ Contractor's records
® Lump Sum ❑ Engineer's record
❑ Time& Material ❑ Other
❑ Other(see attached Bid Schedule)
Estimated decrease in Allowance: Estimated change in Contract Time:
$6,283.00 Increase or decrease by 0 calendar days.
REC4/1 .'DED: AU�H RI ,ED:
y (
//
IFS: Alexander Dunko. PE By: Corinne Than
Project Manager Owner's Representative
C.Ao
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Draft Invoice SI65962 5. Water
January 31, 2023 arolest Corporation
External Document No.
4500212570
Page 1/1
Collier County BOCC U.S. WATER SERVICES CORPORATION
3299 Tamiami Trail East, Suite 700 4939 CROSS BAYOU BOULEVARD
Attn: Accounts Payable NEW PORT RICHEY, FL 34652
Naples, FL 34112-5749
Your Reference Payment Terms Shipment Method
Net 30 days
Job Number: J01269 WA: 19-7622-302.25
Job Description: Collier County BOCC
Change Order#1
Unit Price Line Amount Excl.
Date Description Task No. Qty Unit Excl.Tax Tax
09/13/22 IET Lid (with 15% mark-up) 0002 1 EA 5,175.00 5,175.00
09/13/22 Maintenance Technician 0002 16 EA 70.00 1,120.00
Subtotal 6,295.00
Total Tax 0.00
Total$ Incl.Tax 6,295.00
Toll Free Phone No. Email
(866) 753-8292 Ext. 219 (727)848-8292 Ext. 219 ar@uswatercorp.net
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Paints&Coatings, Inc.
17660 East Street ( '
North Fort Myers, FL 33917 US
JO)ai119�'�
(239) 997 6645 � d
carl@paintsandcoatings.net 1.
www.paintsandcoatings.net i -The Finrslin\Li ualsrSlrw•lurehehahihlaUnn.C,
/ Excls_sive applicators of PET
BILL TO INVOICE 122-9342
U.S. Water Services Corporation
5605 2nd St. W.
Lehigh Acres, FL 33971 DATE 05/11/2022 TERMS Due upon receipt
DUE DATE 05/20/2022
PROJECT NAME
Collier PS 302.25
DESCRIPTION AMOUNT
CONFINED Provide Certified Confined Space Permit 100.00
SPACE PERMIT
RH-IET-Coating Lift Station 6'ID Approx. 11'VF Blast&coat with IET 8,478.00
RH-Invert Structural rebuild invert/channel 1,500.00
RH-Water Leaks Inspect, Repair water leaks&supply material to fix leaks 1,300.00
RH-IET-Crete Form & pour 1' riser with IET-Crete 4,500.00
Crane Services
Set lid with crane on lift station
We appreciate your business and look forward to helping you SUBTOTAL 15,878.00
again soon.
TAX 0.00
Please, make checks payable to: Paints& Coatings, Inc. TOTAL 15,878.00
Item in Red Box is in relation to Work TOTAL DUE $15,878.00
Directive #1
52005 15,878.00
J012690002 M3
CC 5/13
10%late charge on balances outstanding more than 30 days from date of invoice.This company complies with any and or all lien laws per
Florida Statutes.This contract is entered into in Lee County and all disputes arising from this contract will be litigated in Lee County.Buyer
agrees to pay outside agency/attorney's fees if this contract is referred for collection/litigation.
CAC
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Collier County Engineering & Project Management Division
WORK DIRECTIVE CHANGE
CONTRACT#/PROJECT NAME: WORK DIRECTIVE #2
#19-7622-302.25 Pump Station 302.25 Rehabilitation
PURCHASE ORDER#: 4500212570 DATE OF ISSUANCE: May 2,2022
OWNER: Collier County Board of Commissioners PROJECT#: 70145.3.1
CONTRACTOR: U.S. Water Services Corporation ENGINEER/DESIGN PROFESSIONAL:Q. Grady
Minor& Associates, P.A.
You are directed to proceed promptly with the following change(s):
Detailed and specific explanation/rationale of the requested change(s) to the task(s) and / or the additional days
added (if requested): The Change is requested to allow the Contractor to install a new 4-inch plug valve on the
existing 4-inch force main due to the existing 4-inch plug valve determined to being inoperable.
Whti this change was not included in the original contract: When the Contractor began rehabilitation efforts on
the pump station it was proposed that a new 6-inch force main would tie into the existing 4-inch force main and
ultimately tie into the existing 30-inch force main within the County ROW. The existing 4-inch plug valve was
believed to be operable during design. but was determined during construction to be inoperable. In order to
provide flexibility in isolating PS 302.25 and/or flow in the County's wastewater collection system.the inoperable
existing 4-inch plug valve needs to be replaced.
Describe the impact if this change is not processed: If this change is not processed, the County's Wastewater
Collection Division will not be able to isolate PS 302.25 and/or the flow in the County's wastewater collection
system.
Attachments: Contractor's proposal for 4-inch plug flake installation
If a claim is made that the above change(s) have affected Contract/Allowance Price or Contract Times any
claim for a Change Order based thereon will involve one or more of the following methods of determining the
effect of the changes(s).
Method of determining change in Method of determining change in Contract Times:
Contract/Allowance Price:
❑ Unit Prices ❑ Contractor's records
❑ Lump Sum ❑ Engineer's record
® Time& Material ❑ Other
El Other(see attached Bid Schedule)
Estimated decrease in Allowance: Estimated change in Contract Time:
$TBD Increase or decrease by 0 calendar days.
RECOMMENDED: T O,IZED:
By Alex Dunko. PE By: Corinne Trtan
Project Manager Owners Representative
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Draft Invoice SI65170 UiJALaLef
January 12, 2023
: =s ale ! 9e8tion
External Document No.
4500212570
Page 1/1
Collier County BOCC U.S. WATER SERVICES CORPORATION
3299 Tamiami Trail East, Suite 700 4939 CROSS BAYOU BOULEVARD
Attn: Accounts Payable NEW PORT RICHEY, FL 34652
Naples, FL 34112-5749
Your Reference Payment Terms Shipment Method
Net 30 days
Job Number: J01269 WA: 19-7622-302.25
Job Description: Collier County BOCC
Change Order #2
Unit Price Line Amount Excl.
Date Description Task No. Qty Unit Excl.Tax Tax
09/13/22 4" PV& MJ fittings (with 15% mark-up+ 0002 1 EA 2,551.57 2,551.57
tax)
09/13/22 Project Manager 0002 1 EA 123.80 123.80
09/13/22 Maintenance Supervisor 0002 4 EA 90.00 360.00
09/13/22 Maintenance Technician 0002 8 EA 70.00 560.00
Subtotal 3,595.37
Total Tax 0.00
Total$ Incl.Tax 3,595.37
Toll Free Phone No. Email
(866) 753-8292 Ext. 219 (727) 848-8292 Ext. 219 ar@uswatercorp.net
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FORTIUNE •' 1 of 1
WATERWORKS SALES ORDER ACKNOWLEDGEMENT 11/18/22
5889314 10:48:29
REMIT TO: WAREHOUSE: 009 PAYMENT: CHARGE
FORTILINE FORT MYERS FORTILINE FORT MYERS
PO BOX 744053 4810 LAREDO AVE
ATLANTA, GA 30384-4053 FORT MYERS, FL 33905
Phone # 239 332 0112
SOLD TO: 213329 SHIP TO: SPECIAL INSTRUCTIONS:
US WATER SERVICES COF.FOR,ATIDN US WATER SERVICES CORPORATION
5605 2ND STREET W 5605 2ND STREET W
LEHIGH ACRES, FL 33971 LEHIGH ACRES, FL 33971
CUSTOMER PO JOB NAME JOB# CSR SLS ORDER DATE SHIPPING METHOD ORIG ORDER#
GET SHOP2 SHOP2 NES PSP 11/18/22 OUR TRUCK 0000000
LINE ITEM/DESCRIPTION UOM ORDER SHIPPED BIO UNIT PRICE DISCOUNT NET PRICE
001 4MPV 4" MJ PLUG VLV EA 1 _ 0 1295.0000 1295.00
011980
Y14
002 64MRP401 6"X4" MJ REDUCER P401 C153 EA 1 1 0 426.7500 426.75
272694
W06 002 001
003 461SLLD 461S SCREW VB DOM LESS LID EA 1 1 0 145.0000 145.00
308404
Y04
004 VBLIDSD 5-1/4 VB LID M/SEWER DOMESTIC EA 1 1 C 37.3300 37.33
011817
Y04
005 44000P 4" SG PVC REST W/ACC 4000P EA 2 2 0 70.4000 140.80
395057
W03 002 001 / W03 002 003
F/C900 4.80 OD
006 43000P 4" STAR GRIP DIP W/ACC 3000P EA 1 1 0 63.8500 63.85
242209
W03 002 002 / W02 002 005
NO. CTNS WEIGHT SHIPPED VIA SHIP DATE PICKED BY FILLED BY Subtotal 2,108.73
OCR TFU^-; Tax: 126.53
PACKED BY CHECKED BY DATE RECEIVED RECEIVED BY Freight: .00
Other:
MERCHANDISE CANNOT BE RETURNED WITHOUT PRIOR AUTHORIZATION Total Due: 2,235.26
Any short mi ages or descreAanoes corceng th.s onie,r moat be reported vkittiin 24 hogs. ,
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