Backup documents 07/11/2023 Item #16C 3ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6
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 touring lines #t through 92 � m lete tha t—,rq. n 4 r ..... A U-
• - --- ---------- �-----
Route to Addressees (List in routing order)
- ••••�-•- •• ••.-, .�.. •.. ...w ....., v..�..n.. �., u..0 tUl
Office
rvalu LV u1G I.VUIII
Initials
HLLUIIIG Vlllee.
Date
1. N/A
2. N/A
3. County Attorney Office
County Attorney Office
4. BCC Office
Board of County
Commissioners
9C
Z
5. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION I I t
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 missinn information
Name of Primary Staff
Shon Fandrich, P.E., Supervison of Project
Phone Number
239-315-2181
Contact / Department
Management for Collections and I
Agenda Date Item was
7/11/2023
Agenda Item Number
16.C.3
Approved by the BCC
Type of Document(s)
Change Order
Number of Original
One
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
aDDroDriate.
Initial
Applicable)
l .
Does the document require the chairman's signature? (stamped unless otherwise stated)
Yes SF
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 SF
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 SF
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 SF
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
si nature and initials are required.
do PS
7.
In most cases (some contracts are an exception), the original document and this routing slip
Yes SF
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 _7/11/2023 and all changes made
Yes SF
during the meeting have been incorporated in the attached document. The Countyis
AttorneyOffice has reviewed the changes, if applicable.
"" s
9.
Initials of attorney verifying that the attached document is the version approved by thebt
BCC, all changes directed by the BCC have been made, and the document is ready for the
for
Chairman's signature.
MAO
1: 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
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Go ter County
❑ Contract Modification
Z Work Order Modification
Procurement Services
Change Order Form
Contract #: 20-7800 Change #: Purchase Order #: [_4!1216158� Project #: ' 1067.24,6
lonzraciorlFirrn Name PWC Joint Venture LLC �— -- i �ortracUProject: Carica HVAC Improvements
Project Manager Name; Shon Fandrich, P.E.Division Name: I
Engineering and Project Management
Original Contract/Work Order Amount
$
452,000.00
6/22/21, 11B
Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount
$
452,000.00
6/22/21, 11B
Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount
$
452,000000
6/21/2026
SAP Contract Expiration Date (Master)
Dollar Amount of this Change
$ 0.00
0.00%
Total Change from Original Amount
Revised Contract/Work Order Total
1 $
452,000.001
0.00%
Change from Current BCC Approved Amount
Cumulative Changes
I $
0.001
0.00%
Change from Current Amount
Completion Date, Description of the Task(s) Change, and Rationale for the Change
Notice to Proceed 1/1$l2022 Original 9i30/22 Last Approved 02/23/23 Revised Date 02/23l23
Date Completion Date Date (includes this change)
# of Days Added 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 andr'or Contractor if needed.
1. This change is to authorize the use of allowance funds for the following items:
Work Directive #2 — Revise conduit layout
Item
Description
Amount
ennaining Allowance Balance
1
Work Directive #2 — Conduit
Layout Changes
$4,224,00
$34,747.08
2, This item was an additional item that was added to the contract. Additional conduits were required due to the orientation of the HVAC
units that were provided. These conduits were added to ensure that the proper operation of the exterior HVAC units were achieved.
3. if these changes are not processed, the HVAC units would not have been able to operate as intended.
Final approval of this Change Order is contingent upon approval by the Board. If Board approval not issued, this
Change Order shall be null and void.1
FandrichShon
Prepared by: Date:
Shon Fandrich, P.E., Senior Project 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 of or related to the change set forth herein, including claims for impact and delay costs
Accepted by: _ ,� _ ,�--�-- Date:
Michael Bridgeman, PWC Joint Venture LLC���
_�
l Digitally signed �byT�y-er 9C��inright
Accepted by:T�nr�aTO nTyannghtP.E., era Tech
Accepted by: BullertBenjamin
Date'
Benjamin N. Bullert, P.E., Principal Project Manager
McLeanMatthew
Approved by: Date:__
(Division Director or Designee)
Revised'. 01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY\�,
03092023 Admire RPC CC EG i
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ATTESTV-.�'�'�
Cryst l : I $ IV el ttt Courts
& Co� tr er
C"4/Dated:
(SEAL) Attest as to Chairman's
t signature only
A oved as to fo and e ality
By:
Scott R. Teach
Deputy County Attorney
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
Rick LoCastro, Chairman
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Approved )by, DoriaPriscilla Digitally signed byDoriaPriscilla
Date:
, `" (Procurement Professional)
Change Order/Amendment Summary
CO#
AMD#
Description
COST
TIME
Justification
Additive (+)
Deductive (-)
Days
Added
New
Amount
1
Utilized $1,028.92
of allowance with
$38,971.08
remaining for an
additional concrete
um
I
Items were necessary to prevent
damade to other parts of the pump
station.
2
Utilized $4,224.00
of the allowance
with $34,747.08
remaining for
additional electrical
conduits.
Items were necessary to ensure
HVAC operation.
I
Revised: 01/14/2021 (Divisions who may require additional signatures may include on separate sheet.)
fPROCUREMENT
USE ONLY
RL 8CC ES
�� 03092023
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Collier County EngineerinE & Project Management Division
WORK DIRECTIVE CHANGE
CONTRACT # /PROJECT NAME: 71067.24.6 / 20-7800 / Carica HVAC Improvements
WORK DIRECTIVE # 002 PURCHASE ORDER #: 4500216158
DATE OF ISSUANCE: 12/8/22
CONTRACTOR: PWC Joint Venture LLC
OWNER: Collier County Board of Commissioners
ENGINEER/DESIGN PROFESSIONAL:
Tetra Tech Inc.
You are directed to proceed promptly with the following change(s):
Description: Provide conduits for low voltage wires from the air handlers and actuators to the DDC controller.
Purpose of Work Directive Change: The purpose of this work directive is to clarify the intent of supplying conduits from the
actuators and air handlers to the DDC controller located inside the electrical room. These conduits are necessary to complete the
installation of the HVAC units.
Reason/lustification: The conduits are necessary for the installation of the 11VAC units and the units cannot function without
them.
Attachments: Drawing Sheet E-101
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
Contract/Allowance Price:
❑ Unit Prices
❑ Lump Sum
® Time & Material
❑ Other
Estimated increase (decrease) in Allowance
S TBD
RECOMMENIYED:
By: Tyler WApr�ght, P.F.
En4 er
Method of determining change in Contract Times:
® Contractor's records
❑ Engineer's record
❑ Other
Estimated change in Contract Time:
Increase or decrease by 0 calendar days.
AUTHORIZED:
PndrichShon
Owner's Representative
12/09/22 11:38 AM
mm
1 6C
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H031V'd.L31
P'N
1 51
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itPWC Joint Venture, LIX.
5256 Summerlin Cornrnons Way Suite 203
Bldg H2
Fort Myers, YL, 33907
(239) 270-5907 Office
(239)'270-5943 Fax
PROJECT NAME: Carica PS HVAC Improvements CONTRACT 21-7800
PROJECT NO: Purchase Order/Work Order NO:4500216158 PWC JOB NO. 2021-05.02
GENERAL CONTRACTOR: PWC Joint Venture DATE: 211612023
DESCRIPTION OF CHANGE: Provide conduits fro low voltage wires from theair handlers actuators to the DDC controller
PWC Direct Costs
Additive Costs
A LaSor 0.00
B Material $0.00
C Equipment $0.00
D Subtotal of Additive Cost
Deductive Costs {use minus sign to denote negative figures)
E Labor
F Material 0.00
G Equipment
H Subtotal of Deductive Cost $0.00
I Contractor's Total Direct Cost (D+H) 0.00
i General Contractor's Mark-up 0.00
10% markup
K Total PWC Direct Costs + Mark-up (Line I +J) $0.00
L Total Subcontractor Direct Costs $4,22a.00
M General Contractor's Mark-up on Subcontractor Direct Costs so.00
0% Markup
N Subtotal $4,224.00
Tax/Fees
O Total PWC Change Request (Line K + L + M + N) $4,224.00
To the best of my knowledge and belief I certify that all costs listed above are correct.
L&64t C� 2/16/2023
Dale
Contractor Signature
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".3.k
i
�%Aa
Technical Management Associates
March I, 2023
INVOICE #2528
PWC JOINT VENTURE, LLC
mbridgeman((Dpw,- Ilc.com
5256 SUMMERLIN COMMONS WAY STE 203 BLDG 2
FORT MYERS FL 33907
Project: TMA 1182-7
CARICA PUMP STATION HVAC IMPROVEMENTS
10251 Metro Parkway
Suite 118
Ft, Myers, FL 33966
Phone: 239.437.9582
Fax: 239.437.9576
Additional controls per Work Directive #02 issued 1218/22 $4,224,00
- Work Performed from 12!8/22 through 12/15/22
— Qz 1n:) On
Additional controls per urawing issuea iz1"zN1 _ -
TOTAL $7,366.00
TOTAL AMOUNT DUE THIS INVOICE BY
.. $7,366.00
#VALUE!