Backup Documents 10/24/2023 Item #16C 2 16C 2
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
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 Hoard meeting.
**NEW** ROUTING SLIP
Complete routing lines ill 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 thrc ugh H2,complete the checklist,and forward to he County Attorney Office.
Route to Addressee(s)(List in routing order) Office Initials Date
1.
2,
3. County Attorney Office County Attorney Office
4. BCC Office Board of County
Commissioners /14( „efS' (6124/2 3
5. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATIO
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 Fern Sivert,PUEPMD Phone Number 252-5376
Contact/ Department _
Agenda Date Item was Agenda Item Number 15C2
Approved by the BCC 10.24-2023
Type of Document Change Order Number of Original
Attached Documents Attached i
PO number or account
number if document is NA
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. _ init'al A licable
Pre
I. Does the document require the chairman's original signature? /Le
2. Does the document need to be sent to another agency for additional signatures? If yes,
provide the Contact Information (Name; Agency;Address; Pitons)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 !�
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 the616
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
ss*nature and initials are required.
7. In most cases (some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE. �Jt
Some documents are time sensitive and require forwarding to Tallahassee within a certain o f
time frame or the BCC's actions are nullified. Bea ar of your deadlines!
8. The document was approved by the BCC onte ,$and all changes made during N/A is>f=
the meeting have been incorporated in the attach document. The County l
,,.�y� an optic ntfoq
Attorney's Office has reviewed the changes,if applicable. Sl1 ►'" 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 nn ( an option*.
Chairman's signature. y` 1 this line:
1.n.._...1/...-.._,n......-I TIT.T•....I Il.:.:..,.1\........-_..n _n1:.. "nun/\-:-:...1 no,AA I1...3._.1 1,,A[ 1'........A n AA A[. J 11,'ln,.n
16C 2
Procurement Services
et) )IeY COMVIt%;y Change Order Moral
tom,-•�.�d
(A Contract Modlticallon ❑Work Order Modification
Contract I!: 22-7001 1 Change Ih 1 Purchase Order i): 4500220505 Project!!: 70130.2,1.2
Contractor/Finn Name: OneSource Construction Co.&Builders,Inc. contmoulrojocl; NCRWiP Storage Building
Project Manager Name: Tom ShoedDivision Name: PUEPMD
Original ContraotlWork Order Amount $ 1,242,707.00 0/13/2022;11C Original BCC Approval Date; Agenda Item!!
Current BCC Approved Amount Lost BCO Approval Date; Agenda Item!!
Current Contract/Work Order Amount $ 1,242,707.00 11/17/2023 SAP Contract Expiration Date(Master)
Dollar Amount of this Change $ 0.00 0,00% Total Change from Original Amount
Revised Contraot/Work Order Total $ 1,242,707,00 , 4DIVI01 Change from Current BCC Approved Amount
Cumuiati\e Changes $ 0.00 0.00% Change from Current Amount
Completion Date,Description of the Taek(e)Change,and Rationale for the Change
Notice to Proceed 10/10/2022 Original 11/17/2023 Last Approved 11/17/2023 ovisod Date TOD
Date Completion Dale Date 'ncivdos this change)
i!of Days Added 75 Select Tasks 0 Add now lask(s) (]Doloto lask(s) ❑Change task(s) ®Other
Provide a response to the following:1.)detailed and specific explanation/rationale of the requested changes)to the lask(s)and!or
the additional days added(If requested);2.)why this change vine not Included In the original contract;end,3.) describe the impact
If this change Is not processed. Attach additional information from the Design Professional and/or Contractor If noodod.
The project la currently suspended with 70 days remaining on the contract.This change order provides for a 76•day no cost lime
oxtenslon.
1. The contractor has requested additional time duo to the the amount of time It took the pre•engineered building supplier to
provide signed and soalod plans required by the County's permitting department.Additionally,there was an extended period of
time during She permitting process es a largo number of requests for Information were requested by the various permitting
entities that required resolution prior to permit Issuance.Also,seasonal rains have Impacted the contractor's ability to Install
the necessary hit material and achieve required compaction densities prior to forming,reinforcing and pouring the building slab.
2. This change was not Included In the original contract as was not known how long the permitting duration would take or to viral
extent Inclement weather would Impact the estimated project schedule.
3. If this change is not processed,the contractor will not finish Iho project within the established limo frame.
S° Tom Digitally signed by SivertTom
V �� Date:2023,09,13 12:33:29-04'00'
Prepared by: Date:
(Torn Siverl,PUEPMD) !(LA 9/13/23
Acceptance of this Change Order shall constitute a modification to contract!work order identified above and will be subject to all the sente
terms and conditions as contained in the contract/wed,order Indicated above,as fully as If the same wore stated In this acceptance.The
adjustment,If any,to thep CS/htracl shall coast Wu-strife padfinal settlement of anyand oil claims of the Contractor/Vendor!Consultant/
Design Profession i a XI of or relate o limo' Ago sot fort rare n, Aiding claims for Impact and delay costs.Cf
Accepted byL,� �?,t►,`, GUu -C.�/1 Date: ! - v45
(Oaor0o Chauvin, n ffco Construction Co.6,Ouildina,Inc.)
Accepted by: Data:
(Tyler Wad r rTech,Inc.)
McLeanMatthew care:
Approved by:
r:rs:"c ava»�,s>s r;:.,,,,
(Mall McLean,Division Director or Designee)
ZiiT mermanSue t'1< adb/gi,,,n,, ht
Approved by: o,u:7on03.I<g24&51'w Date:
(Procurement Professional)
Revlsad:01l1'1l202I (Divlslons who may requiro addltlen°I aianoluros may lnduda on separate armed.) paoceaiu!Nt Wit ONLY
Admin /see) acorns
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1 6 C 2 4 1,, i
_ . ...
ATTUST: ROAR!)OF COUNTY COMMISSIONERS
Crystal IC,Kinysl :OTI.4,of Cowls COLLIER COUNTY, FLORIDA
&CO0;11.011er . •:,
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„ ,7-7yAkiktv.c.,..:,,,.-.,. • -.., fl
Dat4,,i •,'‘ /'e.-- 14 4,..---1::,
vaRick LoCastro, Chairman
,,i 2c13
. .
to Chairman's
s3;. signature only
2 A Pi ved as to fort 1 at le lity
t It.Tea li
Deputy County Attorney
•
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id
16C 2
Change ordor/Alnendmont Summary
COST TIME
COP AMON Deaorlplion bays New Justification
Additive(+) DeductiveO Added Amount
Time extension duo to permitting
1 Time Extension 75 470 sealed
buildingpsigned
a9 sosubmittal duration
and weathor delays.
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Rovlsed;0 5/141202 1 (0Ivlsrons who may raqulr)additional alanolures may Ineluda on somata shoal.) PROCURKT O ONLY
AOmin \/NEUa COO
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