Backup Documents 11/14/2023 Item #16B 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 B 5
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
1. Jamie Khawaja Transportation Eng.
Kt a °° 11/22/2023
2.
3. County Attorney Office County Attorney Office 1 )/)?423
4. BCC Office Board of County p�
Commissioners 1"- $1j/$,/ i V 2Z
5. Minutes and Records Clerk of Court's Office ( ( 11 I t p 64y1
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 Jamie Khawaja/Transportation Eng. Contact Information 239-348-1328
Contact/Department
Agenda Date Item was 11/14/2023 Agenda Item Number 16.B.5
Approved by the BCC
Type of Document Change Order#3 adding time to the Number of Original 1
Attached Whippoorwill Road Project Documents Attached
PO number or account 4500210603
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 ✓JK
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 ✓JK
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 ✓JK
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 ✓JK
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 11/14/2023 and all changes made during ✓JK 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 ✓JK N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the option,=� „,
Chairman's signature. this,line.
� �3 �
� �� �� �
Procurement Services
Change Order Form
[D Contract Modification O Work Order Modification
Contract 20-773--- Change M---- 3 Purchase Ond*r#:| 4500210603 | Project M 00219
----------' mmippnnmwU�`�m,�eUuLakeoD,Conne�|on
Cnnt,ao1n�RrmNume: Quality Enterprises Con�axVpro/om: _____
---- | Transportation Engineering Services
Project Manager Name: Jam/eK»awaja DivisionNemo:
original Ountruct/Wom Order Amour
I $ 4.720�50.00 4'13'21�I 1x _original BCC Approval Date:Agenda|tem#
CuneniBCG Approved Amount $ 4,720,450.00 � �/0'1 1'22 16x11 Last BCC Approval Date;Agenda Item w
Current Contract/Work Order Amount $ 4.720.450.00 00128/2023 SAP Contract Expiration Date(Moste)
| Dollar Anpun,uf this Change $ 0.00 0,00% Total Change from Original Amount
Revised CmntrmcmNorR Order Total $ *.720�5O. .DO 800% Change hmmCunantBCC Appnmod Amount
Cumulative Changes _ o 0,00 ' 0.00% Change from Current Amount .
Completion Date,Description of the Tmmk(s)
_q*angq,and Rationale for the Chan8o______��������_
Notice+wProceed Original 11/18�2 umn Approved O8�823 Revised Date T BD
' r/.���
CompletionDo�[ Date \ yov/vopomwa�nw�
Data � __-
P of Days Added | O» Select Toaxm []Add newxosNo) []Dmimo task(s) []Change moNs> x ommr
Provide an,s 'vtn�h*on|Yo— �—ng'1�u'�ui|�uoouspnninorxpi*nmunmrot|o"a�oJd`mmque�edo»ongo(s}onthatuoh�)*nu/or
r,""~ this hIncluded|nV,wohg|ne|cnn�an�*nd �bethe impact
��*«�d��in»m|uwynw�d��(�mq��mxnd>��'�vhytm�nmQ* � om�auionm|an�«nc�n�,ac�ri�—�>` �eyo
unu
�mis change im not pmce*mnm. *uac omdmone|mmnm�mnnnmme Design Professional ...._ _
—,NOTE:A notice
-------- issued nn July 27, 2023 leaving 32 days oo the originalmmxaotivnrkm order. m Th* vismduo�of
nunnp*mm will be determined when the work is started again
1 60 additional days are being mquaa$;d due to unforeseen supply chain issues&material scarcities, Hence the
' contractor was not able to complete the construction of the traffic signal at the intersection of Marbella Lakes Dr.&
Livingston Rd.The County iu experiencing similar delays with procuring traffiosignal controller cabinets and nther
traffic signal equipment,
at
2, The change being vaquee dweanotinn\uded )ntheongina\uontractbonmuaethusoiauueoweronotforeaeeab\m
is not processed
3� a/�Nmhmeification»fc«nma »eg«ha�»e . this signal cannot be cnmp|'ged and the new roadway ounnendoncannot be
opened tn the public.
' ^ �zz�����~
Prepared by: 1�h� VV��a]����l�� �~~~-~��� _ Date:
Jamie Khawaja,Project Manager U.Transportation Engineering
Acceptance of this Change Order shall constitute a modification to contract Y work order identified above and will be subjectto all the same
terms co
ntract m stated in The
e � if m�aConma�shall cnnut$vtoa�U and final�o\mnentn[any and all daimuof the Contnaoor/Vendor/cnnou|�n\Design /
w�v��»�� any,~ou|arismooutofnre|atammthochungeve/forthke,oin.\nc|mdingdaimsk`,impactonude|aycmsto.
��� ��- /��-
Accepted by: "�__��� --' - _
Louis 1 Gaudio,Vice President,Quality Enterprises, Inc.
Digitally signed o/r^vm"»mauno=
Approved by' 7-hOMO��s&�8tth��VV ow�:ouuoon.1z1s:*o:»*'«4*»` nate_____-__.___
auoow Thom E.Supervisor of Project Management,Transportation Engineering
AhmadJay
4^�0O��H]��V ������.��'��itally signed 'uo�`y1��*no Da�:__
Appmvedby: ' '� ' �
Jay . Division Director,TranspmxativnEngineering
n�wp:u�u/'���oe� (o*/o/^no*mo�ay�no��oomov^o/u/o^�umomuv/nmoue^^,m»om�vxem�) -
1, 6 B5
ATTEST: BOARD OF COUNTY COMMISSIONERS
Cryst4I.44 .101/4 Clerk of Courts COLLIER COLIN FY, It
'-- •
Attest as to Chairman's Rick LoCastro, Chairman
*Ied: tE!: 1. , .J;) si nature only.
(S .) t''
: • ell MO'''s
Appro‘ scl as to form and all
By:
))/..
Scott Teach
Deputy County Attorney
,..--.
974
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~=� SC0ttT[iOityscl= mny `n
Appr"vedby: 10.42 58-04'00' Date _
Trinity Sc.ott, Department Head,Transportation Manmgmmnm Services Department
mmu/lyugn" �n/mam°mm"
Yi1rOaZ��eathe( o",°.zo'`m�`om.�az'�no� om*�
Approved by:
- _
lPrOGU,omenL Strategist, pmuvnomeotServices
....... --_
Change Order/Amendment Summary
COST TIME
Justification
CO# AMD# Description Days New
Additive Deductive
_,Ldded Amount
Add 188 days 0 0 168 682 Needed days to complete project.
777 Needed days to complete project
. A-- - _' |
'------ '---- --------------------- -------- �
3 Add 60 days O O sO 837 Needed days m complete project
-___. __- __--_'_____--____'-__
_ __-_'__ __-
____-_- .____-_ ___- � --
'
mevise :n//1wcv 1 (Divisions who may enmre additional oigwwrpn may/mymmvn separate nhom.) /' pn»CU^e«EN`m=6Nx _
16 B5
Khawajaiamie
From: Joe Vaccaro <JVaccaro@geusa.com>
Sent Wednesday,August 16,2023 11:24 AM
To: Khawaja)amie
Cc: CastroJulio;Lou Gaudio
Subject: Re:Whippoorwill Street Lights @ Marbella&Days for CO
This email is from an external source.Confirm this is a trusted sender and use extreme caution when
opening attachments or clicking links.
i l
I followed up with FPL and said if all goes well lights should've energized end of this week.And as for time to install
signalization and testing period,60 days.
Joe Vaccaro
347.453 1688
L.239-435.7200
jvaccaro4'geusa.com
3':94 Shearwater Street,Naples,r-t.341.17
NOTICE:
This email contain ntormation chat is legally privilege and con fi.dentiai.. If you have received thin
ua.;.nag(c, in error, notify me iuu:edlacely and delete .:.ri.s message. Any unauthot:i<ed d.sclosure,
sahv,i.ny, .iistriburinn or other u:e of t.;i rniormation .otric;ly prohibited.
f I
On Aug 14,2023,at 4:16 PM, KhawajaJamie<Jarnie.Khawaja@colliercountyfl.gov>wrote:
Joe,
Did the street lights at Marbella get tested,if so were the residents satisfied?Also any update on the
days for signalization at Livingston that Julio mentioned on Friday?
'Thanks.
Project Manager
Transportation Engineering Division
Construction Engineering Inspection (CEl)
Cell: (239)253-0354
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