Backup Documents 02/13/2024 Item #16F 6 ORIGINAL DOCUMENTS CHECKLIST& ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 F �...
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. County Attorney's Office County Attorney Office 191 c 2 /3�
2. BCC Office Board of County Commissioners Chairman
3. Minutes and Records Clerk of Court's Office ,//
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 addresses above, may need to contact staff for additional or missing information.
Name of Primary Staff Bendisa E. Zela, Facilities Division Phone Number 239-252-8440
Contact/Department Email Bendisa.Zela@colliercountyfl.gov
Agenda Date Item was February 13,2024 Agenda Item
Approved by the BCC Number 16.F.6
Type of Document Approve Change Order No. 2,adding 425 Number of
Attached days to the Professional Services Original 1
Agreement 21-7884 with Matern Documents
Professional Engineering, Inc., for the Attached
New Chiller Plant Building K. (Project
No. 50214)
PO number or account Facilities Division is requesting a
number if document is completed copy
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? N/A
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. The original document has been signed/initialed for legal sufficiency. (All documents to
be signed by the Chairman,except for most letters,must be reviewed and signed by the BEZ
Office of the County Attorney.
4. All handwritten strikethroughs 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 BEZ
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
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's 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 BCC approved the document on February 13,2024,-and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County 1lib 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 N/A is not
BCC, all changes directed by the BCC have been made, and the document is ready for the s pal� an option for
Chairman's signature. �` ( this line.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
16F6 *--
Procurement Services
Cl ter COL4fty Change Order Form
El Contract Modification ❑Work Order Modification
Contract#: 21-7884 Change#: 2 Purchase Order#: 4500216578 Project#: 50214.1
Matern Professional Engineering, Inc. Design Services for New Chiller Plant Bldg K,Jail
Contractor/Firm Name: 9 g, Contract/Project: Generator 8 Platform
Tim Rygiel Facilities Mangernent
Project Manager Name: Division Name:
Original Contract/Work Order Amount $ 1,406,974.00 1/25/22 16C5 Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount $ 1,493,552.407 1/25/22 16C5 Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount $ 1,493,552.40 5/31/2024 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 6.15% Total Change from Original Amount
Revised Contract/Work Order Total $ 1,493,552.40 0.00% Change from Current BCC Approved Amount
Cumulative Changes $ 86,578.40 0.00% Change from Current Amount
Completion Date, Description of the Task(s)Change, and Rationale for the Change _ —J
•
Notice to Proceed 2/11/2022 Original 2/1/2024 Last Approved 5/31/2024 Revised Date 7/30/2025
Date Completion Date Date (Includes this change)
Added 425 of DaysSelect Tasks ❑Add new task(s) El 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 and/or Contractor if needed.
1. This change order will add 425 days to the contract to allow the vendor to continue providing services through the
completion of construction and revises Schedule C of the agreement as follows:
Task 3-300 days
Task 4-330 days
Task 5-420 days
Task 6-1205 days
Task 7-1265 days
2. The additional time needed was unknown until the GMP for the construction portion of this work was awarded.
3. If this change order is not approved, the design team will not be available during the construction phase as required.
RygielTimothy Digitally signed by RygielTimothy
Prepared by: Date: 2024.01.10 12:11:31 -05'00'
Date:
Tim Rygiel-PMP, CFM, Project Manager III, Facilities Management
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.
Digitally signed by Kevm I Gntfith
Kevin T Griffith DN c-US o-Florida.dnaballfiur-A01 4 1 00000001 86E1D05bACce01ID59,
cn=Kem T Griffith
Accepted by: Dare zoze.ol.11 11 z147-esoo Date:
K.Todd Griffith, PE,SVP-Director of SWFL Division, Matern Professional Engineering, Inc.
M eCo rm i ckJ o h n Digitally signed by McCormickJohn
Date: 2024.01.11 11:47:40 -05'00'
Approved by:-_-.- _...-_._ Date:
John McCormick, PE, Division Director, Facilities Management
McNealLindsey Digitally signed by McNealLindsey
Approved by: _ Date: 2024.01.23 14:25:31 -05'00' Date:
(Procurement Professional)
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin aRpC BCC ES
16F6 }—
ATTFST: BOARD OF COUNTY COMMISSIONERS
Crystal K. Kinzel, Clerk of Courts COLLIER COUNTY, FLORIDA
& ComptrollFi:
y1 ` Ch a , Chairman
Diced ° , 1`J '--b-as-to-Chaim-Ian's
(SEAL)",,,,,"signature only.
v i,
Appro as o ffot an alit
r).t.Q yy�/ _County Attorney
A/.i!'
1
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) _ PROCUREMENT USE ONLY
Admin � BCC ES
16F6
Change Order/Amendment Summary
COST TIME
CO# AMD# Description Days New Justification
Additive(+) Deductive(-) Added Amount
1 Revised Schedule To reflect the employees
F added/removed from the project.
Added 120 days
1 and utilized 120 840 Estimated construction costs
$125,659.20 of the dictated amended design direction.
Contingency
Revised Schedule To include the scope for Task 9—
2 A, B, 8.2.1,and C $86,578.40 Building K Flood Proofing.
to include Task 9.
If this change order is not
2 Adds 425 days to 425 1,265 approved,the design team will not
the contract be available during the construction
phase as required.
•
•
•
•
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) _ PROCUREMENT USE ONLY
Admin BCC
BCC ES