Backup Documents 02/27/2024 Item #16F 4 ORIGINAL DOCUMENTS CHECKLIST& ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 F 4
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 �Q -/ �,�a1
2. BCC Office Board of County Commissioners Chairman �1
C7r/Sf, 127 N
3. Minutes and Records Clerk of Court's Office / 9:56
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 dditional 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 27,2024 Agenda Item
Approved by the BCC Number 16.F.4
Type of Document Approve administrative Change Order No. Number of
Attached 5 for a 30-day time extension under Collier Original 1
County Jail Laundry Renovation Documents
Agreement No.22-7959R with OneSource Attached
Construction Company & Builders, Inc.
(Project No. 50185)
PO number or account The Facilities Division is requesting a
number if the document completed copy
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? 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. re
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 27,2024,and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County cer an option for
Attorney's Office has reviewed the changes,if applicable. this lne.
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 c1c,J,j, an option for
Chairman's signature. JK, 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
16F4
Procurement Services
Co i r C014.11tY Change Order Form
®Contract Modification ❑Work Order Modification
Contract#: 22-7959R Change#: 05 Purchase Order#: 4500221922 Project#: 50185
Contractor/Firm Name: OneSource Construction Company& Contract/Project: Collier County Jail Laundry Renovation
Builders. Inc.
Project Manager Name: Olivier Sureau, PMP Division Name: Facilities Management
Original Contract/Work Order Amount $ 2,094,550.00 9-13-22 11D Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount $ 2,094,550.007 9-13-22 11D Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount $ 2,094,550.00 6/15/2024 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount
Revised Contract/Work Order Total ( $ 2,094,550.00 0.00% Change from Current BCC Approved Amount
Cumulative Changes J $ 0.00 0.00% Chan e from Current Amount
Completion Date, Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed 11-29-2022 Original 5-22-2024 Last Approved 6-15-2024 Revised Date 7-15-2024
Date Completion Date Date (Includes this change)
#of Days Added 30 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 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.
1. This change order will add 30 days extending the substantial completion date from 2/16/2024 to 3/17/2024.The additional time is required to
complete Phase 2 due to underground conditions found during Phase 1 which dictated relocation of the new lint interceptor.
2. These changes were not included in the original contract as the underground conditions were unknown at the time the project was bid.
3. If this change order is not processed,the contractor will not be able complete phase 2 of the project prior to the current substantial completion date.
SureauOlivier Digitally signed by SureauOlivier
Prepared by: Date: 2024.01.12 15:47:35 -05'00' Date:
Olivier Sureau, PMP Senior Project Manager, Facilities Management 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/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.
George Chauvin Digitally signed by George Chauvin
Accepted by: Date: 2024.01.23 09:33:59 -05'00' Date:
OneSource Construction Company&Builders, Inc.
n Digitally signed by Marc Lean
Reason:I have reviewed this document
< .
Accepted by: / � �-*�-- Date:2024.01.24 10:31:06-05'00' Date:
Stantec Consulting Services, Inc.
McCormickJohn Digitally signed by McCormickJohn
Approved by. Date: 2024.01.24 11:31:19 -05'00' Date:
John McCormick, P.E. Division Director, Facilties Management
McNealLindsey Digitally signed by McNealLindsey
Approved by Date: 2024.01.25 07:30:25 -05'00' Date:
(Procurement Professional)
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admin Rpt BCC ES
1 6 F 4 •
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K. Kinit
itr ''of Courts COLLIER OUNTY,FLORIDA
&Com• v f
By: �` By
:A kris Hall, Chairman
Dated: J_ ' 4.c/
(SE tt-),A -sfas_ • ai ans
,'signature only
Ap oved as to f /11 lity:
By:
Scott R. Teach
Deputy County Attorney
116110
Allike
16F4
Change Order/Amendment Summary
COST TIME
CO# AMD# Description Additive(+) Deductive(-) Days New Justification
Added Amount
Uses Allowance for If this change order is not processed it
in the amount would not have the appliances
1 WD#1
of$18,106.98inthenecessary for the operation of the
laundry.
Uses Allowance for If this change order is not processed
WD#3 and#5 in the there would not be working security,
2 of ! fire,and gas detection systems,which
amount
$108,331.49amount ofis necessary for the health and security
of the staff and inmates.
If this change order is not processed the
demolition differences between the
Uses Allowance for contract plans and on-site conditions
3 WD#2 and#4 in the will not be implemented,the laundry
amount of services for the jail would be interrupted
$30,854.01 during the transition of laundry facilities,
and consequently a functional new
laundry facility would not be provided.
If this change order is not processed,
there will be no air conditioning provided
Uses Allowance for to the new phase 2 offices,CCSO will
4 WD#6 in the amount be unable to operate the laundry per
of$16,849.52 their policy,and vibration from the
dryers will transfer to the Sheriff's office
space.
If this change order is not processed,
5 Adds 30 days to the 30 570 the contractor will not be able complete
contract time phase 2 of the project prior to the
current substantial completion date.
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Adman Rpt BCC ES