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Backup Documents 03/12/2024 Item #16C2 16 02 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 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 routing lines#1 through#2,complete the checklist,and forward to the County Attomey Office. Route to Addressee(s)(List in routing order) Office Initials Date 2. 3. County Attorney Office County Attorney Office ' 2 „ �`�[ 4. BCC Office Board of County / // Commissioners, G / 3/L3/2`/ 5. Minutes and Records Clerk of Court's Office // ( / (! i‘15/ 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 Liz Gosselin/PUD-EPMD Phone Number 239-252-1037 Contact/Department Agenda Date Item was 03/12/2024 Agenda Item Number 16.C.2 Approved by the BCC Type of Document(s) Change Order Number of Original 1 Attached Documents Attached PO number or account 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(instead of stamp)? L.G. 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 L.G 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 L.G. 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 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 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 03/12/2024 and all changes made during L.G. N/A is not the meeting have been incorporated in the attached document. The County Attorney an option for Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the L.G. BCC,all changes directed by the BCC have been made,and the document is ready for the ari op i n r Chairman's signature. this line. I: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 16C2 Procurement Services _ © tTer Cox'inty Change Order Form 4.1 Contract Modification 0 Work Order Modification Contract#: 23-8058 Change#1 3 1 Purchase Order#: 4500224424 Project#: 70253.6 Contractor/Firm Name: Accurate Drilling Services,Inc. ContractIProject: Golden Gate City Transmission Water Main Improvements—Phase 1A—Golf Course Project Manager Name: Liz Gosselin Division Name: Engineering and Project Management Original Contract/Work Order Amount $ 4,008,590.00 03/28/23, 11.A Original BCC Approval Date; Agenda Item# Current BCC Approved Amount $ 4,008,590.0d N/A Last BCC Approval Date;Agenda item# Current Contract/Work Order Amount $ 4,008,590.00 1/4/2024 SAP Contract Expiration Date(Master) Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount Revised ContractWWork Order Total $ 4,008,590,00 0.00% Change from Current BCC Approved Amount Cumulative Changes $ 0.00 0.00% Change from Current Amount Completion Date,Description of the Task(s)Change,and Rationale for the Change Notice to Proceed 08/07/2023 Original 01/04/2024 Last Approved 04/05/2024 Revised Date 05/06f2024 Date Completion Date Date (includes this change #of Days Added 30 Select Tasks 0 Add new task(s) Q Delete task(s) ❑Change task(s) ►i1 Other This change order is to add contract time due to re-scheduling the connection to the existing 36-inch transmission water main.This change order will add 30 days to the contract time, The substantial completion date will also be extended another 30 days after the resume work letter is issued. The new substantial completion date will be April 5,2024, 1, Detailed and specific expianatlonlratlonale of the requested change(s)to the task(s)and I or the additional days added(if requested. This change order is to add contract time to accommodate the re-scheduling of the connection to the existing 36-inch transmission water main. The contractor was asked to re-schedule the connection to the existing 36-inch transmission water main due to unforeseen issues with the County's Water System. The additional time was needed to confirm that operations of the regional water system would maintain at normal operating levels during this 5-day shutdown 2. Why this change was not included in the original contract. The County nor the contractor anticipated any issues with the existing regional water system.These unforeseen Issues temporarily delayed the contractor from connecting to the existing 36-Inch transmission water main. 3. Describe the impact If this change is not processed. Adding the time will confirm that normal water operations will remain after shutting down this segment of 36-inch transmission water main for 5 days and will allow the contractor to accommodate a new date to connect to the existing 36-inch transmission water main and to complete the project within the contract timeframe. Revised.01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY Admin BCC eCC ES 16C2 • DWa9'dY df b]Gws.b,u2 DU,C�ik(ka.,dtr.[.'�r�`M'�4.SNMmsdrib.W+fim++1, Gosse linLiz W.D9NU,uNm+ReDU.PoyD ==4,,VWe+sAM^Wem.M. w 1Yl0ra 41111204.59.1,02W OG d1"4 OCn Date: Prepared by: .-_ .m - -- Liz Gosselin,Project Manager II,Engineering and Project Management Division KLA 2/12/2024 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 1 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 i Vendor I Consultant i Design Professional arising out of or related to the change set forth herein,Including claims for Impact and delay costs. Accepted by: - Date: ( /.//L/ Mario Acevedo,President,Accurate Drilling Services,Inc. Michael S Dickey Digitally signed by Michael S Dickey Accepted by: y Date:2024.02.12 10:10:15-05'00' Date: Michael S.Dickey,P.E.,Engineer of Record,Johnson Engineering,inc. ,'2gwdly Orel by OdertO.Namon (N1 f•W nd`M,I rtvun4 oyanwt oa d gar,CNrtl PUNMry , BullertBenjamin �roDC AUno L DU•PUD nU DUs1ms.DC lr [N:-ni... UC , Approved by: °" 0)d02+2,20200-0 D0 Date: Benjamin N.Bulled,Supervisor,Engineering and Project Management Division Q4 Y A"eE by h,a h,.,ttLv ���{{{ 1 DN E M tl WNA,NC0 D*TCOU',rye yo CN.+MCLea Satdwu. McLean tth e' Af G U00000U r <wMA 0C PR Fls q Proia, L C Q VfA V h ,OU 00 , Aac m. nG 01)fma,D* ynd DGreI Approved by:_ Ddk 202 02.1212,4200500' Date: Matthew McLean,Division Director,Engineering and Project Management Division M cN ea l L n d sey Digitally signed by McNealLindsey Date:2024,02.13 12:37:14-05'00' Date: Approved by: Procurement Services Division Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY Ad min ply BCC ES S 16 �� C 2 Change Order/Amendment Summary _ — oouT TIME - - o0ft Amo8 Description on Days New Justification Additive Deductive H �ddvu Amount ------- — The allowance ix necessary to nmerNocost ofoddiUvn�wv�. UnauY�|n*oncn and�oagUUmna|days a� �ndx-Puy\�m Nv.38 $O0O �oOO 45 �g5 nnx*s»aywa|vwc*macmrm 1 AddK|nnuf4 �ays ' � �"|sohopmjcmt. - to contract Total Romaininn Allowance after co#11:=S^221.;.24825 =($300�,OO.V0'$7O.7s1Jo) _ -- -- -- Thuountramorha»onmmomred extensive difficulties|nthe construction of this project and Addition vfnodays °mkoUha�mnvamomnthem. z to contract. $0.00 $U.U» »O 2z» Adding the time will allow the contractor mhv able mcomplete the project within the contract Umvfraxno. The contractor noouod to re- schedule the connection to the Addition p/nndays existing 3O-|nch transmission water o to contract, $O�o $O�oo 30 usS mainounmun�pmeen|xvunx~im ' the coun,y'u Water System. � ! ,w�uv��`mavwu ���:o«1��1 (ow��w�m���mmmm�a/�m��nsm�m*««w���a sheet.) °m1, o# ocuES 16C2 ATTEST: BOARD OF COUNTY COMMISSIONERS Crystal K. Ki el:TClr. : _ ourts COLLIER COUNTY, FLORIDA ::iii `'`, B Dated: A*1161( I' / ac �;. Chris H , Chairman (S . L)- . e astO:plairman's ?iature only Appro forma gal : By: ,-.(2____ `>.e County Attorney Styli— Q. ele k 1 it C/0' Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY Admin R BCC ES