Backup Documents 03/26/2024 Item #16F 3 ORIGINAL DOCUMENTS CHECKLIST& ROUTING SLIP 1 6 F 3 .
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. County Attorneys Office County Attorney Office V.7 /Jz 1��?
2. BCC Office Board of County Commissioners Chairman
3. Minutes and Records Clerk of Court's Office .�/ •��/ 1y 44
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 March 26,2024 Agenda Item
Approved by the BCC Number 16.F.3
Type of Document Approve Change Order No. 1 for a 180-day Number of
Attached time extension for the Collier County Jail Original
Fire Alarm Replacement" project under Documents
Agreement No. 22-8018 with National Attached
Security Fire Alarm Systems, LLC
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)
I. 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 March 26,2024,and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County w.l,,6 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 I ,�-! !fl 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
1 6 F 3
CO#1er Ci01411ty Procurement Services
Change Order Form
El Contract Modification L Work Order Modification
Contract#: 22-8018 Change#:ri Purchase Order#: 4500223988 Project#: 50237.1
Contractor/Firm Name: National Security Fire Alarm Systems,LLC Contract/Project: Collier County Jail Fire Alarm Replacement
Project Manager Name: Tim Rygiel Division Name: Facilities Management
Original Contract/Work Order Amount $ 1,671,000.00 2/28/23 16C3 Original BCC Approval Date; Agenda Item#
Current BCC Approved Amount $ 1,671,000.00 2/28/23 16C3 Last BCC Approval Date; Agenda Item#
Current Contract/Work Order Amount $ 1,671,000.00 6/1/2024 SAP Contract Expiration Date (Master)
Dollar Amount of this Change 0.00% Total Change from Original Amount
Revised Contract/Work Order Total $ 1,671,000.00 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 4.3-2023 Original 6-1-2024 Last Approved 6-1-2024 Revised Date 11-28-2024
Date — Completion Date Date (Includes this change)
#of Days Added 180 Select Tasks ❑Add new task(s) ❑Delete task(s) Li 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 1
if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed,
1. This change order will add 180 days to the contract time providing a new substantial completion date of 10/29/2024.
2. During shop drawing review, Greater Naples Fire Department alerted us to an egress issue at the Jail Complex.This issue is
indirectly related to the Fire Alarm System and requires additional work that will need to be resolved prior to approval of the new
Fire Alarm System by the Greater Naples Fire inspector.
3. If this change is not approved, the Fire Department inspections required for the new alarm system will not be approved and the
project will not be completed.
Ryg i e I T i m oth y Digitally signed by RygielTimothy
Prepared by: Date: 2024.02.26 09:39:17 -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.
OglaNl nd byCbl,uyr.N'n*A
ou,ur-cnau,e•.nwn.,.o.uaNwe,,d,cw.na.r..�,.;w.w...� .u..c-ur
Christopher Morra Jr0onI,n,$a, 202000 nn1 ,
•
Accepted by: pnb]DUAL].,19',aW00
Godl P92 922 Vn099TD1 C Date:
Christopher Morra, President, National Security Fire Alarm Systems,LLC
VICTOR J. LATAVISH ARCHITECT Digitally
Iitallys402d2 yvic-ro J. OTAVISHARCHITECT
Accepted by Date:
Victor J. Latavish,Architect,PA
M cCo rm i ckJ oh n Digitally signed by,McConmickJohn
Approved by: Date: 2024.03.01 11:08:03-05'00' Date:
John McCormick,PE, Division Director,Facilities Management . ..
McNeal Lindsey Digitally signed by McNealLindsey
Approved by: 1 Date:2024.03.07 08'37:25-05'00' ' Date:
(Procurement Professional) .
Revised:01/14/2021 (Divisions who may require additional signatures may Include on separate sheet.) __PRocurseMENT USE ONLY
Adrnln RP°'f ecc ES
16F 3
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K. KlaiprCplyirCourts COLLIER C U TY, FLORIDA
&Comptg,ler. '
1
By 4'V k* By:
ris Hall. Chairman
111 03-tt-
(SEMI) g4,ils to C airman's
Lig_sIgnature only
Appro as to form an e ali
By:
Scott R. Teach
Deputy County Attorney
16F 3
Change Order/Amendment Summary
_ COST TIME
CO# AMD# Description —`"`— Days New Justification
Additive(+) Deductive(-) Added Amount
During shop drawing review,
Greater Naples Fire Department
Adds 180 days alerted us to an egress issue at the
providing a new Jail Complex.This Issue is
1 substantial 180 605 indirectly related to the Fire Alarm
completion date of System and requires additional
10/29/2024 work that will need to be resolved
prior to approval of the new Fire
Alarm System by the Greater
Naples Fire Inspector,
Revised:01/1412021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Attmin 1 BCC [BCC ES