Backup Documents 05/14/2024 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 Attorney's Office County Attorney Office / 521 /9 ]
2. BCC Office Board of County Commissioners Chairman [[
3. Minutes and Records Clerk of Court's Office / (
4
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(a,colliercountyfl.gov
Agenda Date Item was May 14,2024 Agenda Item
Approved by the BCC Number 16.F.3
Type of Document Change Order No.2,adding 21 days and Number of
Attached utilizing$14,780 of the owner's allowance for Original 1
Purchase Order No.4500229425 under Documents
Agreement No.23-8147 with Quality Attached
Enterprises USA,Inc.,for the"Big Corkscrew
Island Regional Park Phase 2A Access Road,"
and authorize the Chairman to sign the
attached Change Order.(Project No.80039)
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.
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 May 14,2024_and all changes made during the N/A is not
meeting have been incorporated in the attached document. The County Attorney's an option for
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 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
16F 3 4
Procurement Services
CD 70YOLlY11;�' Change Order Form
®Contract Modification ❑Work Order Modification
Contract#: 23-8147 Change#: 2 Purchase Order#: 4500229425 Project#: 80039/70194
Contractor/Firm Name: Quality Enterprises USA, Inc. Contract/Project: BCIRP Phase 2A Access Road
Project Manager Name: James Morton Division Name: Facilities Management
Original Contract/Work Order Amount S 9,028,810.55 11/14/23 11C Original BCC Approval Date; Agenda Item #
Current BCC Approved Amount $ 9,028,810.55'1 11/14/23 11C Last BCC Approval Date; Agenda Item #
Current Contract/Work Order Amount $ 7,648,252.56 9/18/2024 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 -15.29% Total Change from Original Amount
Revised Contract/Work Order Total $ 7,648,252.56 -15.29% Change from Current BCC Apprmed Amount
Cumulative Changes $ (1,380,557.99) 0.00% Change from Current Amount
Completion Date, Description of the Task(s)Change, and Rationale for the Change
Notice to Proceed 1/22/2024 Original 9/18/2024 Last Approved 9/18/2024 Revised Date 10/9/2024
Date Completion Date Date (Includes this change)
#of Days Added 21 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/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 21 days and utilize$14,780.00 of the Owners Allowance, leaving a balance of$382,785.55 for WD
#2 issued to abandon the existing irrigation well.
2. This change was not anticipated because the necessity for the contractor to have to plug an abandoned existing 6 inch well on
the property was not known at the start of the project. Previous expectations were that the previous property owner would
remove all encumbrances, but the negotiated agreement with the property owner excludes responsibility regarding the well.
3. If this is not processed,the existing irrigation well on the property would remain in the way of the road construction and the
project could not be completed.
BaroneTony Digitally signed by BaroneTony
Prepared by:
Date: 2024.03.21 18:10:11 -04'00' Date:
Tony Barone, PMP, Supervisor Project Management, 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.
Lou Gaudio Digitally signed by Lou Gaudio
Accepted by: Date: 2024.03.22 15:01:56 -04'00' Date:
Louis J.Gaudio, Vice President, Quality Enterprises USA, Inc.
Michael J. Delate P.E. Digitally signed by Michael J. Delate, P.E.
Accepted by: Date: 2024.03.22 09:01:47 -04'00' Date:
Michael Delate, PE, Q. Grady Minor&Associates, P.A.
M cCo rm i ckJ o h n Digitally signed by McCormickJohn
Approved by: Date: 2024.03.22 15:16:22 -04'00' Date:
John McCormick, PE, Division Director, Facilities Management
ZImmermanBecca Digitally signed by ZimmermanBecca
Approved by: Date: 2024.04.11 15:24:53-04'00' Date:
(Procurement Professional)
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
\___ ;� — Admin RPM BCC ES
16F 3
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K. Kinzel,CWriz of Courts COLLIER U TY, FLORIDA
& mptrgiler.
By: By:
Chris Hall, Chairman
Dated:
,4f i* n s
r_.
star .ure only
Appr ed s to form I ality:
By:
Scott R. Teach
Deputy County Attorney
41
GAO
16F 3
Change Order/Amendment Summary
COST TIME
CO# AMD# Description Days New Justification
Additive(+) Deductive (-) Added Amount
DMP of drainage To provide a cost savings to the
1 and utility $(1,380,557.99) County in the amount of
materials $78,144.78.
Adds 21 days and To abandon the existing irrigation
uses allowance for well. If the existing irrigation well on
2 WD#2. 21 261 the property would remain, it would
$397,565.55- be in the way of the road
$14,780.00= construction and the project could
$382,785.55 not be completed.
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) \ PROCUREMENT USE ONLY
AQ Admin BCC
BCC ES