Backup Documents 12/10/2024 Item #16C 7 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 C 7
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 Count+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#I through#2,complete the checklist,and forward to the Coun Attorney Office.
iRoute to Addressees)(List in routing order) Office I Initials Date
i.
2. r--
3. County Attorney Office County Attorney Office
- /2-/ )'''))11)2j4i
4. BCC Office Board of County
_ Commissioners s":-t�{�y 743 f5I 12i'Lo'Z t(
5. Minutes and Records Clerk of Court's Office `
14(4-/ t
PRIMARY CONTACT INFORMATI
ON ,,/et{A-
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact informat ne in the event one.of the
addressees above,may need to contact staff for additional or missing information.P(4a\ j f , u,,i,,,,,,ii L;�( u? ti Wit)it)
Name of Primary Staff Phone Number I
Contact/ Department ak.,,,,,(-,,:- -tu. Q tclliy� .0(7i)- 1. `-'J 2 j-2.�'Z—{�Z''9
Agenda Date Item was
g � Agenda Item Number �
. Approved by the BCC 12.-10-2.O2_4 ('2021-) - 1(103 ,(c,. C. ,
Type of Document Number of Original
Attached 7 + .&)O 41? -\—'' mac Documents Attached .'ii' I r
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)
I. Does the document require the chairman's original signature?
2. Does the document need to be sent to another agency for additional signatures? If yes,
provide the Contact Information(Name; Agency;Address; Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by 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's
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
si•nature and initials are re.aired.
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 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 our deadlines!
8. The document was approved by the BCC on to and all changes made during ; N/A is not _
the meeting have been incorporated in the attached document. The County 5/211„0 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 , i N/A is not '
BCC,all changes directed by the BCC have been made,and the document is ready for the . -ii�n an option for
Chairman's signature. this line.
I: Fonns/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
16C7
WORK ORDER/PURCHASE ORDER
Contract#20-7800 "UNDERGROUND CONTRACTOR SERVICES"
Contract Expiration Date: June 21,2026
This Work Order is for professional contractual services for work known as:
Project Name: PS 309.23 Rehabilitation
Project No: 70141.9,70141.10, 70141.11.
The work is specified in the proposal dated September 17,2024,which is attached hereto and made a
part of this Work Order. In accordance with Terms and Conditions of the Agreement referenced above,
this Work Order/Purchase Order is assigned to:DOUGLAS N HIGGINS INC.
Scope of Work: As detailed in the attached proposal and the following:
* Task I -70141.10 General Conditions (Bid Items 1-4)
* Task II-70141.9 Demolition(Bid Items 5-8)
* Task III - 70141.10 Pump Station (Bid Items 9-22)
* Task IV-70141.10 Site Work(Bid Items 23, 25, and 26)
* Task V -70141.11 Site Work(Bid Item 24- Site Fence & Gates)
* Task VI -70141.10 Owner's Allowance
Schedule of Work: Complete work within 580 days from the date of the Notice to Proceed which is
accompanying this Work Order. The Consultant agrees that any Work Order that extends beyond the
expiration date of Agreement# 20-7800 will survive and remain subject to the terms and conditions of
that Agreement until the completion or termination of this Work Order.
Compensation: In accordance with the Agreement referenced above, the County will compensate the
Firm in accordance with following method(s): ®Negotiated Lump Sum (NLS) ❑Lump Sum Plus
Reimbursable Costs(LS+RC) ZTime&Material(T&M) _Cost Plus Fixed Fee(CPFF),as provided
in the attached proposal.
Task I $110,000.00 (NLS)
Task II $51,000.00 (NLS)
Task III $454,000.00 (NLS)
Task IV $101,043.00 (NLS)
Task V $36,000.00 (NLS)
Task VI $80,000.00 (T&M)
TOTAL FEE $832,043.00
Page 1 of 3
Digitally signed by DeltoroZamira
UN.E=Zamira.Deltoro@colliercountyll.gov,
D e I to rota m i ra CN=DeltoroZamira,OU=General,OU=PPM User
Accounts,OUPUD Planning and Projec[Manageent,
OUPUD,O =Divisions,DCbcc.DC=colliergov,
7��'` 7� DC=net
PREPARED r,D BY: Date:2024.10.1511:53:26-04'00'
Zamira Deltoro,Project Manager III Date
Engineering & Project Management KLA 9/30/24
oaneny,ignaa by Fanermnsnn�
oN:e•sno�Fanenrn(�mniarcnvmyll.gov.
CN=FcnEricnSM1on,OU=General,OU=PPM User
FandrichShon M a�°�o°�Ip°oeo�°eOr:Z=�
DC=Whergov,DC=net
APPROVED BY: 0.i2020'0
'8
0
61023-
04
0
0
'
Shon Fandrich,P.E., Supervisor Date
Engineering&Project Management
Dgitally signed by McLeanMatthew
DN'.E=Matthew.MCLeanicolllercountyll.gov,
McLean MatthewZ'onSOUaPUDPlanigand4=tPMa gamenl,
Ou=Fun,DU=Divisions,DC=bcc,DC=colliergov,DC=net
APPROVEDBY: Date'2024.10.1810:47:06-04'00'
Matthew McLean, P.E., Director Date
Engineering &Project Management Director
Digitally signed by
VonHolleRobert VonHolleRobert
APPROVED BY: Date:2024.10.21 09:45:41-04'00'
Robert Von Holle, Wastewater Director Date
BelloneJoseph Digitally signed by BelloneJoseph
Date:2024.10.22 10:38:24-04'00'
APPROVED BY:
Joseph Bellone, Division Director-Utilities Finance Date
YilmazGeorg Digitally signed by
YilmazGeorge
APPROVED BY: e Date:2024.10.28 11:41:51
Dr. George Yilmaz, Public afiges Department Head Date
By the signature below, the Firm (including employees, officers and/or agents) certifies, and hereby
discloses, that, to the best of their knowledge and belief, all relevant facts concerning past, present, or
currently planned interest or activity(financial,contractual,organizational,or otherwise)which relates
to the proposed work; and bear on whether the Firm has a potential conflict have been fully disclosed.
Additionally,the Firm agrees to notify the Procurement Director,in writing within 48 hours of learning
of any actual or potential conflict of interest that arises during the Work Order and/or project duration.
ACCEPTED BY: Douglas N. l;fig
j
aniel Higg ns.President Date
(Remainder of page intentionally left blank)
Page 2 of 3
16C7
IN WITNESS WHEREOF,the parties hereto,have each,respectively,by an authorized person or
agent,have executed this Work Order on the date and year first written below.
ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal`IC.iCixizel,,clerk of Courts COLLIER C TY,FLORIDA
BU aj• F/v
Chris all, Chairman
Dated: / t
(SEAL) Attest as to Chairman's
signature onty. Name of Firm Dou N. Hi 'ins.Inc.
< ,4 c` '~ By:.
First Witness gnature
aSoLl"., Daniel Higgins. President
TType/print witness nameT TType/print signature and titleT
Second Wit] ess ,,t
T"1'ypc/print witness nameT
A•: ov:. as to Fo an Legality:
De. ty County Attorney
Print ame
Page 3 of 3
16C7
Exhibit C-1
Li this exhibit is not applicable
PUBLIC PAYMENT BOND
Bond No. 35BCSAQ4439
Contract No.
KNOW ALL MEN BY THESE PRESENTS: That Douglas N. Higgins,Inc. as
Principal, and Hartford Accident and Indemnity Company , as Surety, located at
One Hartford Plaza Hartford, CT 06115 (Business Address) are held and firmly bound
t0 Collier County Board of County Commissioner Oblige in the sum of Eight Hundred Thirty-Two Thousand Forty-Three Dollars
($ 832,043.00 ) for the payment whereof we bind ourselves, our heirs, executors, personal
representatives, successors and assigns, jointly and severally.
WHEREAS, Principal has entered into a contract dated as of the 10day of December 2024
with Oblige for Collier County Public Utilities Pump Station 309.23 Rehabilitation
in accordance with
drawings and specifications, which contract is incorporated by reference and made a part hereof, and
is referred to as the Contract.
THE CONDITION OF THIS BOND is that if Principal:
Promptly makes payment to all claimants as defined in Section 255.05(1), Florida Statutes,
supplying Principal with labor, materials or supplies, used directly or indirectly by Principal in the
prosecution of the work provided for in the contract, then this bond is void; otherwise it remains in full
force.
Any changes in or under the Contract and compliance or noncompliance with any formalities
connected with the Contract or the changes do not affect sureties' obligation under this Bond.
The provisions of this bond are subject to the time limitations of Section 255.0592. In no event
will the Surety be liable in the aggregate to claimants for more than the penal sum of this Payment
Bond, regardless of the number of suits that may be filed by claimants.
IN WITNESS WHEREOF, the above parties have executed this instrument this 26th day of
September , 20 24, the name of under-signed representative, pursuant to authority of its governing
body.
Page 19 of 33
Multi-Contractor Award Agreement[2021_ver.11
16C7
Signed, sealed and delivered
in the presence qf: PRINCIPAL:
DOULGAS N. HIGGINS,INC.
/
By:
Witnesses as to Principal Name: Kelly A.'11�ilkie
its: Vice-President
STATE OF Florida
COUNTY OF Collier
The foregoing instrument was acknowledged before me by means of ® physical presence or 0 online
notarization, this 26th of September 2024 by Kelly A.Wilkie as Vice-President
of Douglas N.Higgins,Inc. a Michigan corporation, on behalf of the corporation.
He/she is personally known to me OR has produced personally known
as identification and did (did not) take an oath.
My Commission Expires: 12/02/2025 ,Ot.t Pf'11�( (; �,1l�Cct'
(Signature of Notary Public Stag of Florida)
y:s e¢ c, TAMARA JO LUDWIG t
MY COMMISSION#HH 167476 ` Name: Tamara J.Ludwig
;�' .t (Legibly Printed)
:,��,,,���� EXPIRES:December2,201.5
° F�$• Bonded Thru Notary Public Underwriters
AIININOSATIM
(AFFIX OFFICIAL SEAL) Notary Public, State of Florida
HH167476
Commission No.:
ATTEST: SURETY:
Hartford Accident and Indemnity Company
(Printed Name)
(Business Address)
(Authorized Signature)
Witness as to Surety
(Printed Name)
OR
Page 20 of 33
Multi-Contractor Award Agreement(2021_ver.1)
16C7
Ryan Fr ley As Attorney in Fact
• t L; jAttach Power of Attorney)
Witnesses Thomas ; One Hartford Plaza _
Hartford, CT •.
(Business Address)
Theresa J Foley, Attorney-In-Fact
(Printed Name)
567-318-3843
(Telephone Number)
STATE OF Florida
COUNTY OF Collier
The foregoing instrument was acknowledged before me by means of ll physical presence or 0 online
notarization, this 26th of September 2024 , by Theresa J.Foley as attorney-in-fact
of Hartford Accident and Indemnity,Go. Connecticut corporation, on behalf of the corporation.
He/she is personally known to me OR has produced personally known
as identification and did (did not)take an oath.
My Commission Expires: 12/02/2025 ,f(L°i}1 4C-s � , .
(Signature of Notary Pr blic Stat9' f Florida)
TAMARAJO Lt1DWIG Name: Tamara J.Ludwig
i*f• `ti MYCOMMISSION#Hh1167476 (Legibly Printed)
EXPIRES:December 2,2025
( rkgi3OFFIteRtAILE1liSkAiOubilcUridepariters
Notary Public, State of Florida
Commission No.: HH167476
Page 21 of 33
Multi-Contractor Award Agreement[2021_ver.11
1 6 C 7
[_f this exhibit is not applicable
EXHIBIT C.2
PUBLIC PERFORMANCE BOND
Bond No. 35BCSAQ4439
Contract No.
KNOW ALL MEN BY THESE PRESENTS: That Douglas N.Higgins,Inc.
as Principal, and Hartford Accident and Indemnity Company
as Surety, located at One Hartford Plaza Hartford,CT 06115
(Business Address) are held and firmly bound to Collier County Board of
County Commissioners as Oblige in the sum of Fight Hundred Thirty-Two Thousand Porty-Three Dollars
($ 832,043.00 )for the payment whereof we bond ourselves,our heirs,executors,
personal representatives, successors and assigns,jointly and severally.
WHEREAS, Principal has entered into a contract dated as of thel0day of December
2024 , with Oblige for Collier County Public Utilities Pump Station 309.23 Rehabilitation
in accordance with drawings and specifications, which contractor is incorporated by reference and made a pat
hereof, and is referred to as the Contract.
THE CONDITION OF THIS BOND is that if Principal:
1. Performs the Contract at the times and in the manner prescribed in the Contract, and
2. Pays Oblige any and all losses, damages, costs and attorneys' fees that Oblige sustains because of
any default by Principal under the Contract, including, but not limited to, all delay damages,whether
liquidated or actual, incurred by Oblige; and
3. Performs the guarantee of all work and materials furnished under the Contract for the time specified
in the Contract, then this bond is void; otherwise it remains in full force. Any changes in or under the
Contract and compliance or noncompliance with any formalities connected with the Contract or the
changes do not affect Sureties obligation under this bond.
The Surety, for value received, hereby stipulates and agrees that no changes, extensions of time,
alterations or additions to the terms of the Contract or other work to be performed hereunder,or the specifications
referred to therein shall in anywise affect its obligations under this bond, and it does hereby waive notice of any
such changes, extensions of time, alternations or additions to the terms of the Contract or to work or to the
specifications.
Page 22 of 33
Multi-Contractor Award Agreement[2021_ver.11
16C7
This instrument shall be construed in all respects as a common law bond. It is expressly understood that
the time provisions and statute of limitations under Section 255.05, Florida Statutes, shall not apply to this bond.
In no event will the Surety be liable in the aggregate to Oblige for more than the penal sum of this
Performance bond regardless of the number of suits that may be filed by Oblige.
IN WITNESS WHEREOF, the above parties have executed this instrument this 26th day of
September , 20 24 , the name of each party being affixed and these presents duly signed by its undersigned
representative, pursuant to authority of its governing body.
Signed, sealed an delivered
in the presence o "" PRINCIPAL:
/;.
___ • /
.� DOUGLAS N.HIGGINS,INC.
11.4-.'F+., ' .•-" By:
Witnesse as to Principal Name: Kelly A.Wilkie
Its: Vice-President
STATE OF Florida
COUNTY OF Collier
The foregoing instrument was acknowledged before me by means of® physical presence or❑ online
notarization, this 26th of September 20 24 by Kelly A.Wilkie as
Vice-President of Douglas N.Higgins,Inc. , a Michigan corporation, on behalf of the corporation.
He/she is personally known to me OR has produced personally known
as identification and did (did not) take an oath.
r
My Commission Expires: 12/02/2025 ,.._. ;111L1 c {'(,c' c
(Signature of Notary Ptlic-StateiFlorida)
Name: Tamara J.Ludwig
(Legibly Printed)
(AFFIX OFFICIAL SEAL) Florida
Notary Public, State of
""'"�'°°`""'.""""�""iu,
Commission No.:
HH 167476
q1sY"u�'•• TAMARA JO LUDWIG
,•' •a. MY COMMISSION Oi-NH 167476
°;;4: ;o", EXPIRES:December 2,2025 d
„w;;?, Bonded Tliru Notary Public UnderwriterslPt uy..- ,"
r.
Page 23 of 33
Multi-Contractor Award Agreement[2021_ver.1]
1 6 C 7
ATTEST: SURETY:
Hartford Accident and Indemnity Company
(Printed Name)
(Business Address)
(Authorized Signature)
Witness as to Surety
(Printed Name)
AT:i2V..-„(.
R Foley ' C As Attorney n Fact '
, ( t" _(Attach Power of Attorney) '
Witnesses Thr.,rr as J t-oiey One Hartford Plaza .,,_ ) (.,,,,,,
Hartford CT
(Business Address)
Theresa J Foley, Attorney-In-Fact
(Printed Name)
567-318-3843
(Telephone Number)
STATE OF Florida
COUNTY OF Collier
The foregoing instrument was acknowledged before me by means of it physical presence or 0 online
notarization, this 26th of September 2024 , by Theresa T.Foley , as Attorney-in-Fact
Of Hartford Accident and Indemnity pa. Connecticut corporation, on behalf of the corporation.
Me/she is personally known to me OR has produced personally known
as identification and did (did not)take an oath.
My Commission Expires: 12/02/2025 ,- 0.,.'i 1114.st -w.- ,A.,(it:l,"ce
(Signature of Notary public-Stat)of Florida)
Name: Tamara J.Ludwig
(Legibly Printed)
(AFFIX OFFICIAL SEAL)
Notary Public, State of Michigan
7aN1r�.: TAMARA JO LUDWIG
A m, ff '°;1 MY COMMISSION it NH167476 HH167476
" EXPIRES:December2,2025 Commission No.:
':$;or e i?,' Bonded Thru Notary Public Underwriters
Page 24 of 33
Multi-Contractor Award Agreement(2021_ver.1)
16C7
Direct inquiries/Claims to:
THE HARTFORD
POWER OF ATTORNEY BOND,T-11
One Flartford Plaza
Hartford,Connecticut 06155
call:868.266-3488 or fax:060.757-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: HYLANT GROUP INC/TROY
Agency Code: 3 5-3 5 1588
X Hartford Fire Insurance Company,a corporation duly organized under the laws of the State of Connecticut
X Hartford Casualty Insurance Company,a corporation duly organized under the laws of the State of Indiana
X Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut
Hartford Underwriters Insurance Company,a corporation duly organized under the laws of the State of Connecticut
Twin City Fire Insurance Company,a corporation duly organized under the laws of the State of Indiana
Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois
Hartford Insurance Company of the Midwest,a corporation duly organized under the laws of the State of Indiana
Hartford Insurance Company of the Southeast,a corporation duly organized under the laws of the State of Florida
having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the"Companies")do hereby make, constitute and appoint,
up to the amount of Unlimited :
Susan E. Hurd, Vicki S. Duncan, Theresa J. Foley, Nicholas R Hylant, Jennifer A.
Jarosz, Jamie Laurencelle, Saraya S. Nair, Kristie A. Pudvan, Judy K. Wilson, Kathy
S Zack of TROY, Michigan
their true and lawful Attorney(s)-in-Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies)only as
delineated above by a, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the
nature thereof,on behalf of the Companies in their business of guaranteeing the fidelity of persons,guaranteeing the performance of contracts and
executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on May 23, 2016 the Companies
have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant
Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are
and will be bound by any mechanically applied signatures applied to this Power of Attorney.
o
At .. +„tfl. ' -- Jef. •
t,
( r i ' ! i tea^�-i�lL 7-%0` //� }!C tea y r y ► I. :i F z L t i .l ;1
+Aloe r070f.� ( •tU 9`a \ r999 A'
`xqt, / J i1
Shelby Wiggins,Assistant Secretary Joelle L.LaPierre,Assistant Vice President
STATE OF FLORIDA
ss. Lake Mary
COUNTY OF SEMINOLE
On this 20th day of May,2021,before me personally came Joelle LaPierre,to me known,who being by me duly sworn,did depose and say:that
(s)he resides in Seminole County,State of Florida; that (s)he is the Assistant Vice President of the Companies, the corporations described in and which
executed the above instrument; that (s)he knows the seals of the said corporations;that the seals affixed to the said instrument are such corporate seals;
that they were so affixed by authority of the Boards of Directors of said corporations and that(s)he signed his/her name thereto by likeauthority.
• Jessica Ciccone
''»1-;; My Commission HH 122280
Expires June 20,2025
I,the undersigned,Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct
copy of the Power of Attorney executed by said Companies,which is still in full force effective as of September 26,2024 .
Signed and sealed in Lake Mary, Florida.
*rYO ' .. r`
�f 944,.0. ` Xg rt tr` WIRY � y c! na 2 ",!r
•
� y - r , a Da . fP,ANnlrtr `\ j °'
1:�A t
r 'tiAr q s � � P ys;/§ rV $1
q�I, ; \. 1I .0 '4 , � { l.;���� e \ 17a.
,
• Keith D.Dozois,Assistant Vice President
16C7
101
THE . '
HARTFORD
Hartford Accident and Indemnity Company
5445 Corporate Drive Suite 300
Troy,MI 48098
September 26, 2024
The Board of County Commissioners of Collier County, FL
3295 Tamiami Trail East
Suite C-2
Naples, FL 34112
RE: Douglas N. Higgins,Inc.
Project: Collier County Public Utilities Pump Station 309/23
Rehabilitation
Bond Number: 35BCSAQ4439
To Whom It May Concern:
Hartford Accident and Indemnity Company approves the request for the Owner, The Board of
County Commissioners of Collier County, FL to insert the Contract Date into the Public
Performance Bond and Public Payment Bond for the captioned.
Please contact me at (248) 822-6451 or tlrar1c.mu1yillecf:),theha=tfo d.cowi if you have any
questions.
Sincerely,
Mark J, Mulville, CPCU
Executive Underwriter
Hartford Accident and Indemnity Company