Backup Documents 01/14/2025 Item #16B 7 16B7
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 routinglines#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' JAMIE KHAWAJA Transportation Engineering Khaw0j0 01/15/2025
2.
3. County Attorney Office County Attorney Office
111"—S
4. BCC Office Board of County
Commissioners 55gl j J ,' 5
5. Minutes and Records Clerk of Court's Office
/7 0
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 JAMIE KHAWAJA Phone Number 239-253-0354
Contact/Department
Agenda Date Item was 01/14/2025 Agenda Item Number 16.B.7
Approved by the BCC
Type of Document(s) Change order#2 for 60198 Number of Original 1
Attached Documents Attached
PO number or account
number if document is 4500226165
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 signature?(stamped unless otherwise stated) JAK U
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 legality. (All documents to be signed by
the Chairman,with the exception of most letters,must be reviewed and signed by the 7 JAK ❑
Office of the County Attorney.)
4. All handwritten strike-through and revisions have been initialed by the County Attorney ❑
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 �/ JAK ❑
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's71 JAK ❑
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 1/14/25 and all changes made during ^� ,is not
the meeting have been incorporated in the attached document. The County Attorney V I JAK 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 t N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the ✓17v 1 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;2.24.05;11/30/12;4/22/16;9/10/21
16B7GoIr +
�r CoHrii;y Procurement Services Change Order Form
Contract# 23-8099 CO#02 PO# 4500226165 Project#: 60198
Project Name: Veterans Memorial Blvd Phase 1 -Noise Barrier Wall Imperial Golf Estates
Contractor/Consultant Name: Coastal Concrete Products LLC
Select One:(]Contract Modification(Construction or Project Specific) ❑Work Order Modification
Project Manager Name: Jamie Khawaja Division Name: Transportation Engineering
Original Contract/Work Order Amount 1941993.75 08/22/2023:16-B 3 Original BCC Approval Date;Agenda Item#
Current BCC Approved Amount 1941993.75 10'22/2024.16 B 22 Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount — 1941993.75 05/06/2025 SAP Contract Expiration Date(MASTER)
Dollar Amount of this Change o.00 o Total%Change from Original Amount
Revised Contract/Work Order Total 1941993.75 0 %Change from Current BCC Approved Amount
Total Cumulative Changes o o %Change from Current Amount
Notice to Proceed 10106/2023 Original NTP 150 Original Final 03106/2024 Last Final 11/07/2024
Date #of Days Completion Date Approved Date
#of Days Added 60 Revised Final Date 1eo�swov/.m�a Esc; Current Substantial Completion Date 10/08/2024
(includes this change) (if applicable)
Provide responses after each question in box below (Responses should be brief and specific). Attach additional information and/or
documentation from the Design Professional and/or Contractor, if needed, with your submission of this Change Order and complete
summary on next page. Check all that apply to this Change Order request:(]Add Time;0 Add funds;0 Use of Allowance;
❑Modify/Delete existing Task(s);❑Add new Task(s);❑Reallocate funds;0 Other(must be explained in detail below)
1.) This change will add an additional sixty(60) days to the contract due to unforseen underground
field conditions. The additional days being added to the contract is to account for unforeseen utility
conflicts in the field. These underground utility lines could not be accurately verified during the design
phase and due to the tight constraints in this area with right-of-way space, they require rerouting the
wall slightly & relocating county owned fiber-optic lines. All of which has adversely affected the
controlling items of work.
2.) A stop work order was issued on 10/07/2024 with thirty-one (31) days until final completion.
3.) The addition of sixty (60) days to the contract is to account for utility conflicts in the field and could
not be accurately verified in the plans because they were underground and unforseen.
4.) If the additional time is not granted, the noise wall will not meet the designed length &will be less
effective isolating the community from noise and not meet its intended purpose.
Page l of 4
Change Order Form(2023_ver.1)
CAO
1 6 B 7j
Cotter County
Procurement Services Change Order Form
Contract# 23-8099 CO#02 PO#4500226165 Project#: 60198
Project Name:Veterans Memorial Blvd Phase 1 -Noise Barrier Wall Imperial Golf Estates
Contractor/Consultant Name: Coastal Concrete Products LLC
Change Order/Amendment Summary
(If additional spaces needed.attached a separate Summary page to this amendment request)
COST TIME
CO# AMD# Description Additive Deductive Days Total New Justification
(+) (-) Added Time
Use 3,100 from adding 10 days & a gate to
allowance to add 1 retain existing access to
1 8'x6' fence gate 10 160 maintain adjacent wall &
canal.
Add 60 days to time required to complete
complete the project as designed
2 project 60 220
❑Check here if additional summary page/s are attached to this Change Order
Page 2 of 4
Change Order Form(2023_ver.1)
CAO
16B7�
Go ler county
Procurement Services Change Order Form
Contract# 23-8099 CO#02 PO# 4500226165 Project#: 60198
Project Name: Veterans Memorial Blvd Phase 1 -Noise Barrier Wall Imperial Golf Estates
Contractor/Consultant Name: Coastal Concrete Products LLC
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.
Contractor/Consultant/Design Professional signature below must be from an authorized person/officer/director of
the Company or listed as the qualified licensed Professional"Project Coordinator"or Design/Engineer Professional
under the agreement. Signature authority of person signing will be verified through the contract OR through the
Florida Department of State, Division of Corporations (Sunbiz) website(https://dos.myflorida.com/sunbiz/search/).
If the person signing is not listed, we will require signature authority by one of the listed officers/directors of the
company giving that person signature authority.
ON Fala*tn.INy a r.aa.ry pea CF.S-ars a.a,•n.O...frw,.,.w.i.n i.4.r.:r y..,,�x fw�Gvp 7t11•axp.,.n'rn Frgrr.�arl.r\'.Cmq'�:Un nw
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Prepared by: ��. � Date: 11/01/2024
Signature-Division Project Manager
Jamie Khawaja
Printed Name
Accepted by: Date:
Signature-Design/Engineer Professional(if applicable)
Printed Name/Title/Company Na r,�-
-- „- iq -00ty
Accepted by: ,-' Date: •
Signature-Contractor/ConsultantlVend
David E.Torres,Manager,Coasta o ete Products,LLC dba Coastal Site Development
Printed Name/Title/Company Name
Approved by: ThomasMatthew W.4; ;Z-rx`�:,,.�: "`� " "' Date: 11/01/2024
Signature-Division Manager or Designee(Optional)
Matthew Thomas,P.E
(- TC Printed Name
AhmadJayDigitally signed by AhmadJay 11l04/2024
Approved by: Date 2024.11.04 07:01:31-05'00' Date:
Signature-Division Director or Designee(Optional)
Jay Ahmad,P.E.
Printed Name
S cottTri n i ty Digitally signed by ScottTrinity
Approved by: Date:2024.11.22 14:15:57-05'00' Date:
Signature-Division Administrator or Designee(Optional)
Trinity Scott
Printed Name
Page 3 of 4
Change Order Form(2023_ver.1)
CAO
16B7
Coli-rer County
Procurement Services Change Order Form
Contract# 23-8099 CO#2 Po# 4500226165 Project#: 60198
Project Name; Veterans Memorial Blvd Phase 1 -Noise Barrier Wall Imperial Golf Estates
Contractor/Consultant Name: Coastal Concrete Products LLC
FOR PROCURMENT USE ONLY
FY 25 CHO Request# 527
Z i m m e rm a n B Zimme DigitallyrmanB signed by
ecca
pp by: ecca Date:2024.12.03
Approved 10:12:21-05'00'
Signature-Procurement Professional Signature/Date
Approved by:
Signature-Procurement Manager/Director(OPTIONAL)
APPROVAL TYPE:
❑ Administrative ❑ Administrative-BCC Report nBCC Stand-Alone ES (BCC Approval Required)
BCC APPROVAL
ATTEST:
Crystal K. K,irfiel,Clerk. Circuit Court BOARD OF COUNTY COMMISSIONERS
and Cor troller '' : COLLIE COUNTY, FLORIDA
By: B
Dated: 6 Burt Saunders, Chairman
Ades,as,to, hairman's
signature only
(SEAL) Agenda# i f Hf zs 1637
A roved a to F. .nd egalit
Deputy County Attorney
S6,,Yf- 2 �.. b L-._
Print Name
Page 4 of 4 /)
Change Order Form(2023_ver.1) _._...r 1
CAO
16B7
Jamie Khawaja
From: Jason Tomassetti <jtomassetti@fl-star.com>
Sent: Tuesday, October 29, 2024 4:17 PM
To: Jamie Khawaja; David E.Torres
Cc: Tim Winschel
Subject: RE: 60198 - VMB Wall CO#1 BCC approved - Status update
Attachments: VMB - Proposed CO.pdf
EXTERNAL EMAIL:This email is from an external source. Confirm this is a trusted sender and use extreme
caution when opening attachments or clicking links.
Hi Jamie
Are you referring to last month's invoice that needs to be updated?
I attached the revised proposal for review. As far as time goes,we are going to need 60 days as soon as the directive is
issued . The initial 15 days will be for equipment and crew mobilization.
Also, a couple reminders:
1. The wall alignment will not follow the original design. We will try to follow what has been discussed in the RFI
(wall will end up being in front of the utility pole and guy wires.)
2. Due to the uncertainty of the data cable,force main, and water main locations,we can't guarantee the remaining
80 to100 feet of wall can be completed. This proposal only covers data cable relocation.
3. There is a possibility that the top of wall for the remaining 80 feet or so will be a foot or so lower than the current
top of wall elevation due to existing ground slope.
Any questions, please let us know.
Thanks
Jason Tomassetti, P.E.
ET/`R
3520 Kraft Road
Naples, FL 34105
0: (239)231-3311
M: (239)297-2251
From:Jamie Khawaja <Jamie.Khawaja@colliercountyfl.gov>
Sent:Tuesday, October 29, 2024 3:56 PM
To: David E.Torres<david@torrescompanies.com>
Cc:Jason Tomassetti<jtomassetti@fl-star.com>;Tim Winschel<twinschel@coastalconcreteproducts.com>
Subject: 60198-VMB Wall CO#1 BCC approved -Status update
David see attached BCC approved CO#1.
Also where are we at on the time assessment&updated Invoice?
Thanks.
1