Backup Documents 02/11/2025 Item #16F 3 ORIGINAL DOCUMENTS CHECKLIST&ROUTING SLIP C C
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO V !-
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
o1/4
2. BCC Office Board of County Commissioners Chairman
1351)l j( 2/ly(z5
3. Minutes and Records Clerk of Court's Office ,f/I�(/ fi x� n'444.1
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. Miller,Facilities Division Phone 239-252-8440
Contact/Department Number Bendisa.Miller@colliercountyfl.gov
colliercountyfl.gov
Email
Agenda Date Item was February 11,2025 Agenda
Approved by the BCC Item I 6.F.3
Number
Type of Document Attached Recommendation to ratify administratively approved Number of
Change Order No.5,adding 14 days to the contract Original 1
time under Agreement No.23-8070RR with JR&Co., Documents
Inc.,for the professional construction services to Attached
install new roofing on the Collier County Jail Building
J-l.,and authorize the Chairman to sign the attached
Change Order.(Project No.50229)
PO number or account The Facilities Division is requesting a completed copy
number if the document is to
be recorded
INSTRUCTIONS&CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not
(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,provide the Contact N/A
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 Office of the County Attorney. BEM
4. All handwritten strikethroughs and revisions have been initialed by the County Attorney's Office and all N/A
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 BEM
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 N/A
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 February 11,2025,and all changes made during the meeting N/A is not an
have been incorporated in the attached document. The County Attorney's Office has reviewed the {I Yh option for this
changes,if applicable. )V-'` line.
9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes N/A is not an
directed by the BCC have been made,and the document is ready for the Chairman's signature. l ell) option for this
T 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 6F 3
Co ler ,
y Procurement Services Change Order Form
Contract# 23-8070RR CO# 05 Po# 4500229850 Project#: 50229.2
Project Name: Collier County Jail (Building J-1) Roof Replacement
Contractor/Consultant Name: JR & Co., Inc.
Select One: 0 Contract Modification (Construction or Project Specific) ❑Work Order Modification
Project Manager Name: Tim Rygiel-PMP, CFM Division Name: Facilities Management
Original Contract/Work Order Amount $4,633.210 00 01/09(2024 11F ' Original BCC Approval Date,Agenda Item#
Current BCC Approved Amount $4,633,210.00 101/09/2024 11F i Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount $4,237 804 10 3/3/2025 SAP Contract Expiration Date (MASTER)
Dollar Amount of this Change So 00 L 8 53% r Total%Change from Original Amount
Revised Contract/Work Order Total $4,237,804.10 t 0.00% %Change from Current BCC Approved Amount
Total Cumulative Changes -$395,405.90 0.00% %Change from Current Amount
Notice to Proceed 1 Original NTP Original Final Last Final
2/1/2024 395 3/2/2025 3/2/2025
Date #of Days Completion Date Approved Date
#of Days Added 14 Revised Final Date 3/16/2025 Current Substantial Completion Date [1/31/2025
(includes this change)I______ (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 Chang!Order request: E Add Time; ❑Add funds: ❑ Use of Allowance;
❑ Modify/Delete existing Task(s); ❑ Add new Task(s); (i Reallocate funds; ❑ Other(must be explained in detail below)
1.) Detail of change/s to be made through this Change Order.
This change order will add 14 days to the project due to weather delays incurred from multiple storm
events in 2024.
2.) If this Change Order is currently under a Stop Work, please identify the date issued and number of
days remaining or"N/A" if not applicable.
N/A
3.) Explain why this change was not included in the original contract/Work Order.
It was unknown at the time of award that weather would affect the project schedule.
4.) Describe the impact if this change is not processed.
If this change is not processed, the contractor will not have enough time to meet the substantial
completion date.
Page 1 of 4
Change Order Form (2023_ver.1)
,t.I)
16F 3
Cater County
Procurement Services Change Order Form
Contract# 23-8070RR CO# 05 PO# 4500229850 Project#: 50229.2
Project Name: Collier County Jail (Building J-1) Roof Replacement
Contractor/Consultant Name: JR & Co., Inc.
Change Order/Amendment Summary
(If additional spaces needed, attached a separate Summary page to this amendment request)
•
COST i TIME
CO# AMD# Description Additive Deductive Days Total New Justification
(+) (� I Added Time Direct Materials To provide a cost savings tot
1 Purchase $(395,405.90) the County in the amount of
$22,381.47.
Use of Allowance for The skylights would remain, leaving
WD#2 in the amount of potential water infiltration points and
2 $44,547.75 leaving a security issues. This would leave an
balance of$281,452.25. ! ongoing maintenance and security
Issue unaddressed.
Use of Allowance for This change order replaced
WD#4 in the amount of deteriorated duct work in the CCSO
3 $9,491.60 leaving a IT mechanical room required to allow
balance of$271,960.65. for the proper operation of the HVAC
exhaust system.
Use of Allowance for This change order modified the
WD#6 in the amount of I roofing attachment detail provided in
4 $13,825.12 leaving a the Design drawings in order to
balance of$258,135.53 adhere the new roofing membrane
to the existing parapet wall.
Adds 14 days to This change order adds an
5 the project time. 14 409 additional 14 days to allow
the contractor to meet
substantial completion.
❑ Check here if additional summary page/s are attached to this Change Order
Page 2 of 4
Change Order Form(2023 ver.1)
f
16F 3
CotPler County
Procurement Services Change Order Form
Contract# 23-8070RR CO# 05 Po# 4500229850 Project#: 50229.2
Project Name: Collier County Jail (Building J-1) Roof Replacement
Contractor/Consultant Name: JR & Co., Inc.
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/n 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.rnyflorida.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.
RygielTimothy Digitally signed by RygielTimothy
Prepared by: Y9 y Date:2025.01.27 09:17:54-05500' Date;
Signature-Division Project Manager
Tim Rygiel-PMP, CFM, Project Manager III
Printed Name
Victor J Latavish Digitally signed by Victor J Latavish
Accepted by: Date:2025.01.27 10:47:06-05'00' Date:
Signature- Design/Engineer Professional (if applicable)
Victor Latavish,AIA, Victor J. Latavish,Architect, P.A.
Printed Name/Title/Company Name
Accepted by: - Date: l/-//(/1
Signa rtt r o i ant/Ven or
Jonathan Schilling, Presi &Co., Inc.
Printed Name/Title/Company Name
Approved by: Date:
Signature-Division Manager or Designee(Optional)
Printed Name
Delon Brian Digitally signed by DelonyBrian
Approved by: y Date:2025.01.24 09:09:01 -05'00' Date:
Signature-Division Director or Designee (Optional)
Brian DeLony, PE, Interim Division Director
Printed Name
Approved by: Date: _
Signature-Division Administrator or Designee (Optional)
Printed Name
Page 3 of 4
Change Order Form(2023_ver.1)
, ,�t >
16F 3
Coder County
Procurement Services Change Order Form
Contract# 23-8070RR CO# 5 Po# 4500229850 Project#: 50229.2
Project Name: Collier County Jail (Building J-1) Roof Replacement
Contractor/Consultant Name: JR & Co., Inc.
FOR PROCURMENT USE ONLY
FY 25 CHO Request# 1562 -- l
Bowden Stephanie Date:Digitally2025.01.2 signed b8 Bowd15:45:15enS-05tep' hanie00'
Approved by ..__._._ _.._._
Signature-Procurement Professional Signature/Date
Approved by:
Signature-Procurement Manager/Director(OPTIONAL)
APPROVAL TYPE:
Administrative ✓ Administrative-BCC Report BCC Stand-Alone ES (BCC Approval Required)
BCC APPROVAL 7
ATTEST:
Crystal K. Kinzel, CWIlsopf the Circuit Court BOARD OF COUNTY COMMISSIONERS
and Comptrpliet ,.'.A.:,, , ` COLLIER COUNTY, FLORIDA
4/141%
By: By. __ CL(i �—
Dated eja ' ., ,. 120C Burt Saunders, Chairman
Attest��`s�.fo h2irmtin's
s- sigl re only
(SEAL) Agenda#Af3 _2111125
ppr ve as t o �an�Legality:
eputy ounty Attorney
r� ie 7
Prin Name
Page 4 of 4 '
Change Order Form(2023 ver.1)