Backup Documents 02/25/2025 Item #16F 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6F
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 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.
2. (Enter your Dept here)
3. County Attorney Office County Attorney Office 5U2�
4. BCC Office Board of County
Commissioners 55 4y m f 315/25
5. Minutes and Records Clerk of Court's Office ( r
3161
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 Phone Number
Contact/Department MA A A 13i[' cl x Zq 3 9
Agenda Date Item was Agenda Item Number rr
Approved by the BCC L125(Z5 lb 1 r
t
Type of Document(s) Number of Original
Attached Art5 e_ OrJ< Documents Attached
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. (In, Applicable)
1. Does the document require the chairman's signature?(stamped unless otherwise stated)
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
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
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
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 2/25 and all changes made during N/A is not
the meeting have been incorporated in the attar ed document. The County Attorney [[ an option for
Office has reviewed the changes, if applicable. 5111 f A 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 h an option for
Chairman's signature. S t,�
l: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
16F1
Co tiler County
Procurement Services Change Order Form
Contract# 21-7883-ST CO# 13 PO# 4500229878 Project#: 50214.2
Project Name: First Amendment for Main Campus Upgrades
Contractor/Consultant Name: 0-A-K/Florida Inc.
Select One:El Contract Modification(Construction or Project Specific) ❑Work Order Modification
Project Manager Name: Tim Rygiel-PMP,CFM, Project Manager ill Division Name: Facilities Management
Original Contract/Work Order Amount $17,648,689.97 1/9/2024 11G Original BCC Approval Date;Agenda Item#
Current BCC Approved Amount $17,648,689.97 1/9/2024 11G Last BCC Approval Date; Agenda Item#
Current Contract/Work Order Amount $16,627,040,98 6/18/2025 SAP Contract Expiration Date(MASTER)
Dollar Amount of this Change -5.79% Total% Change from Original Amount
Revised Contract/Work Order Total $16,627,040.98 0.00% %Change from Current BCC Approved Amount
Total Cumulative Changes -$1,021,648.99 0.00% %Change from Current Amount
Notice to Proceed 2-19-2024 Original NTP 485 Original Final 6-18-2025 Last Final 7-15-2025
Date #of Days Completion Date Approved Date
#of Days Added 15 Revised Final Date 7.30 2025 Current Substantial Completion Date 5-16-2025
(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: El Add Time;❑Add funds; ❑ Use of Allowance;
LI Modify/Delete existing Task(s); ❑Add new Task(s); ❑ 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 15 days to the contract time to allow for schedule disruption caused by a
companion Collier County project to replace the transformers in Building K.
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.
Due to the timing and urgent need of the transformer replacement, O-A-K will need to delay work on
the exterior doors and stucco at the electrical room of Building K. Best efforts had been made by the
County Project Manager to avoid this conflict but were unsuccessful. This scheduling delay is due in no
part on the contractor.
4.) Describe the impact if this change is not processed.
If this change is not processed, the County will have placed an undue hardship on the contractor to
finish work by the contracted substantial completion date and be subject to Liquidated Damages.
Page 1 of 4
Change Order Form(2023_ver.1)
16F1
C;or County
Procurement Services Change Order Form
Contract# 21-7883-ST CO# 13 PO# 4500229878 Project#: 50214.2
Project Name: First Amendment for Main Campus Upgrades
Contractor/Consultant Name: O-A-K/Florida Inc.
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
Direct Material To provide cost savings to
1 Purchase $(391 87a 82) the County in the amount of
$22,181.82
Direct Material To provide cost savings to
2 Purchase $(335,349.02) the County in the amount of
$18,982.02
Direct Material To provide cost savings to
3 Purchase $(267,798.40) the County in the amount of
$15,148.40
Adds 7 days to the If this change order is not
contract time and processed, the project will not be in
4 uses $11,219.01 of 7 492 compliance with the LDC and
Certificate of Completion cannot be
the Contingency. obtained.
Adds 5 days to the If this change order is not
contract time and processed the new system
5 uses $6,473.50 of 5 497 will not operate properly.
the Contingency.
Administrative change to If this change order is not processed the
acknowledge the Schedule of Values will not reflect the
6 subcontractor substitution and transfer of work from the original
reconciliation of the Schedule subcontractor to the substitute contractor.
of Values.
Deductive change If this change order is not
7 order to correct errors $(26,622.75) processed there would be an
made on the GMP. overpayment on the payment
and performance bonds.
Adds 10 days to the If this change order is not processed,all
contract time and required changes would not be
8 10 507 accounted for posing safety risks,
uses$42,329.74 of in-continuity,and inability to complete
the Contingency, the project.
0 Check here if additional summary page/s are attached to this Change Order
Page 2 of 4
Change Order Form(2023_ver.1)
CA(
16F1
co r C.,,apinty
Procurement Services Change Order Form
Contract# 21-7883-ST CO# 13 PO# 4500229878 Project#: 50214.2
Project Name: First Amendment for Main Campus Upgrades
Contractor/Consultant Name: 0-A-K/Florida Inc.
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
Administrative change to If this change order is not processed
acknowledge the the Schedule of Values will not reflect
9 subcontractor substitution and reconciliation of the Schedule the transfer of work from the original
of Values under WD#11. subcontractor to the substitute
subcontractor.
Utilizes $8,467.50 If this change order is not processed,
scope elimination and required changes
10 of the Contingency. would not be accounted for as well as
not being in compliance with the current
Collier County Standards.
Utilizes $17,977.30 If this change order is not processed the
new fuel storage tank and generators would
of the Contingency. not meet the Hazmat requirements and the
11 PH balance of the water would be
detrimental to the new equipment being
installed.
Adds 5 days to the If this change is not processed,the
contract and reconcile calculation errors on change order
12 calculation errors from 5 512 #10 and the weather delays due to
CO#10 increasing the Hurricane Milton would not be
allowance by$20.41. recognized.
Adds 15 days to Time is being added to allow for
the contract. schedule disruption caused by a
13 15 527 companion Collier County project to
replace the transformers in Building
K.
❑Check here if additional summary page/s are attached to this Change Order
Page 2 of 4
Change Order Form(2023_ver.1)
16F1
Collie- County
Procurement Services Change Order Form
Contract# 21-7883-ST CO# 13 PO# 4500229878 Project#: 50214.2
Project Name: First Amendment for Main Campus Upgrades
ContractorlConsultant Name: O-A-K/Florida 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 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.mvflorida.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.
Prepared by: RygielTimothy Digitally signed by RygielTimothy Date:
Y9 y Date:2025.01.10 12:33:03-05'00'
Signature-Division Project Manager
Tim Rygiel PMP, CFM, Project Manager III, Facilities Management
Printed Name
IGgdN1y t�gnrd by K Todd GMUth
K. Todd Griffith DN m•R lcdd Div,a,n.rma.Prol.rnooal Engirttnnq K.amL Vice o eVdm,
Accepted b D,.cn,nt,W,,I.,,1.m,.�., �,�„ ,,n M..=t
p Y o.,.1q75ol,,,,,>1.o,n, Date:
Signature-Design/Engineer Professional(if applicable)
K.Todd Griffith, PE, SVP-Director of SWFL Division, Matern Professional Engineering, Inc.
Printed Name/Title/Company Name
Matthew Zwack Digitally signed by Matthew Zwack
Accepted by: Dale:2025.01.20 08:50:13-05'00' Date:
Signature-Contractor/Consultant/Vendor
Matthew Zwack, President, O-A-K/Florida, 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:2025.01.15 13:16:03-05'00' Date:
Signature-Division Director or Designee (Optional)
Brian DeLony, PE, Interim Division Director, Facilities Management
Printed Name
Approved by: Date:
Signature-Division Administrator or Designee(Optional)
Printed Name
Page 3 of 4
Change Order Form(2023_ver.1)
16F1
Corr County
Procurement Services Change Order Form
Contract# 21-7883-ST CO# 13 PO# 4500229878 Project#: 50214.2
Project Name: First Amendment for Main Campus Upgrades
Contractor/Consultant Name: 0-A-K/Florida Inc.
FOR PROCURMENT USE ONLY
FY 25 CHO Request# 555
BowdenStephanie Digitally signed by BowdenStephanie
Approved by: F' Dale:2025.01.22 09:56:11 -05'00'
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
ATTEST:
Crystal K.Kinz0of the Circuit Court BOARD OF COUNTY COMMISSIONERS
and Complrol1 w COLLIER C UNTY, FLORIDA
By; ,•to, _�«� By: _
41 Burt L Saunders
, Chairman
Dated
Attest as,to Chairmanis Date: 2/is/as
(SoPft 11Ye only. Agenda# 14. (-•
A rov ,ib or nd Lega'ty:
Deputy County Attorney
c t -z �-
Print Name
Page 4 of 4
Change Order Form(2023_ver.1)