Loading...
Backup Documents 03/11/2025 Item #16B12 16B12 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. **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 Office CAO 3Ii/ � 2.Board of County Commissioners Office BOCC j ( 500 3. Minutes and Records Clerk of Court's Office l5 l 3,i2/Z S t rp5 4. Send to for signature: 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 Dennis McCoy 252-5726 TMSD Contact/Department Agenda Date Item was March 11,2025 Agenda Item Number 16 B.12 Approved by the BCC Type of Document Attached Change Order No.2 Agreement No 22-7944 with KCA Number of Original 1 for Design Services for 16'h Street Ne Bridge project Documents Attached PO number or account N/A number if 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 STAMP OK Stamp OK 2. Does the document need to be sent to another agency for additional signatures? If yes,provide the N/A 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 DM 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 Attomey's Office and N/A 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 DM 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 DM 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 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 document was approved by the BCC on 3/11/2025_and all changes made during the DM meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC,all changes directed by the BCC have been made, and the document 5F-641 12 is ready for the Chairman's signature. 16B12 Coder County Procurement Services Change Order Form Contract# 22-7944 CO#2 PO#4500218691 Project#: 60212.1 Project Name: 16th Street NE Bridge Contractor/Consultant Name: Kissinger Campo&Associates, Corp. Select One: 0 Contract Modification(Construction or Project Specific) ❑Work Order Modification Project Manager Name: Dennis F. McCoy Division Name: Transportation Engineering Original Contract/Work Order Amount $1 370.255.68 '7r2122.11L Original BCC Approval Date;Agenda Item# Current BCC Approved Amount 51.374 255.68 6/25/2024,16.8:4 Last BCC Approval Date;Agenda Item# Current Contract/Work Order Amount _51.374,255.68 /2119/2026 SAP Contract Expiration Date(MASTER) Dollar Amount of this Change $21 735.94 1.58%u Total%Change from Original Amount Revised Contract/Work Order Total 51,395,991.62 1.58% %Change from Current BCC Approved Amount Total Cumulative Changes $21,735.94 1.58% %Change from Current Amount Notice to Proceed 7/28/2022 ' Original NTP 1240 Original Final II 12/19,2025 Last Final 12/19/2026 Date #of Days Completion Date • Approved Date #of Days Added Revised Final Date 8/16/2027 Current Substantial Completion Date NA 240 (includes this change) (if applicable) __ Provide responses after each question in box below (Responses should be brief and specific). Attach additional information and/or documentation from the Design Professional and/or Contractor, if needed, with your submission of this Change Order and complete summary on next page. Check all that apply to this Change Order request:0 Add Time; 0 Add funds; ❑ Use of Allowance; ❑Modify/Delete existing Task(s);'0 Add new Task(s); 0 Reallocate funds; ❑Other(must be explained in detail below) 1.) This Change Order will add a total of$ 21,735 and 240 calender days to the contract. The remaining funds ($13,206.06) unused from Task 8 (Water Boring-Optional Service),will be reallocated from Task 8 to the new Task 9 (Final Plans and Specifications Updates). The final total funding far Task 9 will be $34,942. The Consultant previously prepared permitting documents and applied for a Florida Department of Environmental Protection (FDEP) Section 404 Permit required for the project as identified in the contract scope of services. Prior to final approval and issuance of the FDEP 404 permit. a federal court order was passed on 2/15/2024. divesting FDEP of its authority to issue State 404 Program permits in Florida. As a result. the consultant prepared and submitted a permit application to the United States Army Corps of Engineers (USACE) to obtain Federal 404 permit authorization. The permitting agency is currently processing the permit. Because the USACE Permit was not approved in time to advertise the solicitation for construction before January 1, 2025, the Project Plan Specifications and Standards will need to be updated to meet the new FDOT Fiscal Year 2024-25 Specifications and Standards. This update will specifically consist of additional structural and geotechnical analysis, pay item revisions and probable cost estimate revisions. 2.) N/A. 3.) The change in agency ownership of the 404 permit occurred after the design consultant's contract was approved and after the permit was originally applied for. The new permit was not issued prior to the deadline required by FDOT; thus, the project now falls under the 2024-25 fiscal year requirements. i 4.) The plan changes are required by FDOT per the Local Agency Program (LAP) Grant . The $8.7M grant could be jeopardized if the required changes are not completed. Page 1 of 4 Change Order Form (2023_ver.1) 16 B12 .Ca> r aw ty Procurement Services Change Order Form Contract# 22-7944 CO# 2 PO# 4500218691 Project#: 60212.1 Project Name: 16th Street NE Bridge Contractor/Consultant Name: Kissinger Campo &Associates, Corp. 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 i Justification (+) (-) Added Time Submitting New 404 Needed to complete 1 Permit Application 365 1605 permitting requirement for 0to USACOE this project Plan revisions and updates to $ Needed for Local Agency 2024-25 Fiscal Year Specifications and Standards.In addition.the Program (LAP) Grant 2 remaining S13,206.06 in funds from '$21,735.94 240 1845 • Task 6wll be reallocated to this 1 requirements Task(Task 9) i 0 Check here if additional summary page/s are attached to this Change Order Page 2 of 4 Change Order Form (2023_ver.1) 16B12 c other county Procurement Services Change Order Form Contract# 22-7944 CO#2 PO# 4500218691 Project#: 60212.1 Project Name: 16th Street NE Bridge Contractor/consuitant Name: Kissinger Campo &Associates, Corp. 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%sunbizisearch/). 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. McCo Dennis Digitally signed by McCoyDennis Prepared by: Y Date 2025.01.21 08:02:43-05'00' Date: Signature-Division Project Manager Dennis F McCoy, Project Manager Ill, Transportation Engineering Division Printed Name Accepted by: Date: Signature-Design/Engineer Professional (if applicable) Printed Name/Title/Company Name Accepted by: Paul G Foley Date: 2025.01.21 13:13:40-05`00' Date: Signature-Contractor/ConsultantNendor Paul G. Foley, P.E., CEO/President. Kisinger Campo&Associates, Corp. Printed Name/Title/Company Name Approved by: Date Signature-Division Manager or Designee(Optional) Printed Name AhmadJay Digitally signed by AhmadJay Approved by: Date 2025.01.21 14 52.25-05'00' Date. Signature-Division Director or Designee(Optional) Jay Ahmad, P.E.. Director, Transportation Engineering Division Printed Name Digitally signed by Sccttl r.nity ScottTrinity Data 2025.01.27 Approved by: 09.13.48-05DC' Date' Signature-Division Administrator or Designee (Optional) Trinity Scott, Department Head, TMSD Department Printed Name Page 3 of 4 Change Order Form (2023_ver.1) 16B12 CmintY Procurement Services Change Order Form Contract# 22-7944 CO#2 PO#4500218691 Project#:60212.1 Project Name: 16th Street NE Bridge Contractor/Consultant Name: Kissinger Campo&Associates, Corp. FOR PROCURMENT USE ONLY FY 25 CHO Request# 563 Bowden Stephanie DigitallysignedbyBowdenStephanie pate:2025.01.31 14:38:26-05'00' Approved by: Signature-Procurement Professional Signature/Date Approved by: Signature-Procurement Manager/Director(OPTIONAL) APPROVAL TYPE: ❑ Administrative Administrative-BCC Report [Ti BCC Stand-Alone ES(BCC Approval Required) BCC APPROVAL ATTEST: Crystal K. Kinzel, Cle,k'af;the Circuit Court BOARD OF COUNTY COMMISSIONERS and Comptroller COLLIER COUNTY, FLORIDA By: • By: Y.t.,1•4 Burt L Saunders . Chairman Dated. f . a A sf as Ca' haiirrran's signature only Date: 3/11 I25 (SEAL) Agenda# 16 d 1 Z Appr ved as Fcyrrr9an Leg ity: De County Attorney �.•••4# p PrintlGame Page 4 of 4 Change Order Form(2023 ver.1) L.AO 16B12 KISINGER CAMPO & SS ) CIATES SCOPE OF SERVICES For CHANGE ORDER NO. 2—FINAL PLANS AND SPECIFICATIONS UPDATES To PROFESSIONAL SERVICES AGREEMENT For DESIGN SERVICES FOR 161/1 STREET NE BRIDGE(CONTRACT 22-7944) (Golden Gate Boulevard West to Randall Boulevard) County Project No.60212.1 FPin 451283-1-58-01 Purchase Order No. 4500218691 January 17. 2025 PART 1: OVERVIEW Kisinger Campo& Associates, Inc. (CONSULTANT)has been requested and retained to provide plans and specifications updates associated with Collier County Project No. 60212.1 (FPID 451283-1-58-0 1) 16th Street NE Bridge(Golden Gate Boulevard West to Randall Boulevard)(PROJECT). On behalf of the COUNTY,the CONSULTANT prepared and submitted Final Signed and Sealed Plans and Specifications(dated 2/22/24)based upon Florida Department of Transportation(FDOT)Standard Plans and Specifications,FY 2023-24 in accordance with Exhibit B of the project LAP Agreement. A Design Complete Memo was subsequently obtained from FDOT on March 6,2024. Prior to final permit approval and issuance of the FDEP 404 permit,a federal court order was passed on 2/15/2024,divesting FDEP of its authority to issue State 404 Program permits in Florida. As a result,the project was not let within FY 2023-24 and will require final design documents to be updated in accordance with FDOT Standard Plans and Specifications, FY 2024-25 in accordance with Task 3.7 of the original contract.Task 3.7 of the Original Contract states, "The effort needed for Plans Update services will vary from project to project, depending on size and complexity of the project, as well as the duration 1 13461 Parker Commons Blvd.,Suite 104 I Ft.Myers 33912 I . 239,278.5999 I 239.278.1776 I r: ,.ty .om CAO 1 6 B 1 2 ` n, KISINGER CAMPO x -"°' & ASSOCIATES of time spent "on the shelf". Specific services will he negotiated as necessary as a contract amendment. " This Change Order provides for the CONSULTANT'S services to add the following Scope of Services to Collier County Project No. 60212.1. The following CONSULTANT Services are an addition to the work listed in the original contract. PART 2: SCOPE OF WORK TASK 9.0 FINAL PLANS AND SPECIFICATIONS UPDATES • Plans Update(Scope Activity 3.7) o Review FY 24/25 Standard Plan Revisions for impacts any revisions may have to Final Plans. o Update final plans, including notes and key sheet to reflect revisions from FY24/25 Standard Plans. o Review FY 24/25 Standard Specification Revisions for impacts any revisions may have to Final Plans. o Update plans. including notes. key sheets,summary of pay items,and/or pay item notes to reflect revisions from FY24/25 Standard Specifications. o In the Structures Plans, update the Pile Data Table and Pay Items to reflect updates to FY24/25 Standard Specifications. Updates to Structures Plans include additional analysis of the end bent foundations and additional pay items related to Specifications Section 455 for foundation installation. End bent foundation analysis shall utilize existing borings and geotechnical data. o The Geotechnical Engineer of Record(GEOR) shall provide recommendations for updates to the Pile Data Table within the Structures Plans component. including test pile lengths and updates to the Pile Data Table Notes. The GEOR shall also provide recommended updates to the pay items related to Specifications Section 455 for foundation installation. Additional geotechnical investigation is not proposed. o Review Basis of Estimates for any pay item revisions and update plans accordingly. o Update Opinion of Probable Cost and Bid Tabs o Quality Assurance/Quality Control o Supervision o Coordination 2 13461 Parker Commons Blvd.,Suite 104 I Ft.Myers 33912 I 239.278.5999 J . 239.278.1776 I . • CAO 1 6 B 12 KcA KISINGER CAMPO • Prime Consultant Project Manager Meetings(Scope Activity 3.6) o Includes Prime CONSULTANT Project Manager's time and attendance of one(1)virtual meeting with COUNTY Staff to facilitate final County and FDOT reviews. PART 3: EXCLUSIONS/ASSUMPTIONS The following tasks are not included in the Scope of Work for this Change Order: 1. Services other than those specifically listed above. 2. Assumes the project will be let within FY 2024-25. If the project is not let within FY 2024-25,the CONSULTANT reserves the right to renegotiate as pending revisions to future Standard Plans and Specifications for FY 2025-26 and beyond cannot be determined. 3. Updates associated with the 2025 FDOT Design Manual,2025 Drainage Manual, and 2025 Flexible Pavement Design Manual. Per Roadway Design Bulletin(RDB) 24-04, implementation is effective on all projects beginning design on or after January 1,2025 and on projects currently in the design phase where implementation will not adversely impact production schedules. A Design Complete Memo was issued for the project on March 6, 2024. 4. This scope is limited to plan revisions and updates directly required by FY 24/25 Standard Plan Revisions, FY 24/25 Standard Specification Revisions,and the 2024 Basis of Estimates Manual updates. Additional revisions requested by FDOT or the COUNTY beyond this limited scope will be considered extra work and excluded from this scope of work. Revision requests based on the additional review of the approved Final Signed and Sealed Plans and Specifications(dated 2/22/24),will be considered additional effort outside of the scope of this change order. 5. Additional post design services will be necessary as a result of the services identified herein.No additional post design services are included as part of these services. It is understood that these will be added as a future change order. PART 4: PROJECT SCHEDULE Additional 240 days(8 months). PART 5: COMPENSATION An estimated budget to be utilized for the above tasks has been established and is shown as Attachment A—Estimate of Work Effort and Cost. A staff hour estimate for the above Scope of Services has been prepared for the sole purpose of establishing the maximum upset limit for this Change Order. • The COUNTY will compensate the CONSULTANT a fee of$34,942.00 for Task 9 3 cnn: 13461 Parker Commons Blvd.,Suite 104 I Ft.Myers 33912 ( 239.278.5999 t 239.278.1776 ` 16 B 1 2 KISINGER CAMPO & ASS CIATES Final Plans and Specifications Updates plus expenses on a LUMP SUM basis, Unused funds from Task 8—35.49 Water Boring(Optional Service)will be reallocated to Task-9 Final Plans and Specifications Updates as follows: Tasks/ttens Description 1S or NTE Odtinai Contract Adjustments)by Adjustment(s)due Total Compensation all previous CO(s) to this CO per Task 1 30%Submittal IS $ 605,759.19 $ $ 605,759.19 2 60%Submittal LS S 343,370.49 $ - $ 343,370.49 3 90%Submittal LS $ 196,655.88 $ $ 196,655.88 4 Final Design LS S 94,916.90 S 41,558.00 5 - $ 136,474.90 5 3.8 Post Design Services NTE $ 72,933.16 $ - $ 72,933.16 6 17.Retaining Walls(Optional Service) LS 5 19,199.00 $ (19,199.00) S S - 7 27.10 Additional SUE(Optional Service) NTE $ 5,856.00 $ 5,856.00 8 35.49 Water Boring(Optional Service) NTE S 35,565.06 $ (22.359.00) $ (13,206.06) 5 - 9 Final Plans&Spec Updates(as Necessary) LS $ - $ - $ 34,942.00 S 34,942.00 Project Total: $ 1,374,255.68 $ - $ 21,735.94 $ 1,395,991.62 The hourly rates shown for staff reflect the Rate Schedule agreed upon and match those approved under Contract 22-7944. 4 13461 Parker Commons Blvd.,Suite 104 I Ft.Myers 33912(,";• ;.239.278.5999 I + 239.278.1776( :.:,:. :< , ;;; tom 16B12 KISINGER CAMPO & ASSOCIATES Attachment A—Estimate of Work Effort and Cost. 5 13461 Parker Commons Blvd.,Suite 104 I Ft.Myers 33912(Phone:239.278.5999 I 239.278.1776 n t rcampo.com CAO 16B12 O N r 0 C. • O q t0 /G N f0 M g�{ ILL co if) A fA p {A 8 8 8 v O O O LL N IA I—CO in N O O O O ' 8 $ w w yr E Gi 19 1:71O o O. 0 o0i 8 t [D of Q m r- C h °o 2 4, w TO N Li,G�7 O d 8 o• z- 2 .0 LL U `o c'n `° �o 0 V! h I— F 7 u C in o —y v a- a: `y �n m C Qf Lt. U w I o ❑ N cn a m gr o N d O N q CO it ^ 0 rn ri m U C • 2 < m o 'o' o o .r �o n O j U g Er. a r a o Q z o YA c Q co QS Co .0 0 N c6 N O Q N CAO 16B12 kzi t'Af„ s1 1 ll!Hft9 ilif H a t itii HI. il i I I fl 8 8 8 8 8 8 8 8 s 8 s ,. c .. I . s s 0 o s ds .itiiiis Li$ 8 8 8 8 8 8 8 8 8 8 1 �j o o d * o d o a 8 8 S 8 8 8! ! 8 d ~ 8Y o d 8 S _ a - . cock o L 1 j d o d o d o d 6 l s W d o o o o d 0 6 WI 1,1 r;in !s g s H a a s s d a .. u»di III IIN 3 a » 8 8 8 8 8 8 8 8 8 8 d c o 0 0 a 8 8 8 s o nnaind o s 8 8 iz lb: O » u 8 8, ,1 8 8 S E 8 :1 : III 8 8 8 8 8 8 8 8 /4 4 nillSi 8 8 list. , . I 1 i i 1 M M r I c o t y l u 0 4 ` . !- I g 1 I - 16 B1 2 Kimley>>>Horn January 17, 2025 Mr. Jesse Gill, PE Senior Project Manager Kisinger Campo&Associates 13461 Parker Commons Blvd., Suite 104 Ft. Myers, FL 33912 Dear Jesse. Kimley-Horn is pleased to submit the attached fee proposal to assist Kisinger Campo and Associates by providing Signalization & Signing & Pavement Marking Services for the plans and specifications updates associated with the Scope of Services for Change Order#2-Final Plans and Specifications Updates for Collier County Project No. 60212.1 (FPID 451283-1-58-01) 16th Street NE Bridge(Golden Gate Boulevard West to Randall Boulevard). Below is a summary of our total negotiated lump sum fee request of$6,870.00. Collier County County 60212.1 -Design Services for 16th St NE Bridge CO#2 Proposal- Plans Update Updated 1r1,25 Senior Project i Senior Task Manager';Engineer Engineer Total Consultant No. Task Title 5201.00 S175.00 $136.00 (Hours) Fee 9.0 Plans Update(Scope Activity 3.7) FY 24/25 Standard Plan Revisions-Review&Update Plans 2.50 4.00 4.00 10.50 $1,746.50 FY 24'25 Standard Specification Revision-Revew&Update Plans/Spec 2.50 4.00 4.00 10.50 $1.746.50 Basis of Estimates-Reaew and Update Plans 1.00 2.00 2.00 5.00 S823.00 Opinion of Probable Cost update 1.00 2.00 1.00 4.00 5687.00 Quality Assurance/Quarry Control 1.00 2.00 0.00 3.00 $551,00 Supenvision 1.00 1.00 0.00 2.00 $376.00 Coordrnatior 1.00 1.00 0.00 2.00 $376.00 Prime Consultant Project Manager Meetings(Scope Activity_3.6) Attendance of one(1)virtual meeting -. 1.50 1.50 0.00 3.00 $564.00 Contract Maintenance and Project Documentation(Scope Activity 3.4( Two hours per month for additional eight(8)months 0.00 I 0.00 0.00 0.00 50.00 Reimbursables(NTE) TOTAL HOURS 11.50 I 17.50 I 11.00 I 40.00 56,870.00 We appreciate this opportunity to provide these services to the Kisinger Campo and Associates and are excited to get started. Respectfully, el„Lk c\jt. Richard Arico, PE Senior Project Manager kimley-horn.com 2640 Golden Gate Pkwy, Suite 201 Naples, FL 34105 239 999 3187 CAO 16B12 11,111% January 17, 2025 Kisinger Campo &Associates 13461 Parker Commons Blvd, Suite 104 Ft. Myers, FL 33912 Attn: Jesse E. Gil, PE Project Manager Re: Geotechnical Fee Estimate -Supplemental 16th Street NE Bridge (Contract 22-7944) Collier County, Florida County Project No.60212.1 FPID:451283-1-58-01 TSF Project No.7511-22-279 Dear Jesse, It is our understanding that the plans will be updated to FY 24/25.As requested, Tierra South Florida,Inc. (TSFGeo) is pleased to submit this fee estimate to provide geotechnical services for the above-referenced project plans update. The estimated fee for the performance of the services was determined on a unit rate basis in accordance with the existing sub agreement between TSFGeo and KCA. The maximum fee for this request is$9,520. Services will be performed after your approval and based on the project schedule We appreciate the opportunity to provide our services to you under this Contract. If you should have any questions concerning our proposal, please contact our office. Respectfully submitted, TSF, INC. Amy L. Guisinger, P.E. Principal Engineer Attachments: Fee Estimate 2765 Vista Parkway,Suite 10•West Palm Beach,Florida 33411 561-687-8536•www.TSFGeo.com State of Florida Registration No.28073 CAO 16 B12 8 8 8 a 8 8 8 8 8 8 m ` k ' § ; E ` 8 ® ;! Ca ; V. % m 2@@ t ! ` ! 7 ' # � | e , e . 0 a , 8' 8 G , & ! » 7 ! kk2 o o \ @ M & ± ! @ m ` ! @' m ; . , /; )§ / | f | ! q ! » / m § 7. 6o6 8 86c6o o f 6 § I i3.; © ! 8 t ( / 8 8 8 ! 8 1f ` ° - CO .- , _ . ?! 1 # 8 ! ; a m ! ` ! ` ; z w (6 , !0fi / ,AA2 _ °f§— 8 » * ƒ $ ± 0 & * ± § }A . , !� 2 ( / ! % 0 0 � 0 0 8 8 ! 2. Aga ; 8' § ( m 8' ` # ` 8 k|! 0 ° . . . . . , 6 ; !!: 8 8 8' 8 8 , @ ' , f , 8 |I 0 0 _ 0 0 . 0 !!! # 8 8 + ƒ 8 ® - # f§ e e @ , _ : : N ; § - . . , ! ! f k \ 2 ` i — B. } | \ : f. k 1 { ! . $. \ a R - \ k E \ ! k 2 / \ « ! ; - � \ } ƒ \ { ! \ . _ ! S. ; / / } I E \ \ } ) { ( p o \ } / A \ . ' - 2 + o , | /• 8 . } » I g.. - CAD 16B12 AFFIDAVIT REGARDING LABOR AND SERVICES Effective July 1, 2024, pursuant to §787.06(13), Florida Statutes, when a contract is executed, renewed, or extended between a nongovernmental entity and a governmental entity, the nongovernmental entity must provide the governmental entity with an affidavit signed by an officer or a representative of the nongovernmental entity under penalty of perjury attesting that the nongovernmental entity does not use coercion for labor or services. Nongovernmental Entity's Name: Kisinger Campo&Associates,Corp. Address: 201 North Franklin Street,Suite 900,Tampa, FL 33602 Phone Number: 813-871-5331 Authorized Representative's Name: Paul G.Foley,P.E. Authorized Representative's Title: CEO/President Email Address: pfoiey@kcaeng.com AFFIDAVIT Paul G.Foley,P.E. (Name of Authorized Representative), as authorized representative attest that Kisinger Campo&Associates,Corp. (Name of Nongovernmental Entity) does not use coercion for labor or services as defined in§787.06,Florida Statutes. Under penalt of perjury, I declare that I have read the foregoing Affidavit and that the facts stated in it are true. 7/4i- 1/23/25 (Signature of authorized representative) Date STATE OF FLORIDA COUNTY OF HILLSBOROUGH Sworn to(or affirmed)and subscribed before me, by means of physical presence or online notarization this �xt't day of 104w4,a1, 20Z •by 17G 1 jL __.__(Name of Affiant),who produced their as identification or are rsonally known to me.__, nt. c y :R" Ahllf la. icouC i Notary Public *: :•a MY COMMISSION#1NN373667 , FYPIRIM March 18,2027 tVivtli Lt Z2-7' _- • - ^" n--.. Commission Expires Personally Known E'OR Produced Identification t] Type of Identification Produced: CONTRACT,RENEWAL,OR EXTENSION REQUEST FORM Version:2025.1