Backup Documents 03/11/2025 Item #16B 8 ` 6 B 8
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 Attomey Office.
Route to Addressee(s)(List in routing order) Office Initials Date
1.Shannon Bassett PMP, Field Inspector II Transportation Engineering Shannon
WO 2025.0312
Bassett 151759 4)1'00
2. Kimberly Brandes, Admin Support Transportation Engineering Brandes B;ena=
Specialist II Kimberly°o02-04 2
3. County Attorney Office County Attorney Office /.%91 7/1/
Uk
4. BCC Office Board of County Commissioners N 4 3/i Siz
5. Minutes and Records Clerk of Court's Office i
Z! Ol�dt I
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 Shannon Bassett/Transportation Contact Information 239-348-1328
Contact/Department Engineering
Agenda Date Item was 03/11/2025 Agenda Item Number 16.13.8
Approved by the BCC
Type of Document Change Order#1 for adding time to the Number of Original 1
Attached Bike Lanes 111th Ave NE Bluebill Ave Documents Attached
Bridge to 7th Ave N Project
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 Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK ✓SB
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 ✓SB
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 N/A
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 ✓SB
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 N/A
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 your deadlines!
8. The document was approved by the BCC on 03/11/25 and all changes made during ✓SB N/A is not
the meeting have been incorporated in the attached document. The County an.optir;for
Attorney's Office has reviewed the changes,if applicable. 2�6
9. Initials of attorney verifying that the attached document is the version approved by the •
t
BCC,all changes directed by the BCC have been made,and the document is ready for the 4:114 an idAtion for
Chairman's signature. this line.
16B8
CI €yr Comity
Procurement Services Change Order Form
Contract# 23-8150 G2A77 CO#01 PO#4500232595 Project#: 33620.2 FPN441846-1-58-01
Project Name: Bike Lanes 111th Ave N E Bluebill Ave Bridge to 7th Ave N (LAP)
Contractor/Consultant Name: Thomas Marine Construction inc.
Select One: Contract Modification(Construction or Project Specific) ❑Work Order Modification
Project Manager Name: Shannon Bassett PMP Division Name: Transportation Engineering
Original Contract/Work Order Amount $1,871.602,07 02/27/24#1681 Original BCC Approval Date;Agenda Item#
Current BCC Approved Amount $1,871,602.07 02/27/24#16E31 Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount $1,871,602,07 103/10/25 SAP Contract Expiration Date(MASTER)
Dollar Amount of this Change $0.00 I 0.00% Total%Change from Original Amount
Revised Contract/Work Order Total I $1.871,602.07 0.00% % Change from Current BCC Approved Amount
Total Cumulative Changes so.00 o.00% °I° Change from Current Amount
Notice to Proceed 08/12/24 Original NTP Original Final Last Final
210 03/10/25 03/10/25
Date , #of Days Completion Date Approved Date
#of Days Added 14 Revised Final Date 03/24/25 Current Substantial Completion Date 02/08/25
(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; 0 Use of Allowance;
0 Modify/Delete existing Task(s);0 Add new Task(s); 0 Reallocate funds;0 Other(must be explained in detail below)
1.) This change will add an additional Fourteen (14) days to the contract due to inclement weather,
hurricanes and observed holidays.
2.) N/A.
3.) Eleven (11) days due to inclement weather, caused in part by hurricanes in September and October
2024 and three (3) days due to the observed holidays on September 2, 2024, November 28, 2024 and
November 29, 2024.
4. ) Weather days are not part of the bid documents but added on as needed and requested by the
contractor. This is in accordance with FDOT specifications per the contract.
Page 1 of 4
Change Order Form(2023_ver.1)
A
1 6 B..8
CAT GOidlity
Procurement Services Change Order Form
Contract# 23-8150 G2A77 CO# 01 PO# 4500232595 Project#: 33620.2 FPN441846-1-58-01
Project Name: Bike Lanes 111th Ave N E Bluebill Ave Bridge to 7th Ave N (LAP)
Contractor/consuitant Name: Thomas Marine Construction 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.myfloricia.com%sunhiz/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.
Shannon Bassett Digitally signed by Shannon Bassett
Prepared by: Date:2025.01.17 11:24:45-05'00' Date:
Signature-Division Project Manager
Shannon Bassett PMP, Field Inspector II, Transportation Enginnering
Printed Name
Accepted by: Date:
Signature-Design/Engineer Professional (if applicable)
N/A
Printed Name/Title/Company Name
Mark D Digitally signed by Mark D
Mabee
Mabee Date:2025.01.31
Accepted by: II 21 39-0bdo• Date:
Signature-Contractor/Consultant/Vettdor
Mark Mabee, Vice President, Thomas Marine Construction, Inc
Printed Name/Title/Company Name
ThomasMatthew
Approved by: Date.
Signature-Division Manager or Designee(Optional)
Matthew Thomas.P.E.,Supervisor of Project Management,Transportation Engineering
Printed Name
AhmadJay Digitally signed by AhmadJay
Approved by: Date:2025.01,21 14:46:49-05'00' Date:
Signature-Division Director or Designee(Optional)
Jay Ahmad, P.E.. Division Director, Transportation Engineering
Printed Name
Digdally signed by
5cntt T Tinily
ScottTri n i ty Date:21i25.02.04
Approved by: 16 33: 4.0500' Date:
Signature-Division Administrator or Designee (Optional)
Trinity Scott,Department Head.Transportation Management Services Department
Printed Name
Page 3 of 4
Change Order Form(2023_ver.1)
16 B8
cc- .7 r County
_»per Procurement Services Change Order Form
Contract# 23-8150 G2A77 CO# 1 PO#4500232595 Project#: 33620.2 FPN441846-1-58-01
Project Name: Bike Lanes 111th Ave N E Bluebill Ave Bridge to 7th Ave N (LAP)
contractor/consultant Name: Thomas Marine Construction inc.
FOR PROCURMENT USE ONLY
FY 25 CHO Request# 571
Bowden Ste p h a n i e Digitally signed by BowdenStephanie
Approved by Date:2025,02.07 11:53:19-05'00'
Signature-Procurement Professional Signature/Date
Approved by:
Signature-Procurement Manager/Director(OPTIONAL)
APPROVAL TYPE:
C] Administrative X Administrative-BCC Report fl BCC Stand-Alone ES (BCC Approval Required)
BCC APPROVAL
ATTEST:
Crystal K. Kinzel,Cl r he Circuit Court BOARD OF COUNTY COMMISSIONERS
and ComptroNer- COLLIER COUNTY, FLORIDA
,'
By: ' BY
lio.:: A "e4e€441114"'
At st to C �� irman's Burt L. Saunders , Chairman
trill" rL .
= Date: 3/I I/ZS
(SEAL) Agenda# ji`, 04.3
\Approve s d gality:
CDep County Attorn
_ Z44 Q ----.Qa.e. L_
Print Name
Page4of4
Change Order Form(2023_ver.1) 1p
16BR
Co r Cointo
Procurement Services Change Order Form
Contract# 23-8150 G2A77 CO# 01 PO# 4500232595 Project#: 33620.2 FPN441846-1-58-01
Project Name: Bike Lanes 111th Ave N E Bluebill Ave Bridge to 7th Ave N (LAP)
Contractor/Consultant Name: Thomas Marine Construction 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
Add 14 days to I To allow the contractor
p1 complete the 14 224 additional time to construct
project the project per plan,
•
•
•
•
❑Check here if additional summary page/s are attached to this Change Order
Page 2 of 4
Change Order Form(2023_ver.1)
1688
Hi hSpans
ENGINEERING, INC.
2121 McGregor Blvd, Ste. 200
Fort Myers, FL 33901
Office: 239.433.3000
Fax: 888.449.2462
December 5th, 2024 Letter No. 001
Delivery Via E-mail:
Mmabee@tmcfla.com
To: Mark D. Mabee, Vice President/Project Manager
ADJUSTMENT TO CONTRACT TIME FOR THE EFFECTS OF INCLEMENT
Subject: WEATHER, SUSPENSION OF OPERATIONS DURING HOLIDAYS AND
SPECIAL EVENTS
Fin No: 441846-1-58-01
FAP No: D122 039 B
Contract No: G2A77
County: Collier
Project Description: Bike Lanes Along 111th Ave. N. East of Bluebill Ave. Bridge to 7th St. N. (LAP)
Dear: Mr. Mabee,
Inclement Weather
The daily reports documenting the effects of inclement weather have been evaluated for the period
beginning August 12, 2024 to December 5, 2024. It has been determined 11 calendar day(s)
(September 3rd, 4th, 24th, 25th, 26th, 27th, October 7th, 8th, 9th, 10th, 11th) meet the criteria
established by the contract for granting additional contract time due to the effects of inclement
weather. It has been determined that 11 contract day(s) will be added to the total authorized contract
time.
Holidays
16B8
As outlined in Specification Subarticle 8-6.4, the Daily Reports documenting the holiday period
beginning August 12, 2024 to December 5, 2024 has been evaluated. It has been determined that 3
calendar day(s) (September 2"d, November 28th & 29th) meet the criteria established by the
Contract for granting additional time due to the suspension of operations for this holiday period.
Veterans Day (Monday November, 11 2024) was a holiday that Thomas Marine Construction
elected to work, thus no additional contract day will be granted for this reason. Pursuant to
Specification Subarticle 8-7.3.2, 3 contract day(s) will be added to the total authorized contract time.
Special Events
As outlined in Specification Subarticle 8-6.4, the Daily Reports documenting the Special Event from
August 12, 2024 to December 5, 2024. It has been determined that 0 calendar day(s) meet the
criteria established by the Contract for granting additional time due to the suspension of operations
for this Special Event period. Pursuant to Specification Subarticle 8-7.3.2. 0 contract day(s) will be
added to the total authorized contract time.
Your company has ten (10) days from receipt of this notice to appeal the number of days granted
herein. Any such appeal must be accompanied by all available specific facts supporting your position.
Failure to make an appeal or to provide the specific facts within ten (10) days from receipt of this
notice shall constitute a waiver of any rights to appeal the Department's decision at a later date.
Sincerely,
Edward W. Cooper
Project Administrator
Ah
16B8
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: 1 Thomas Marine Construction,Inc.
Address: 8999 High Cotton Lane,Fort Myers,FL 333005
Phone. Number: 239-337-0008
Authorized Representative's Name: Mark D.Mabee
Authorized Representative's Title: Vice President
Email Address: mmnbee@tmcfla.com
AFFIDAVIT
1 Mark D.Mabee _(Name of Authorized Representative),as authorized representative attest
that Thomas Marine Construction,Inc. (Name of Nongovernmental Entity)does not use coercion for labor or
services as defined in §787.06, Florida Statutes.
Under pent i y of perjury,I d lare that I have read the foregoing Affidavit and that the facts stated in it are true.
'.. -... ) 1/22/25
(Signatire of authorized fepresentative) Date
STATE OF FLORIDA
COUNTY OF LEE
Sworn to(or affirmed)and subscribed before me,by means of PI physical presence or online notarization this
:i;�•� day of ,; �r,, ._., 20.;Vi,bytiloW. 45 "r(;,.;,;, , (Name of Affiant),who produced their
as identification or a're personally known to me,
t l
Notary Public
i 1
t . 1
rl _
Commission expires
Personally Known ® OR Produced Identification(71
Type of Identification Produced:
LINDA SOLICH
commission#Hit 346132
•,, iow`,; Expires February 5,2027
CONTRACT,RENEWAL,OR EXTENSION REQUEST FORM Versipn•2025..1.
CA