Backup Documents 03/25/2025 Item #16B 7 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 D 7
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.
3. County Attorney Office County Attorney Office
h-)
4. BCC Office Board of County
Commissioners Pdy/6b/ y/Z/L5
5. Minutes and Records Clerk of Court's Office
114- 141426 1S3
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 Keyla Castro,PINE Phone Number 239-252-5853
Contact/Department
Agenda Date Item was 03/25/2025 Agenda Item Number 16.B.7
Approved by the BCC
Type of Document(s) Change order Number of Original
Attached 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. (Initial) Applicable)
I. Does the document require the chairman's original signature(instead of stamp)? KC
2. Does the document need to be sent to another agency for additional signatures? If yes, KC
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 KC
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 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 KC
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 KC
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip KC
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 03/25/2025 and all changes made during KC N/A is not
the meeting have been incorporated in the attached document. The County Attorney 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 KC N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the 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
1687
Copier County
Procurement Services Change Order Form
Contract# 23-8108 CO# 1 PO# 4500231142 Project#: 33736.3.2
Project Name: Design Sevices for Collier Area Transit Operations and Maintenance Facility
Contractor/Consultant Name: Jacobs Engineering Group, Inc.
Select One:❑Q Contract Modification(Construction or Project Specific) ❑Work Order Modification
Project Manager Name: Liz Soriano Division Name: PTNE
Original Contract/Work Order Amount $1,735,063.00 2/13/2024;1682 Original BCC Approval Date;Agenda Item#
Current BCC Approved Amount $1.735,063.00 2/13/2024;16B2 Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount $1,735,063.00 1/16/2025 SAP Contract Expiration Date(MASTER)
Dollar Amount of this Change so.00 o.00% Total%Change from Original Amount
Revised Contract/Work Order Total $1,735.063.00 0.00% %Change from Current BCC Approved Amount
Total Cumulative Changes $o.00 o.00% %Change from Current Amount
Notice to Proceed Task 1-4;5/012024 Original NTP Task 1-4:252 Original Final Ta«1-4;1m8/2025 1 Last Final Task 1 4;1/16/2025
Date #of Days _Completion Date Approved Date
#of Days Added Revised Final Date Current Substantial Completion Date
Task 1 4;50 (includes this change) Teo (if applicable) N/A
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:❑s Add Time; El Add funds;❑ Use of Allowance;
El 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.
Change order is for adding time and zero dollars to Task 3 and 4 to allow to complete 100% plans.
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.
This Change Order is currently under a Stop Work, issued on 1/15/2025 and one day remaining.
3.) Explain why this change was not included in the original contract/Work Order.
A time extension is needed to allow the consultant to complete through Task 4 as the proposed plans
that were submitted needed to be revised as there were some items that were cost prohibited. The
days that were necessary to complete Task 3 and 4 were used to evaluate the costs and the plans to
be able to meet the planned budget.
4.) Describe the impact if this change is not processed.
If this change order is not approved the design plans cannot move forward and the project can not
move forward and therefore the project will need to be terminated.
Page 1 of 4
Change Order Form(2023_ver,1)
' 6S7
Cofer County
Procurement Services Change Order Form
Contract# 23-8108 CO# 1 PO# 4500231142 Project#: 33736.3.2
Project Name: Design Sevices for Collier Area Transit Operations and Maintenance Facility
Contractor/Consultant Name: Jacobs Engineering Group, 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
Adding 50 days additional days are needed to
1 50 302 complete up to task 4, due to
a redesign of the conceptual
plan needed to meet budget.
❑ Check here if additional summary page/s are attached to this Change Order
Page 2 of 4
Change Order Form(2023_ver.1)
CAO
16S7
Coer County
Procurement Services Change Order Form
Contract# 23-8108 CO# 1 PO# 4500231142 Project#: 33736.3.2
Project Name: Design Sevices for Collier Area Transit Operations and Maintenance Facility
Contractor/Consultant Name: Jacobs Engineering Group, 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.
SorianoLiz Digitally signed by SorianoLiz
Prepared by: Date:2025.01.30 13:29:52-05'00' Date: 1/30/2025
Signature-Division Project Manager
Liz Soriano
Printed Name Digitally signed by Kevin Regalado
Accepted by: Date:2025.01.30 13:38:57-05'00' Date: 1/30/2025
Signature-Design/Engineer Professional(if applicable)
Printed Name/Title/Company Name
Accepted by: Date:
Signature-Contractor/Consultant/Vendor
Printed Name/Title/Company Name
DeleonOmar Digitally signed by DeleonOmar
Approved by: Date:2025.02.04 09:42:39-05'00' Date: 2/04/25
Signature-Division Manager or Designee(Optional)
Omar De Leon
Printed Name
WeIISBrian Digitally signed by WellsBrian
Approved by: Date:2025.02.04 10:52:36-05'00' Date: 02/04/2025
Signature-Division Director or Designee(Optional)
Brian Wells
Printed Name
ZS
ScottTri n ity Digitally signed by ScottTrinity
Approved by: Date: 2025.02.11 11:30:55-05'00' Date:
Signature-Division Administrator or Designee(Optional)
CS (Grants) Trinity Scott
Printed Name
Page 3 of 4
Change Order Form(2023_ver.1)
CAo
16R7
Co r County
Procurement Services Change Order Form
Contract# 23-8108 CO# 1 PO# 4500231142 Project#: 33736.3.2
Project Name: Design Sevices for Collier Area Transit Operations and Maintenance Facility
Contractor/Consultant Name: Jacobs Engineering Group, Inc.
FOR PROCURMENT USE ONLY
FY25 CHO Request# 575
BOW denStephant•e Digitally signed by BowdenStephanie
Date:2025.02.12 15:15:24-05'00'
Approved by:
Signature-Procurement Professional Signature/Date
Approved by:
Signature-Procurement Manager/Director(OPTIONAL)
APPROVAL TYPE:
❑ Administrative X Administrative-BCC Report ❑ BCC Stand-Alone ES (BCC Approval Required)
BCC APPROVAL
ATTEST:
Crystal K. Kinzel, Clerk of the Circuit Court BOARD OF COUNTY COMMISSIONERS
and Comptroller COLLIER COUNTY, FLORIDA
•
BylcIP-A-,V-1440,AA.41--e-GLI)C-- By4e4...,eel.0)6&4 .
,, Attest as to Chairman's
Burt L. Saunders
i ' ,12b?r signature onlyChairman
�Oated: �'�" 'QZ_
, ! ' f'1',,`'` ' .-, Date: 03/25/2025
(SEAL) Agenda# 16.B.7
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Ap oved as to For eg ty:
County
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Print Name
Page 4
Change Order Formm(2023 ver.1)
Ce),
t 6 B 7
3/25/2025
Item # 16.B.7
ID# 2025-722
Collier County
Board of County Commissioners
Item Number: 16.B.7.
Item ID#: 2025-722
Item Title: Recommendation to ratify administratively approved Change Order No. 1,adding fifty days to Tasks 1 through 4
for Purchase Order No.4500231142,under Agreement No.23-8108 with Jacobs Engineering Group,Inc.,for Design Services
for the Collier Area Transit Operations and Maintenance Facility,and authorize the Chairman to sign the attached Change
Order.(Project No.33736 and 33767)
Meeting Date: 3/25/2025
Entered By:
Name: Keyla Castro,Operations Support Specialist 11
(02/21/2025 3:47 PM)
Email: Keyla.Castro@ColiierCountyFL.gov
Prepared By:
Name: Liz Soriano,Project Manager,Public Transit&Neighborhood Enhancement Division
Approved By:
Keyla Castro Created/Initiated-2/21/2025
Jeanne Marcella Approved-2/21/2025
Brian Wells Approved-2/21/2025
Procurement Services Gatekeeper Approved-2/22/2025
Brandy Otero Approved-2/24/2025
Ellen Sheffey Approved-2/25/2025
Sandra Srnka Approved-2/25/2025
Trinity Scott Approved-2/26/2025
Scott Teach Approved-2/27/2025
Erica Robinson Approved-3/3/2025
Elaine English Approved-3/3/2025
Debra Windsor Approved-3/3/2025
Agnieszka Chudy Approved-3/3/2025
Therese Stanley Approved-3/5/2025
Maggie Lopez Approved-3/13/2025
Jeff Klatzkow Approved-3/13/2025
Amy Patterson Final Approval-3/13/2025