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Backup Documents 04/08/2025 Item #16B 9 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 B 9 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 D�yaanv a�9aae 1.Shannon Bassett PMP, Field Inspector II Transportation Engineering Shannon bB S�;;a�° Bassett Date.2025 04 11 11.51.12-04.00' 2. Kimberly Brandes, Admin Support Transportation Engineering Brandes B;aa,"4Km7be,17 Kimberly Date 2°�504' Specialist II � 3. County Attorney Office County Attorney OfficeV�j ! V0//.. 4. BCC Office Board of County / Commissioners !/S4//*/ / y//7/zs 5. Minutes and Records Clerk of Court's Office 1:Cfretat 1iife. . PRIMARY CONTACT INFORMATIO 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 04/08/2025 Agenda Item Number 16.B.9 Approved by the BCC _ Type of Document Change Order#1 for adding time to the Number of Original 1 Attached Green Blvd Bike Lanes 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 therNot Applicable column,whichever is Yes N/A (Not appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature STAMP OK V 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 V 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 03/12/25 and all changes made during ✓ SB N/A is not the meeting have been incorporated in the attached document. The County an option for Attorney's Office has reviewed the changes,if applicable. 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 an option for Chairman's signature. this line. 1 6 B 9 Co r County Procurement Services Change Order Form Contract# 23-8157 G2M22 CO#01 PO#4500233049Project#: 33849 FPN438093-2-58-01 Project Name:Green Boulevard Bike Lanes (LAP) Contractor/Consultant Name: Quality Enterprises USA,inc Select One: E Contract Modification(Construction or Project Specific) ❑Work Order Modification Project Manager Name: Shannon Bassett PMP Division Name: Transportation Engineering Original Contract/Work Order Amount ( S2,065.254.12 04/23/24#1SB11 Original BCC Approval Date;Agenda Item# Current BCC Approved Amount , $2,065,254.12 04/23/24#16B11 Last BCC Approval Date;Agenda Item# Current Contract/Work Order Amount S2,065,254.12 '04/19/25 SAP Contract Expiration Date(MASTER) Dollar Amount of this Change $0.00 0.00% Total%Change from Original Amount Revised Contract/Work Order Total a2.c65,254.12 0.0o% %Change from Current BCC Approved Amount Total Cumulative Changes so.0o o.00% %Change from Current Amount Notice to Proceed 10/21/24 Original NTP 180 Original Final 04/19/25 Last Final p4/19125 Date #of Days Completion Date Approved Date #of Days Added 21 Revised Final Date TBD Current Substantial Completion Date 03/20/25 (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;❑Add funds;❑ Use of Allowance; ❑Modify/Delete existing Task(s);0 Add new Task(s);0 Reallocate funds;0 Other(must be explained in detail below) 1.) This $0 Change Order will add twenty-one (21) additional days due to unforeseen utility conflicts, observed holidays and construction/repair activities done by others. 2,) A work stop was issued on 2-3-25 due to a continuing utility conflict with Lumen facilities on the project. There are seventy-five (75) days remaining on the original contract. 3.) Eighteen (18) days due to unforeseen underground utility conflicts and utility repairs due to Hurricane Milton within the work zone. Three (3) days due to observed holidays on November 28, 2024, December 25, 2024 and January 1, 2025. 4.) These 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) 16B 9 G° r County Procurement Services Change Order Form Contract# 23-8157 G2M22 CO# 01 PO# 4500233049 Project#: 33849 FPN438093-2-58-01 Project Name: Green Boulevard Bike Lanes (LAP) Contractor/Consultant Name: Quality Enterprises USA,Inc Change Order/Amendment Summary (If additional spaces needed,attached a separate Summary page to this amendment request) COST TIME CO# AMO# Description Additive Deductive Days j Total New Justification (+} (-) Added I Time Add 21 days to To allow the contractor 01 complete the 21 201 additional time to construct project i 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 verA) 169 9 Cor CountyProcurement Services Change Order Form Contract# 23-8157 G2M22 CO# 01 PO# 4500233049 Project#: 33849 FPN438093-2-58-01 Project Name: Green Boulevard Bike Lanes (LAP) ContractoriConsultant Name: Quality Enterprises USA,Ine 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.rnyfloricla.c:orrt.surtbizfsearch/Z. 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.2025.02.0E 18:47:26-05'00' Date Signature-Division Project Manager Shannon Bassett, PMP, Field Inspector II, Transportation Engineering Printed Name Accepted by: Date: Signature-DesigntEngineer Professional(if applicable) N/A Printed NamelTitlelCompany Name Accepted by Date: 2/10/2025 Signature-Contractor/Consultant/Vendor Lou Gaudio, Vice President, Quality Enterprises USA, Inc Printed Name/Title/Company Name Approved by ThomasMatthew ; Date. Signature-Division Manager or Designee(Optional) Matthew Thomas,P.E.,Supervisor of Project Management,Transportation Engineering Printed Name AhmadJa Digitally signed try AhmadJay Approved by: Date 2025.02.07 14.44.50-05'00' Date' Signature-Division Director or Designee (Optional) Jay Ahmad, P.E., Division Director, Transportation Engineering Printed Name Oigtally esgred by ScottTrinity Scotty O&,e7T,in025.02„ 11,31 30-05'00' Date. Approved by' 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) L3 B 9 Cott' County Procurement Services Change Order Form Contract# 23-8157 G2M22 Co# 1 PO# 4500233049 Project#: 33849 FPN438093-2-58-01 Project Name: Green Boulevard Bike Lanes (LAP) Contractor/Consultant Name: Quality Enterprises USA,Inc FOR PROCURMENT USE ONLY FY 25 CHO Request# 589 B kAid e n Stephanie Digitally signed by BowdenStephanie Date:2025.02.21 11:30:29-05'00' Approved by: Signature-Procurement Professional Signature/Date Approved by: Signature-Procurement Manager/Director(OPTIONAL) APPROVAL TYPE: Q Administrative Q Administrative-BCC Report [,; BCC Stand-Alone ES(BCC Approval Required) BCC APPROVAL ATTEST: Crystal K.Kl.610f e Circuit Court BOARD OF COUNTY COMMISSIONERS and CofnCl11d1 •.. ,,*, COLLIER COUNTY, FLORIDA • If fi, u sy: , By: /3.4"//ege410001••• . .f Burt L. Saunders , Chairman Dated: Attest ais to biltittraI-(��'2 S stgnature only Date: (SEAL) Agenda# Id I3 1 proved a o F L gality: u County Attar y w # X T.a/ Print Name Page 4 of 4 Change Order Form(2023_ver.1) ' T " f 16B 9 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:'Quality Enterprises USA,Inc. Address: 3494 Shearwater Street,Naples,FL 34117 Phone Number: 239-435-7200 Authorized Representative's Name: Louis J Gaudio u--_---- Authorized Representative's Title: Vice President Email Address: LGaudio@QEUSA.COM AFFIDAVIT 1 Louis J Gaudio (Name of Authorized Representative),as authorized representative attest that Quality Enterprises USA,Inc. (Name of Nongovernmental Entity)does not use coercion for labor or services as defined in§787.06,Florida Statutes. Under penalty of perjury,I declare that I have read the foregoing Affidavit and that the facts stated in it are true. /-6- zS (Signature of authorized representative) Date STATE OF {`1UiZ+tt r# COUNTY OF C.LI(iir'r�- , Sworn to(or affirmed)and subscribed before me,by means of 18 physical presence or©online notarization this Os day of ',)(1;4.1,iy, 20 _5, -' (Name of Affiant),who produced his Florida Driver's License as identification, Notary Public(not required when digital) wsf,hrIir C.OirIN • M'I COMMISSION EXPIRE s Fel-whey r t 2' r,', i tioiWN[Nu hAriy�rro k�rnv Commission Expires �..�. �. Personally Known ! )OR Produced Identification 0 Type of Identification Produced: fJ t6fit 9 „ex a January 31, 2025 Mrs. Shannon Bassett Collier County Project Manager 2885 South Horseshoe Drive Naples, FL 34104 Re: 438093-2-58-01 - Contract Time Extensions Dear Mrs. Bassett: Below is a breakdown of differing scenarios within contract time where contract time extension is justifiable. Contract Time Extension due to Utility Conflict/Hurricane Milton Impacts: Notice To Proceed (NTP) for the Green Blvd. project was given on Monday, October 21st, 2024. On Tuesday, October 22' while performing soft digs, it was discovered that there were conflicts with an unforeseen active CenturyLink conduit and the proposed drainage pipe between Santa Barbara Blvd. (Sta. 102+60) and Logan Ct. (Sta. 105+40). Quality Enterprises (QE) is working with CenturyLink and Collier County to resolve the conflict and schedule a relocation of the utility. In addition to the CenturyLink unforeseen conflict, there was an adjacent active project finalizing contract items overlapping with this project's staging area, as well as ongoing emergency repairs needed within the project limits due to Hurricane Milton.This caused additional delays as QE could not establish their staging area to start work on construction activities. To mitigate delays, the contractor mobilized to other areas of the project to continue working. Based on the request for additional time due to the above delays, the requirements of Specification 8-7.3.2, and the contractor's schedule, we see entitlement to an additional ten (18) contract days. Contract Time Extension due to Holiday Shutdowns: There have been a total of seven eligible holiday days during contract time, however the contractor elected to work on four of those days.Therefore, the contractor will only be granted three (3) contract days for holidays. See breakdown below and attached DWR's for the holidays the contractor elected to work. • 11/11/2024-Veterans Day—Contractor elected to work. No holiday granted. • 11/28/2024-Thanksgiving Day—Contractor did not work. Holiday granted. 2401 First Street,Suite 260,Fort Myers,FL 33901 I USA exa,CO'n 1 . B 9 • 11/29/2024—Day after Thanksgiving Day-Contractor elected to work. No holiday granted. • 12/24/2024—Christmas Eve-Contractor elected to work. No holiday granted. • 12/25/2024—Christmas Day- Contractor did not work. Holiday granted. • 01/01/2025—New Years Day-Contractor did not work. Holiday granted, • 01/20/2025—Martin Luther King Jr, Day- Contractor elected to work. No holiday granted. If you have any questions or concerns, please contact me at (239) 336-9272. Sincerely, �,� , p -I— �r.,�,,."'�, 1 ' Kevin Daugherty, P.E. Senior Project Engineer 2401 First Street,Suite 260,Fort Myers,FL 33901 I USA exo.com 'exp.