Backup Documents 08/26/2025 Item #16F 1 (Absentia 07/22/2025 Item #16F1) ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 F 1
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 County Attorney Office
2. BCC Office Board of County
Commissioners Chairman fS/f[SI `l/5
3. Minutes and Records Clerk of Court's Office OA-6'
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 Sara.Schneeberger, Facilities Division Phone 239-252-5013
Staff Contact/ Number Sara.Schneeberger@colliercountyfl.gov
Department Email
Agenda Date Item July 22,2025— In Absentia Agenda
was Approved by the Item 16.F.1
BCC Number
Type of Document Recommendation to approve Change Order Number of
Attached No. 3, adding 123 days to the Professional Original 1
Services Agreement 21-7884 with Matern Documents
Professional Engineering, Inc., for the New Attached
Chiller Plant Building K. (Project No. 50214)
PO number or account Facilities Division is requesting a completed
number if document is copy
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? N/A
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
signed by the Chairman,with the exception of most letters,must be reviewed and signed SS
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 SS
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 �,�},
si•nature and initials are required. rY
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 July 22,2025—In Absentia N/A is not an
and all changes made during the meeting have been incorporated in the attached qI� option for this
document. The County Attorney's Office has reviewed the changes,if applicable. line.
l:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
9. Initials of attorney verifying that the attached document is the version approved by the 1 i' islot an
BCC, all changes directed by the BCC have been made, and the document is ready for the c,f(1(fl option for this
Chairman's signature. ✓ line.
16F 1
I. Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
1 6 F . 1
Co ...icw.r C,ourft y
Procurement Services Change Order Form
Contract# 21-7884 CO# 03 PO# 4500216578 Project#: 50214.1
Project Name: Design Services for New Chiller Plant Building K, Jail Generator & Platform
Contractor/Consultant Name: Matern Professional Engineering, Inc.
Select One: 0 Contract Modification (Construction or Project Specific) ❑Work Order Modification
Project Manager Name: Tim Rygiel Division Name: Facilities Management
Original Contract/Work Order Amount $1,406.974.00 1/25/202216c5 Original BCC Approval Date; Agenda item#
Current BCC Approved Amount $1,493,552.40 2/13/2024 16F6 Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount $1,403,552.40 7/30/2025 SAP Contract Expiration Date(MASTER)
Dollar Amount of this Change 6.15% Total%Change from Original Amount
Revised Contract/Work Order Total $1,493.55240 0.00% %Change from Current BCC Approved Amount
Total Cumulative Changes $86,578.40 0.0o a %Change from Current Amount
Notice to Proceed l Original NTP Original Final Last Final
2/11/2022 720 2/1/2024 7/30/2025
Date ; #of Days Completion Date Approved Date
#of Days Added 123 Revised Final Date 11/30/2025 Current Substantial Completion Date
(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: ❑Q Add Time; ❑ Add funds; ❑ Use of Allowance;
❑ 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 123 days to the contract to coincide with the current construction schedule
with a Final Completion date of 10/28/2025 and revises Schedule C of the agreement as follows:
Task 6 - 1,328 days
Task 7 - 1,388 days
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.
The additional time needed was unknown until the construction began. This request is to coincide with
the current construction schedule.
4.) Describe the impact if this change is not processed.
If this change order is not approved, the design team will not be available during the construction
phase as required.
Page 1 of 4
Change Order Form(2023_ver.1)
16F 1
cotr comity
Procurement Services Change Order Form
Contract# 21-7884 CO# 03 PO# 4500216578 Project* 50214.1
Project Name: Design Services for New Chiller Plant Building K, Jail Generator& Platform
Contractor/Consultant Name: Matern Professional Engineering, 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
Revised Schedule To reflect the employees
1 F. added/removed from the
project.
Added 120 days Estimated construction costs
and utilized dictated amended design
1 $125,659.20 of the 120 840 direction.
Contingency.
Revised Schedule To include the scope for
2 A, B, B.2.1, and C $86,578.40 Task 9 —
to include Task 9. Building K Flood Proofing.
Adds 425 days to If this change order is not
the contract.
approved,the design team will not
2 425 1,265 be available during the construction
phase as required.
Adds 123 days to This change order is issued to
the COntraCt. coincide with the construction
3 123 1,388 schedule to allow the design team to
be available during the construction
phase as required.
❑ Check here if additional summary page/s are attached to this Change Order
Page 2 of 4
Change Order Form(2023_ver.1)
6F 1
Cca ie-r County
_w -•�..-- �� �- —, ,. Procurement Services Change Order Form
Contract# 21-7884 CO# 03 PO# 4500216578 Project#: 50214.1
Project Name: Design Services for New Chiller Plant Building K, Jail Generator& Platform
Contractor/Consultant Name: Matern Professional Engineering, 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/ConsultanUDesign 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.
R nielTimoth Digitally signed by RygielTimothy
Prepared by. Y9 Date: 2025.06.11 12:35:08-04'00' Date:
Signature-Division Project Manager
Tim Rygiel PMP, CFM, Project Manager Ill, Facilities Management
Printed Name
Kevin T Griffith Digitally signed by Kevin T Griffith
Accepted by: Date.2025.06.11 13:42:01-04'00' Date:
Signature-Design/Engineer Professional (if applicable)
K.Todd Griffith, P.E., SVP- Director of SWFL Division, Matern Professional Engineering, Inc.
Printed Name/Title/Company Name
Accepted by: Date:
Signature-Contractor/Consultant/Vendor
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: 2025.06.11 12:16:21 -04'00' Date:
Signature-Division Director or Designee(Optional)
Brian DeLony, P.E., Division Director, Facilities Management
Printed Name
Approved by: Date:
Signature-Division Administrator or Designee (Optional)
Printed Name
III
Page 3 of 4
Change Order Form(2023_ver.1)
i 6 F 1
Co r County
.,,, .-- Procurement Services Change Order Form
Contract# 21-7884 CO# 3 PO# 4500216578 Project#: 50214.1
Project Name: Design Services for New Chiller Plant Building K, Jail Generator & Platform
contractor/Consultant Name: Matern Professional Engineering, Inc.
FOR PROCURMENT USE ONLY
FY 25 CHO Request# 694 J
Digitally signed by
BowdenStephanie BowdenStephanie
Approved by: Date:2025.06.19 18:27:30-04'00'
Signature-Procurement Professional Signature/Date
Approved by:
Signature-Procurement Manager/Director(OPTIONAL)
APPROVAL TYPE:
X Administrative ri Administrative-BCC Report ❑ BCC Stand-Alone ES (BCC Approval Required)
BCC APPROVAL
ATTEST'
Crystal K. Kjt ehP?t,4the Circuit Court BOARD OF COUNTY COMMISSIONERS
and Com lfzir , ' • COLLIER COUNTY, FLORIDA
By: By:A77141 :d?4;44h14-
-
-,}t :'
r Burt L. Saunders , Chairman
Dated:
10 Cfiafrr *res ZS
s 'I,OturP.only Date:
(SEAL) Agenda # 01
(
Ap roved as to For nd egali
t Cou ty Attor y
.3.y...
Print Narne
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Page 4 of 4
Change Order Form(2023_ver.1)