Backup Documents 09/09/2025 Item #16B 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 B 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.
** 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
h
2
3. County Attorney Office County Attorney Office
1 fl/ 3
4. BCC Office Board of County
Commissioners ,BS 6y
5. Minutes and Records Clerk of Court's Office r
910145
Send via email to Katherine Chachere:
Katherine.Chachere@colliercountyfl.gov
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 Katherine Chachere Phone Number (239)252-5805
Contact/Department
Agenda Date Item was BCC Meeting Date 9/9/25 Agenda Item Number 16.B.1
Approved by the BCC
Type of Document(s) Change Order Number of Original 4
Attached Documents Attached
PO number or account 4500218257
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? KC
2. Does the document need to be sent to another agency for additional signatures? If yes, NA
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 NA
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 NA
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
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 9/9/25 and all changes made N/A is not
during the meeting have been incorporated in the attached document. The County Kr an option for
Attorney 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 KL an option for
Chairman's signature. this line.
1661
Co Tier County
Procurement Services Change Order Form
Contract# 18-7432-C E co#2 Po#4500218257 Project#: 60228.8
Project Name:Oakes Blvd. Sidewalks & Roundabout
Contractor/Consultant Name: Black & Veatch
Select One: ❑Contract Modification(Construction or Project Specific) 0 Work Order Modification
•
Project Manager Name: Katherine Chachere Division Name: Transportation Engineering
Original Contract/Work Order Amount $418,197.40 02/25/20, 16E7 Original BCC Approval Date;Agenda Item#
Current BCC Approved Amount $436,210.58 02/06/24,ADMIN Last BCC Approval Date;Agenda Item#
Current Contract/Work Order Amount $436,210.58 02/24/2026 SAP Contract Expiration Date(MASTER)
•
Dollar Amount of this Change $116,794.74 32.24% Total%Change from Original Amount
Revised Contract/Work Order Total $553,005.32 26.77 %Change from Current BCC Approved Amount
Total Cumulative Changes $134,607.92 26.7Pr %Change from Current Amount
Notice to Proceed 06/27/22 Original NTP 360 Original Final 06/22/23 Last Final 11/15/24
Date #of Days Completion Date Approved Date
#of Days Added 300 Revised Final Date TBD Current Substantial Completion Date NA
(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; Q Use of Allowance;
0 Modify/Delete existing Task(s); ❑Add new Task(s); 0 Reallocate funds; ❑Other(must be explained in detail below)
1.) This change order adds $116,794.74 and 300 days to the contract time due to permitting,
expansion of the stormwater design, water quality efforts, environmental analysis, and permitting with
the Water Management District.
The project requires permitting and coordination due to encroachment into a wetland corridor at the
corner of Spanish Oaks Lane and Oakes Boulevard, the proposed roundabout location. Scope for
refining and expanding the stormwater system and addressing the overall drainage on Oakes Blvd is
also needed.
KAG 7/25/25
2.) A notice to stop work was issued on 6/14/2023, leaving 8 days on the work order. Change Order #1
was processed and approved on 2/6/2024, adding 232 days to the project's work order. A start work
was issued on 3/20/2024 with 240 days remaining. Another stop work notice was issued on 11/6/2024,
leaving 9 days remaining. The revised completion date will be determined when the work is started
again.
3.) The wetland corridor became a constraint for this project as the project developed, not when the
consultant was initially hired as an Engineer for the project. Therefore, the additional permitting,
associated stormwater revisions and environmental impact analysis were not included in the
Engineer's original work order created for this project as the scope was for SFWMD exemption.
4.) If these changes are not authorized, the roundabout, sidewalk, and improved drainage structures
will not be built. These public improvements will not be made, and the taxpayer's money invested in
design and permitting fees will be lost.
Page 1 of 4
Change Order Form(2023_ver.1)
16B1
Co ter County Procurement Services Change Order Form
Contract# 18-7432-CE co#2 PO# 4500218257 Project#: 60228.8
Project Name: Oakes Blvd. Sidewalks & Roundabout
Contractor/Consultant Name: Black&Veatch
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 232 days to Need additional days to
Tasks 1 through 8, $18,013.18 232 592 complete the project.
reallocate &
increase funds.
Add 300 days to Tasks Add days and funds for
1 through 8 the permitting and drainage
2 project, reallocate, & $116,794.74 300 892 design to complete the
increase project funds.
project design.
❑Check here if additional summary page/s are attached to this Change Order
Page 2of4
Change Order Form(2023_ver.1)
16B1
Cofer County
Procurement Services Change Order Form
Contract# 18-7432-CE CO#2 PO# 4500218257 Project#: 60228.8
Project Name: Oakes Blvd. Sidewalks& Roundabout
Contractor/Consultant Name: Black& Veatch
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 (Sunblz) website(https://dos.mvflorida.com/sunblz/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.
ChachereKatherine Digitally signed by ChachereKatherine
Prepared by: Date:2025.07.07 10:20:09-04'00' Date: 07-07-2025
Signature-Division Project Manager
Katherine Chachere, RLA, Project Manager Ill (Licensed),Transportation Engineering
Printed Name
Og�ei .tined by RANI E.Fd..II.PE
Rafael E. Frias III, PE °�; �So;s ,�°Bacit"" u."' �ti<'E
Accepted by: Date:
Signature-ContractorlConsultantiVendor
Rafael E. Frias III, P.E.,Associate Vice President, Black&Veatch
Printed Name/Title/Company Name
AhmadJay Digitally signed by AhmadJay
Approved by: Date:2025.07.09 06:07:24-04'00' Date:
Signature-Division Director
Jay Ahmad, PE, Division Director-Transportation Engineering
Printed Name
Digitally signed by
LC y
ScottTrinity SDale:oolth 202inil5.07.17
Approved by: 09:32:56-04'00' Date:
Signature-Department Head
Trinity Scott, Department Head,Transportation Management Services
Printed Name
Page 3 of 4
Change Order Form(2023_ver.1)
CAO
16B1
Coi[ier County
Procurement Services Change Order Form
Contract# 18-7432-CE co#2 Po# 4500218257 Project#: 60228.8
Project Name: Oakes Blvd. Sidewalks & Roundabout
Contractor/Consultant Name: Black&Veatch
FOR PROCURMENT USE ONLY
FY 25 CHO Request# 716
GiarimoustasViviana Digitally signed by GiarimoustasViviana'
Approved by: Date:2025.07.22 1402:43 0400
Signature-Procurement Professional Signature/Date
Approved by:
Signature-Procurement Manager/Director(OPTIONAL)
APPROVAL TYPE:
Li Administrative ri Administrative-BCC Report Q BCC Stand-Alone ES (BCC Approval Required)
BCC APPROVAL
ATTEST:
gr'�y9� .
Crystal K. Kinzet,-Olfk,b�fthe_Circuit Court BOARD OF COUNTY COMMISSIONERS
and Comptroller jf COLLIER COUNTY, FLORIDA
'sr
By: __, /l. By: /34,19,,Aegifigibes.
Dated: ,.� �.J Burt L. Saunders, Chairman
Attest as to Ch irman"s
signature only t
(SEAL) Agenda# i bt ( G/41/25j
A roved as to For d gality:
D ty County Attorney
sU �� a 1l
Print Name
Page 4 of 4
01'Change Order Form(2023_ver.1)
3: