#19-7624 1st Amendment (Kelly Borthers, Inc.) (TSI Disaster Recovery, LLC) (Quality Enterprises USA, Inc.) (Marine COntracting Group, Inc.) 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.
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. Risk Risk Management -2. County Attorney's Office County Attorney 1(19/ - 4P1/49
4. BCC Office Board of County
Commissioners 133 b„ Az/ oho
o
4. Minutes and Records Clerk of Court's Office ' 6a:11-444 _
0%
5. Procurement Services Procurement Services
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 mai need to contact staff for additional or missing information.
Name of Primary Staff Alison Christman/Procurement Contact Information 239-252-8486
Contact/Department
Agenda Date Item was October 28th,2025 Agenda Item Number 16.A.12
Approved by the BCC
Type of Document Amendment Number of Original 1
Attached Documents Attached
PO number or account N/A 19-7624 Kelly Brothers,INC
number if the Marine Contracting
document is to be Services
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 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. The original document has been signed/initialed for legal sufficiency. (All documents to AC
be 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 AC
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 AC
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's 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 October 28th,2025,and all changes N/A is not
made during the meeting have been incorporated in the attached document. The an option for
County 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 �n�fh0 an option for
Chairman's signature. '"1 this line.
FIRST AMENDMENT TO AGREEMENT No. 19-7624
FOR
Marine Contracting Services
A THIS FIRST AMENDMENT made and entered into on this �4141-'day of
V G-1 v bpi. 2025, by and between Kelly Brothers, Inc., (the "Contractor") and Collier County, a
political subdivision of the State of Florida, (the "County" or"Owner") (collectively, the "Parties"):
WHEREAS,on May 12,2020(Agenda Item No. 16.C.2),the County entered into Agreement
No. 19-7624, "Marine Contracting Services" (the "Agreement"), with the Contractor to provide parts
and services; and
WHEREAS,the Parties desire to amend the Agreement for an additional ninety days through
and including February 5, 2026, or upon issuance of a new contract whichever is sooner.
NOW, THEREFORE, in consideration of the mutual promises and covenants herein
contained, it is agreed by the Parties as follows:
1. The above recitals are hereby incorporated into this First Amendment as if fully set forth herein.
2. Upon execution of this First Amendment, the Parties agreed to extend the Agreement for an
additional ninety days through and including February 5, 2026, or upon issuance of a new
contract for such services, whichever is sooner.
3. All other terms and conditions of the Agreement, as previously amended, shall remain the same.
SIGNATURE PAGE TO FOLLOW
**Remainder of this page left blank intentionally**
Page 1 of 2
First Amendment to Agreement No. 19-7624
IN WITNESS WHEREOF, the Parties have executed this First Amendment on the date and
year first written above by an authorized person or agent.
ATTEST:
Crystal K. Kinzel, Clerk of the Circuit BOARD OF COUNTY COMMISSIONERS
Court and Comptoller COLLIER COUNTY, FLORIDA
n�•
1 '
By: �• By:
- • urt L. Sau ' ,4Zdlowes--
nders, Chairman
Dated:
(SEAL) ; to,Ghaliq' 's
`, `sMMnatur6I,iy
A ro ed to F and Legality:
Sco .Teach
Deputy County Attorney
CONTRACTOR:
Kelly Brothers,Inc.
By:
ignature
Dane Kelly,President
TType/print signature and titleT
Sept.23,2025
Date
Page 2 of 2
First Amendment to Agreement No. 19-7624
AFFIDAVIT REGARDING LABOR AND SERVICES
AND CONTRACTING WITH ENTITIES OF FOREIGN COUNTRIES OF CONCERN PROHIBITED
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.
Effective January 1,2024,a governmental entity may not accept a bid on,a proposal for,or a reply to,or enter into,a contract with
an entity which would grant the entity access to an individual's personal identifying information unless the entity provides the
government with an affidavit signed by an officer or representative under penalty of perjury attesting that the entity does not meet
any of the following criteria: (a)the entity is owned by the government of a foreign country of concern;(b)the government of a
foreign country of concern has a controlling interest in the entity;or(c)the entity is organized under the laws of or has its principal
place of business in a foreign country of concern.
Effective July 1,2025,when an entity extends or renews a contract with a governmental entity which would grant the entity access
to an individual's personal identifying information,the entity must provide the governmental entity with an affidavit signed by an
officer or representative of the entity under penalty of perjury attesting that the entity does not meet any of the criteria in paragraphs
(2)(a)-(c),§287.13 8,Florida Statutes.
Nongovernmental Entity's Name: Kelly Brothers, Inc.
Address: 15775 Pine Ridge Raod,Fort Myers,FL 33908
Phone Number: 239-482-7300
Authorized Representative's Name: Dane Kelly
Authorized Representative's Title: President
Email Address: estimating@kellybros.net
I Dane Kelly (Name of Authorized Representative), as authorized representative attest under
penalty of perjury that Kelly Brothers, Inc. (Name of Nongovernmental Entity) does not: (1) use
coercion for labor or services as defined in §787.06,Florida Statutes,and(2)the nongovernmental entity is not(a)owned by
a government of a foreign country of concern,(b)that a foreign country of concern does not have a controlling interest in the
entity, and (c)that the entity is not organized under the laws of or has its principal place of business in a foreign country of
concern,all as prohibited under§287.138,Florida Statutes.
Under penalty of perjury,I declare that I have read the foregoing Affidavit and that the facts stated in it are true.
9/8/2025
(Signature of authorized representative) Date
STATE OF Florida
COUNTY OF Lee
Sworn to(or affirmed)and subscribed before me,by means of O physical presence or❑online notarization this
8th day of Sept. 20 25 by Dane Kelly (Name of Affiant),who produced his Florida Driver's License as
identification. 1
Ann Marie Aeschliman �-!. C(l,QC/ 9 `t—
,-'
Notary Public
i¢' "u`<- AM MARIEAESCHUMAN
02/11/2027 * • Commiwlon#HH366546
Commission Expires �}" 'r,° E ;ices February11,2027
4-ofnA
Personally Known O OR Produced Identification❑
Type of Identification Produced:
CONTRACT RENEWAL OR EXTENSION REQUEST FORM Version:2025.1
CA