Modification Order #2 - St. Matthew's Hurricane Hardening
CONTRACTIWORK ORDER MODFlCATION
CHECKLIST FORM
PROJECT NAME: St. Matthew's Hur. Hard.
BtDlRFP #.lJ!A.....MOD t#: .!...POt# 4l!R0099320
DEPARTMENT: HoIaina and Human ~
PROJECT # DR 05.... PROJECT MANAGER: Usa Olen
WORK ORDER #: N1A
CONTRACTORlARM NAME:
Sl Me""". HouM Inc.
Original Contract Amount:
$ it3.834
(Starting Point)
CurTent acc Approved Amount:
$ 29l.~
(Last Total Amount Approved by the BeC)
$ 213.1311
(Including An Changes Prior To This Modification)
Current Contract Amount:
Change Amo\int:
Revtaed ContractlWork Order Amount:
$ 09.00
$~ ~39J 13 t.)
(Including This Chang'e Order)
Cumulative Dollar Value of Changes to
this ContractJWork Order:
$ 00.00
Date of Last BCe Approval 5J2~Q07
Agend8ltem# 16026
Percentage of the change over/under current coniract amount
Formula: (Revised Amount I Last BCC approved amooot)-1
o %
CURRENT COMPLETION DATE (5): ORIGINAL: 1,Dri130. 2009
1111s change order will: 0 Add a new Task for $
CURRENT: SeDtember 18. 2009
o Increase Task Number
by$
Othw
Describe the chang...): Clarify contract eX8CU1ion date and amend woltl ttchedule.
Specify the reuons for the change(s) r. 1. Planned or Elective r Z. Unforeseen Conditions r 3. Quantity
Adjustments C 4. Correction of Errors (Plans, Speclftcatlons or Scope of Work) r:: 5. Value Added
r 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change(s).
Identify oil nogatlve ImpllClB to the projocllf 11110 chong. 0""" __ not proc_: jJ .Jr1f"o(' r
U H1-LdJ /Y1 A f, ht; ~ &JrlLfJI(--:br/.
This chtmge was requested by: rtcontActorlConsultant ~ Owner n Uefng Deparbnent r CDeS
r Design Professional rlRegulatory Agency (Specify)
r Other (Specify) Mutual
CONTRACT SPEClAUST PARTICIPATION IN NEGOTlAnONS:
r Yes ~o
nl /
Date: C1/2{;.k!>;
This fonn 1$ to be slgr~~d dafedp~I., .
APPROVED BY: );:tr......~ &'\L.t1_\,
~ M8I1IISJ8f'
APP~VE~Y:
REVIEWED BY: ~.. ~ I 27 ,
Con ecla 1st
0)~1
Date:
6/27/L)9
Date:
EXHIBIT A-I Contract Ameadml1llt for Subrecipient Agreement
Florida Administrative Code 9BER06-J CFDA# 14.228
"St. Matthew's House Inc."
This amendment, dated
by and between the parties to the,
Subrecipient) and Collier County,
"County").
2009 to the referenced agreement shall be
riginal Asn:ement. Sf. Matthew's House Inc. (to be referred to as
political SQbdivision of the state of Florida, (to be referred to as
Stltemeat of Uudem.nd!l1
RE: Contract Florida Administrative Code 9BER06 #1".228 "St. Matthew's House Inc.",
In order to continue the services provided for in the original Agreement document referenced above, the
Sub-Recipient agrees to amend the above referenced AgrOi:lll1ent B.lI foJIOWll:
Note: Words sktlek 1Brellgb have been deleted. Words underlined have been added.
m. TIME OF PERFORMANCE: On page 20f23 amend as follows
The effective date of this Agreement lIDd all rights and dUlics designated hereunder are contingent upon the
timely release of funds for this project by DCA umItr Agreement No. 07DB.3V...{)9-21-01-Z 01. :ffte
.....'" ... Mill ... ... ...... .... ef ....li. 8t till..,...... IBd. .. Services of the
SUBRECIPIENT shaH be undertaken and completed in light of the purposes of this Agreemenl In any
event. all services required hereunder shall be completed by the SUBRECIPIENT prior to f.,,"1 39, 2099
Seotember 18. 2009. Any funds not obligated by the expiratiOn date of this Agreement shall automatically
revert to the COUNTY, as set forth in Part vm F (e). aId Part vm H below.
G. Work Scbedule: On page IS of23 amend as fbllowl
IT'"
Work completion
I ~~~ S.~...bor 18,2009
PlefIH /'late 1/wIII allY t( titMJ t<<1IMtk.' t::.'fetd lhe ,lme/ine,t If)' I'Im "'1{}mh6 d r<e\'_ )f6,w (H)/rejllk IMffl#
be !lJlsmWed /8 HHS
~O-mi \Y9~.ectlI1H~ i.P c:ffr:el for pl'OII'UI monitgrlng:r<<llllnlmcntt 00 Iv. and IS su':, lI1'::~
HOUSING AND HUMAN SERViCES.... ,eon ~lll ~ __<< \II", sqjg ~1Ii ra. . f.t
EXHIBIT A-I Contract Amendmeut for Subrecipient A&r1"mClOt.
Florida Adminis4rative Code 9BER06.1 CFDA# 14.228
"'St. Matthew's House Inc."
Page 2 of2
IN WITNESS WHEREOF, 1he Sub-Recipient and the Owner bave each, respectively, by an authorized
person or agent, hereunder set their hands and seals on tlje date(s) indicated below.
All other tenns and conditions'ofthe agreement shalll'.nain in force,
Su brecipient:
St. Matthews House lne
A-..: a.-(f ;{,-. 2009
Owner:
BT-k~;L~-
Rev, Vam Rmli.llOD
Executive Director
BOMID OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
Witn'l
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(i/lUP (;. IV4- T ",~~
Print Name and Title /fr:,et I- Ifl<
/'f C. If.
PRomCT COORDfNA TOR
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B)': . ", " i-::2 j"f-E. L
- Lisa Dien
By:
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NAI)~IS~TO
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CONTRAC S~crALIST \,~
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By: / .V~