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Modification Order #2 - One by One Infill CONTRACTIWORK ORDER MODIFICATION CHECKLIST FORM PROJECT NAME: One bv One IntllI PROJeCT #: DR 01-01 PROJECT MANAGER: UN OIen BID/RFP #~MOD': LPOI 4&0001932.6 DEPARTMENT: HnI.lna and Human ~~ WORK OROER': NIA CONTRACTORIFIRM HAIlE: One bv One Original ContnlctAmount: $ 415.000 (Starting Point) $ 415.000 (Last Total Amount Approved by the BCC) $ <415,0Qq (l.nducIng All C~ Prior T~ Thia ModFftcal,fon) $ 00.00 $" '*'.5; 000 (Including This Change Order) CUlT8nt Bee Approved Amount: Current Contract Amount Change Amount: RevlMd ContnlctlWork Order Amount: CwnUlatiV8 Dollar Value of Change. to ttll. ContnlctlWortc: Order: s ".00 Date of Last SCC Approvllt 5123f2001 Agenda IbIm 1# 16025 Percentage of the change overlunder current contract amount Formula: (Revised Amount Il..ut Bce approved amount)-1 CURRENT COMPLETION DATE (8): ORIGINAL: ADrtI ~ 2009 o ~o CURRENT: Seotember 18.2009 This change order will: 0 Add. new Task for $ o Increue Task Number by$ other DeKrlbe the change(s): Clarify ~nct execu1ion date and amend work 8chedu"" Specify the rea.OM for the change(s) r. 1. Planned or Elective r 2. Unforeseen Conditions r 3. Quantity Adjustments r 4. Correction of Errors (Plana, Speclficatlone or Scope of Work) r 5. Value Added r 8. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change(s). Identify all negative Impacts to the project if this change order were not pl'OC8H8d: LjJ This clwlge was requested by: nContractorJco....uttantX Owner n UsIng Department r CDES L.Deslgn Pro....,onal rlRegulatory Agency (Specify) r Other (Specify) Mutual CONTRACT SPECIALIST PARTICIPATION IN NEGOTrATlONS: r Yes XNO APPROVED BY: ..r ,,:1c'~ D..L..~ av P!'qect Man A(Y,",",,, I: REVIEWED BY ~. ~. ~/1 Yi) t~ Co Ja 1St ,~/ / Date: J?':t:.->t;/0s: Date: Date: 'I/:J % 9 EXHIBIT A-I Contract AmC8dmonl for Subrecipient Agreement Florida Administrative Code 988-'1 CFDA# 14.228 "One by One LtlldenhipFoundatiOll Inc." This amendment, dated by and between the parties to referred to as Subrecipient) an referred to as "County"). 2009 to the referenced agreement shall be original Agreement, One by One Leadership Foundation Inc. (to be Collier County, a political subdivision of the state of Florida, (to be Statement of V.........I RE: Contract Florida Administrative Code 9BER06 #14.128 "01le by One Leadership Foundation Inc.". In order to continue the services provided for in the ociain41 Agreement document referenced above, the Sub-Recipient agrees to amCl'ld the above referenced AJ1"IlIllIMIJt as follows: Note: Words stN. 1hfeHgh have beeu deleted. Words underlmed have been added. IlL TIME OF PERFORMANCE: On page 2 bf23 amend as follows The effective date of this Agreement and all rights and duties designated hereunder arc contingent upon the timely release of funds fat this projoct by DCA under AgrcemCllt No. 07DB-3V-09-2J-oI-Z 01. l1M lIWeslive .. ..,. .,. the IlIteR .. 01 ...... ~ tit .this .,..........t. ... .. Services of the SUBRECIPIENT shall be undertaken and completed in. light of the purposes of this Agreement In any event, all services required hereunder shall be completed by the SUBRECIPIENT prior to l'.Jlfil 39, 2009 September 18.2009. Any funds not obligated by tbe expil'ltion date of this Agreement sball automatically revert to the COUNTY, as set forth in Part VIII F (e), and Part VIII H below. I ::;, se_w" 8, ZOO9 Please note thai if any of these activities exceed the tl,,",lines by two months a revised work schedule must be submitted IQ HHS. NQn;; !'... ..scbedalca n m dct. for IJnltDIn moniWriAg rca~-:thr: ::';..:~= =~ HOUSING AND HtlMAN SERVICES lIS .crunl tncC "*' .. . . .' Is. EXHIBIT A-I Contract Amendment tbr Subrec.ipicn Agreement fo'lorida Adminimat.ivc Code 98E1lC)6.1 CFDAII14.221 "One by One I....oadcrship Foundation toe." ~e2of2 IN WITNESS WHEREOF, the Sub-Recipient and the ()wner have eacl1, respectively, by an authorized peniOn or agent, hereunder set their hands and seals on thcj date(s) indicated below. All other terms and conditions of the agreement shall rem,in in force. Accepted: ~ 2009 . p POUDdlI&ion Inc Owner: BO~ OF COUNTY COMMISSIONERS COI.j.LIER COUNTY, FLORIDA Witness ~~ -ztf~ I/Awvne~ Print Name and Title PRdJECT 9>PRDIN~.J'OR ., G' ... >.. ( ~;'. ~,.l"~~ _.- ~r l' B..,. '.". >' ...",-,.(, \. ~. '.",,", ~, . ""I, l.i$a Oien DEPAiT DIRE By:. :... Marcy R ./,{:2-.....(::