Backup Documents 09/13/2016 Item #16C 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6c 4
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.
-
2.
- -- - —
3. County Attorney Office County Attorney Office erne-
*
4. BCC Office Board of County 1=3Vb --\
Commissioners WS/ c\\-A:\
5. Minutes and Records Clerk of Court's Office
{r1 q43116 = m
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 Phone Number
Contact/ Department t�d2tKt) Z'2Za�1 , pp.-fro 5a--1/a 33
Agenda Date Item was / ✓ Agenda Item Number
Approved by the BCC 477/3/- /t,ey✓
•
Type of Document /'' ✓ Number of Original
Attached WOE Ot4Documents Attached
PO number or account
number if document is N/ri ! ��►s� l
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?.e �,5 t C
2. Does the document need to be sent to another agency for additional signatures? If yes, "LOC,'
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 r '
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's .I /A
Office and all other parties except the BCC Chairman and the Clerk to the Board N
5. The Chairman's signature line date has been entered as the date of BCC approval of the C�
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 �+,(
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip �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 ?Anter date)and all changes made CC
during the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC, all changes directed by the BCC have been made, and the document is ready for the
Chairman's signature.
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
MEMORANDUM 1 6 C 4
Date: September 15, 2016
To: Corrine Trtan, Project Manager
Public Utilities Department
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Work Order for Contract #14-6213-71
w/Douglas N. Higgins, Inc.
Attached is a scanned copy of the document referenced above, (Item #16C4)
approved by the Board of County Commissioners on Tuesday, September 13,
2016.
The original will be held on file in the Minutes and Record's Department for the
Board's Official Record.
If you have any questions, please feel free to contact me at 252-7240.
Thank you.
Attachment
1 6 C 4
WORK ORDER/PURCHASE ORDER
Contract 14-6213-71 '`Annual Contract for Underground Utility Contracting Services"
Contract Expiration Date: July 7, 2018 ✓
This Work Order is for professional Construction services for work known as:
Project Name: Creekside Boulevard Force Main Extension– Phase 1
Project No: 70044.12.5
The work is specified in the proposal dated July 8, 2016 which is attached hereto and made a part of
this Work Order. In accordance with Terms and Conditions of the Agreement referenced above, this
Work Order/Purchase Order is assigned to: Douglas N. Higgins, Inc.
Scope of Work: As detailed in the attached proposal and the following:
• Task I General
* Task II Wastewater Forcemain
* Task Ill Allowance /
✓,/
Schedule of Work: Complete work within 300 days from the date of the Notice to Proceed (240 days
to substantial completion plus an additional 60 days to final completion) which is accompanying this
Work Order. The Consultant agrees that any Work Order that extends beyond the expiration date of
%/Agreement# 14-6213-71 will survive and remain subject to the terms and conditions of that Agreement
until the completion or termination of this Work Order.
Compensation: In accordance with the Agreement referenced above, the County will compensate the
Firm in accordance with following method(s): Negotiated Lump Sum (NLS) ❑Lump Sum Plus
Reimbursable Costs (LS+RC) Time & Material (T&M) (established hourly rate Schedule A) 0
Cost Plus Fixed Fee (CPFF). (define which method will be used for which tasks) as provided in the
attached proposal.
Task I $ 16,170.00 NLS
Task II $ 572.489.00 NLS vr
Task III $ 50,000.00 T&M
� 1�0
TOTAL FEE 8,659.00 (NLS/T&M) ✓,` 1 �..
Clatoc-c-L-
PREPARED BY:
Corinne Trtan. Project Manager Date
APPROVED BY: —
Craig Paje 'cipal Pr ect anager Date
Page 1 of 3
Cqc.
1 C4
APPROVED BY:
Tom C elik, PPMD Director Date
APPROVED BY: r - e/8//6
Beth Jolinssen, W tewater Director Date
is
401'
APPROVED BY: _ s s a/a/1,6
George Yilmaz, Division Administrator < Date
By the signature below, the Firm (including employees, officers and/or agents) certifies, and hereby
discloses, that, to the best of their knowledge and belief, all relevant facts concerning past, present, or
currently planned interest or activity(financial,contractual, organizational, or otherwise)which relates
to the proposed work; and bear on whether the Firm has a potential conflict have been fully disclosed.
Additionally,the Firm agrees to notify the Procurement Director,in writing within 48 hours of learning
of any actual or potential conflict of interest that arises during the Work Order and/or project duration.
ACCEPTED BY: Douglas N. Higgins, Inc.
Name &Title of Authorized Officer Date
bra eIC, V P
(Remainder of page intentionally left blank)
Page 2 of 3
0
16C4
IN WITNESS WHEREOF,the parties hereto,have each,respectively, by an authorized person or
agent,have executed this Work Order on the date and year first written below.
A 1."1 EST: BOARD OF COUNTY COMMISSIONERS
Dwight E. Brock, Clerk of Courts COLLIE: COUNTY, FLORIDA
By: As- By:
�.
r Donna Fiala,Chairwoman
Dated: .; 1 6 .r.0 1
(SEAL)
Attest to Chairman's Douglas N. Higgins,Inc.
signatureonly.
�? 3
First Witness � �1 Signature
11 _
Bravk t, (. +c I '11+Z
1 aYYitt rem LA)I c' TType/ 'nt signature and titlel'
l Typelprint witness name
sec,. ' . lie,
l(te s 47&-V‘
TType/print witness nameT
Approved as to Form and Legality:
///
Assistant County Attorney
CO)peer) 6yeeri-€ __
Print Name
Page 3 of 3
16C4
Cher Gauntry
Administrative Services Department
Procurement Services Division
REQUEST FOR QUOTATIONS FOR MULTIPLE PROJECTS UNDER CONTRACT
#14-6213"Annual Contract for Underground Utilities&General Contractors"
Date: June 24, 2016
From: Swainson Hall, Procurement Strategist
239-252-6936, Telephone Number
239-252-6597, Fax Number
swainsonhallt''2a coliiergov.net
To: Potential Quoters
Subject: RFQ 14-6213-71 Creekside Forcemain Phase I
As provided in the referenced contract, the Collier County Procurement Services Division is
soliciting quotes for the referenced project.
RFQ Due Date: Friday,July 8,2016 at 3:00 PM •
Wednesday,June 29, 2016 at 2:30PM
Procurement Services Conference Room
Pre-Quote Meeting: 3327 Tamiami Trail E,Naples, Ft,34112
Q&A Deadline: Wn Thursday,July 6, 2015 at 5:00 PM
Number of Days to Final Completion: 240 days to substantial+60 days final=300 days total
Scope Provided Yes
Plans and Specs: Yes
Liquidated Damages: $1,271.50
Payment& Performance Bonds if over$200,00000
Your quotation response for this project is due no later than the date and time specified above. We
will not accept any quotation responses later than the noted time and date. If your firm is unable to
respond electronically, your quotation must be received in the office of the Purchasing Department at
the above referenced address no tater than the time and date specified.We look forward to your
participation in this request for information/quotation process.
Douglas N. Higgins. Inc.
Firm's Complete Legal Name
239-774-3130/239-774-4266
4410001111.
Sign-tura
Vice President
Title ��)
Brandy Bartolone Ice
Print Name Date
C: Corrine Trtan I Project Manager
1
RFQ 14-6213-70
1 6 C 4
8
0 0 c, 0 cri
ta CD 0 ° W. • C' W
c 6 Lri ° ,,-I ,.,'4' •
o 0 N tri ri LD rry
up u, .
0 rr)
Lii• - N 0
. 6 Li-, Ln •=r
ce r..:.. 6. LD
in
N in. •(,-,- (.4
in-
; ifl•
•
. ,
0
00 , 0 0 0
CD CD 0 q 8 0 0
.. op; iri ,t. .4.
. Ft 6
v) 0 ry 01 6 a) `,-.9( (V m ,..1 0 LU
c-t W T-1 0 -..,
1-1
U In Ln mr
r-
- ...1 .-4 cj . k.CC 6 6 0
Cli. '613 /A. -(4- ,--1 W V? 0 V). in Ixin in- in t'l. (-4 t.4 CL
i . CC
0
--..--4-.. I • LL
LU 1:11.1
• id '' ' .rt Lil R
re •Ija W
Lf)
E
e-I r-I o 1-1 .--I
ra 1.--1
N ai 0
- , <
. E EE E E 0
c c 7 7 7 --,4-, v) til v) vi v)
E. u_
D e e. E E E I--
. c c 0
-1 __. _1 __I __I
• , , - -- 1
i 17
C
ro
c ao
i c
. 0
(0 .
U
. a)
1_, 713
8
0 1..,_
v)
,
05 if) a) 74
. .c • 4,
c
ro ro
0 ,x)
c .
•-• sa ra
a.,
0 . 3
C N C
• U E c CT_a)
r6 o o. ,
._ '
t.0 rd
0 2 Lu L-D
=
U
al c2i + ro a)
,..4. ,i
6
. Fa E c c Li rn
0 CU 4 c
cy 4-' c co c 5.- V -"{) cv 0 0 (a
o ..... ..- -c c %Li r., .c
ta (0 , 1,
.....z. ..-- v,
0 0 c .,-. c
03 CL) CV5 '' '-- v,' 31
}.. )- X
(i) 0 T I
a) >- .11'. E a) - - - > 0 0 L.,-, n in 0
._ .. 7 ..- .,-.
to Iv W q-1
U 0 0 p_ o N 1,... Crl
›' >
C a E -0 :.•-••
To cu ct: co -1- „2
Lt) 0 0 z c L.
.--i '4;5 C.1 to 0 re a, CLn :-..- CdrCi 1:5C eri ±Ira 1.9 t
_..
0 4, 0 •-
. 10 .1 .- °) •-• M F• in -' li., MI .0 '-• ii) rti < - Li
i•-•
Z'a -----, T••• L9 = I- E .7= • , _ _.u-
L.) LES ° a, so " "- lii 17:1 -i' E ''g• '4 3
1 0 -0 tv
u u
E r4) v--4 N ro cal ,-I CN1 rrl .01. 1.11 4.7 w 11
N NNN N rNi ..0 rn
,-)
in
e
. . . .