Backup Documents 03/10/2009 Item #16B 3
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 B 3
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
I'rinlun pink paper, Mtach In original dpcuJTl\'nt Uriginal doclJJllcflis sll\luld hi.' fund delivered 1(; The L~(lard ()il1..:..: I'ht cornpktnl muting slip and original
dllCUllll.;nls arc to be j"rwardcd III the Board (:.t1ke ,ml\ f!ft!:!: thl' Heard has taken action on thi.: ilelll,}
ROUTING SLIP
Complete routing lines # I through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
excention oftbe Chairman's si~ature, draw a line through routing: lines # I through #4, comnlete the checklist, and forward to Sue Filson (line #5).
Route to Addressee(s) Office Initials Date
(List in routinl! order)
1.
2.
3.
4.
5. Sue Filson, Executive Manager Board of County Commissioners
6. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending Bee approval. 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. including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the Bee Chainnan's signature are to he delivered to the Bee office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Contact
Agenda Date Item was
A roved b the BCC
Type of Docwnent
Attached
1\01 J i
J) I C
Phone Number
q
Agenda Item Nwnber
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j 1.1 tJ,')
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hi
umber of Original
ocuments Attached
Yes
(Initial)
N/A (Not
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1.
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable colwnn, whichever is
a fO nate.
Original docwnent 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
by the Office ofthe County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and ossibl State Officials.)
All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
The Chairman's signature line date has been entered as the date ofBCC approval ofthe
docwnent or the final ne otiated contract date whichever is a licable.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si ature and initials are re uired.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Sue Filson in the Bee office within 24 hours of BCe approval.
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 our deadlines!
The document was approved hy the BCC on .' .;) - 'I (enter date) and all changes
made during the meeting have been incorporated in the attached document. The
Count Attorne 's Office has reviewed the chan es, if a licable.
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I: Forms! County Forms! Bee Formsl Original Documents Routing Slip WWS Original 9.03.04, Rcvised '-26.05, Rcvised 2.24.05
2.
3.
4.
5.
6.
1683
MEMORANDUM
Date:
March 11, 2009
To:
A.N. Korti, Project Manager
Trans/ECM
From:
Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re:
Contract #08-5045: Goodlette-Frank Intersection
Improvements at Creekside Boulevard
Contractor: AP AC - Southeast, Inc.
Attached please find a copy of Change Order #1 (Agenda Item #16B3), as
referenced above and approved by the Board of County Commissioners on
Tuesday, March 10, 2009.
The Minutes and Records Department has retained the original document
to be kept in the Official Records of the Board.
If you should have any questions, please call me at
252-8411
Thank you.
Attachment (1)
1683
"Annual Contract for Roadway Contractors"
Contract #08-5045, Dated May 13, 2008
This Work Order is for Roadway Contractor's Services, subject to the terms and conditions of the
Contract referenced above, for work known as: Goodlette-Frank Road Intersection Improvements
at Creekside Boulevard.
The work is specified in the proposal dated February 16, 2009 attached hereto and made part of this
Work Order. In accordance with Terms and Conditions of the Agreement referenced above.
Scone of Work: As detailed in the attached proposal and the following:
The improvements include converting the existing southbound right turn lane into Creekside
Boulevard to a southbound through lane and construction of a new exclusive southbound right turn
lane into Creekside Boulevard. Other improvements include milling and resurfacing of the entire
roadway and overbuilding the road surface with asphalt to establish proper cross slope as shown in
the attached plans prepared by Collier County Transportation Engineering & Construction
Management Department (Sheets 1,10), dated November 13,2008.
Schedule of Work: All improvements shall be constructed and completed with substantial completion
within sixty (60) calendar days and completion within seventy five (75) calendar days after issuance of
the Notice-to-Proceed.
Comoensation: In accordance with the Agreement, the County will compensate AP AC - Southeast,
Inc. in accordance with negotiated amount of$219,414.35 as provided in the attached proposal.
Itemized not to exceed amount $ 219,414.35
TOTAL FEE $219.414.35
Any change made subsequent to final department approval will be considered an additional service and
charged according to an executed Change Order as enumerated in Exhibit D of the Agreement.
~repared By: /~~
A. Nyankadau Korti, Project Manager
T.E. & C.M. Department
~ .,
Reviewed By: ~j/l- ;;:-:7;
J"fAhmad, PE, J)frector
T.E. & C.M. Department
eJ./;), (p /DCf
Date' I '
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Datk .
Approved By:
Norman E. Feder, AICP, Administrator
Transportation Division
Date
1
ATTEST:
';'., ''''
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DwIGHT E. BRt>GK, Clerk
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Approved as to Form and
Legal Sufficiency:
~If- R J~
County Attorney
ATTEST:
(Corporate Secretary)
By:
Type Name and Title
BOARD OF COUNTY COMMISSIONERS,
COLLIER CO TY, FLORIDA
BY: ~ d~~
DO~A FIALA, CHAIRMAN '1
Date: IfWcJl J (), c2tJOCl
ACCEPTED BY:
Date: ,;;/:;~ ~ f1
APAC-Southeast. Inc.
Name of Firm
By: 6~~~.
" ,sigl}ature /
C"-tXr-!P5 ;::. f70 ffs ~ ,
Type Name and Title
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