Backup Documents 09/28/2021 Item #16G3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO I 6 G 3
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. County Attorney Office CAO 1/J /�?6 z./
2. Board of County Commissioners Office BOCC 4 ` l
•
3. Minutes and Records Clerk of Court's Office I 61 41-1-1 r-Vr
4. Email executed copy to Heather Meyer GMD South All
Heather.meyer@colliercountyfl.gov
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 Heather Meyer/Airport Authority 239-252-5765
Contact/ Department
Agenda Date Item was Sept 28,2021 Agenda Item Number 16G.3
Approved by the BCC
Type of Document Change Order#1 Atkins 20-7726 Number of Original 1
Attached Documents Attached
PO number or account N/A
number if document is
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 STAMP OK HM
2. Does the document need to be sent to another agency for additional signatures? If yes, HM
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 HM
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 HM
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 HM
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 HM
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
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 Sept.28,2021 and all changes made N/A is not
during the meeting have been incorporated in the attached document. The County an option for
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 an option for
Chairman's signature. this line.
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
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Ann P. Jennejohn
From: Ann P.Jennejohn
Sent: Wednesday, October 6, 2021 11:50 AM
To: MeyerHeather
Subject: Item #16G3 (9-28-21 BCC Meeting)
Attachments: Backup Documents 09_28_2021 Item #16G3.pdf
Hi Heather,
An executed copy of Itewt #1643, from tine September 2s, 202.1
r3CC Meetivtg is attached for your records.
Thavtk you!
Ann Jenne,jolan
13MR Senior Deputy Clerk II
tt.t, k, Clerk to the Value Adjustmevtt 13oard
Office: z39-252-s4o6
Fax: 239-252-8408 (if applicable)
Avwt.Jevtvtejohvt@CollierClerk.com
Office of the Clerk of the Circuit Court
& Comptroller of Collier County
3299 Tamiami Trail, Suite #401
Naples, FL 34112-5324
www.CollierClerk.com
i
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Procurement Services
, Cp ter County Change Order Form
®Contract Modification ❑Work Order Modification
Contract#: 20-7726 Change#: 1 Purchase Order#: 4500208712 Project#: 33605
4500208814 33650
Contractor/Firm Name: Atkins North America, Inc Contract/Project: IMM Rehab Runway 18/36 CEI Services
Andrew Bennett Airport Authority
Project Manager Name: Division Name:
Original Contract/Work Order Amount $ 795,520.00 '12/8/20#14A3 Original BCC Approval Date; Agenda Item#
Current BCC Approved Amount $ 795,520.00 12/8/20#14A3 Last BCC Approval Date; Agenda Item#
Current Contract/Work Order Amount $ 795,520.00 10/8/2021 SAP Contract Expiration Date (Master)
Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount
Revised Contract/Work Order Total $ 795,520.00 0.00% Change from Current BCC Approved Amount
Cumulative Changes $ 0.00 0.00% Change from Current Amount
Completion Date,Description of the Task(s)Change,and Rationale for the Change
Notice to Proceed 12/28/2020 Original 9/29/21 Last Approved 9/29/21 Revised Date 12/23/21
Date Completion Date Date (Includes this change)
#of Days Added 85 Select Tasks ❑Add new task(s) ❑Delete task(s) ❑Change task(s) ®Other
Provide a response to the following: 1.)detailed and specific explanation/rationale of the requested change(s)to the task(s)and I or
the additional days added(if requested);2.)why this change was not included in the original contract;and,3.) describe the impact
if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed.
1. Extend the schedule eighty-five(85)days to allow time for the consultant to provide CEI services through the final completion of
the Runway 18/36 construction and allow days to close out the project.This time extension applies only to the Runway 18/36 tasks
on the contract(PO#4500208712).
2. The construction of Runway 18/36 was placed on a stop work order to allow for the construction of the Taxiway C extension to be
completed first,in order to minimize interruptions to the airport traffic. During this period,the consultant was able to attend
meetings,and respond to RFIs.The Taxiway C project is close to completion,therefore the Runway 18/36 construction can now
continue with a projected construction final completion on 11/25/21.Post design serviceswill be needed throughout project close
out.
3. If this change order is not processed,the consultant will be unavailable to finalize the CEI services and the necessary paperwork
for the grant and project closeout.
BennettAndrew Digitally signed by BennettAndrew
G reW Date:2021.07.27 14:19:37-04'00' Date:
Prepared by:
Andrew Bennett,Airport Executive Manager
Acceptance of this Change Order shall constitute a modification to contract/work order identified above and will be subject to all the same
terms and conditions as contained in the contract/work order indicated above,as fully as if the same were stated in this acceptance.The
adjustment,if any,to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/Vendor/Consultant/
Design Professional arising out of or related to the change set forth herein,including claims for impact and delay costs.
J': /if 4 j.- 7/27/21
Accepted by: , -i Date:
Kevin McCauley,Project Manager,Atkins North America, Inc.
Digitally signed by ShueGene
Accepted by: ShueGene Date.2021.07.28 09.13.49-04'00' Date:
Gene Shue,Division Director, Growth Management Department
ScottTrinity Digitally signed by ScottTrinity
Approved by: Date:2021.07.28 14:35:45-04'00' Date:
Trinity Scott, Deputy Department Head,Growth Management
SchneebererSara Digitally signed by SchneebergerSara
g
Approved by: Date:2021.08.23 09:13:10-04.00• Date:
Sara Schneeberger,Procurement Specialist, Procurement Services
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admln RPt BCC ES
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ATTEST: BOARD OF COUNTY COMMISSIONERS
Crystal K. Kinzel,Clerk of Courts COLLIE 0 ,FLORIDA
&Comptroller) 9 iAor,
::ea
t �O�-• By:
a .' Penny Tay ,Chairperson
:
iSEA )'
Atfest as toetta's
sigfatdre:only
Approv to orm n legality:
By:
Scott R.Teach
Deputy County Attorney
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Change Order/Amendment Summary
COST TIME
CO# AMD# Description Days New Justification
Additive(+) Deductive(-) Added Amount
Days needed to cover CEI services
1 Time Extension 85 360 for construction of Runway 18/36
which was delayed
I "
Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY
Admit' BCC BCC ES