Backup Documents 10/26/2021 Item #16A 9 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 A. 9
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. County Attorney Office CAO ..Vt- 1 11 9,g '
2. Board of County Commissioners Office BOCC
‘19
3. Minutes and Records Clerk of Court's Office YKJ_ / ,' ' *V4 ?•20
/141
4. Send to for signature:
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 Brittany Lazo/GMD-Stormwater 239-252-5728
Contact/ Department Brittany.lazo@cotliercoutyfl.gov
Agenda Date Item was 10/26/2021 Agenda Item Number 16 A.9
Approved by the BCC ID#20155
Type of Document CO#1 Atkins North America 20-7710- Number of Original 1
Attached Plantation Island Pre-Design Study Documents Attached
PO number or account 4500209451
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 N/A
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 BL
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 N/A
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 BL
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 BL
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip BL
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 our deadlines!
8. The document was approved by the BCC o d all changes made during N/A is not
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 i,i 1 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
# 6 A 9 16.A.9.a
Procurement Services
Co Ter County Change Order Form
❑ Contract Modification iZ)Work Order Modification -a
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�°4500209451 60238
Contract#: 20-7710 Change#: 1 Purchase Order#: Project#: to
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Contractor/Firm Name: Atkins North America Inc. Contract/Project: Plantation Island Waterways Pre-Design Study
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Brittany Lazo Capital Project Planning, Impact Fees&Program rt.Project Manager Name: Division Name: ,
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Original Contract/Work Order Amount $ 423,404.00 01/12/21 16A30 Original BCC Approval Date; Agenda Item ; i
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Current BCC Approved Amount $ 423,404.0Cr 01/12/21 16A30 Last BCC Approval Date: Agenda Item # c
Current Contract/Work Order Amount $ 423,404.00 9/10/2021 SAP Contract Expiration Date (Master) N
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Dollar Amount of this Change $ 0.00 0.00% Total Change from Original Amount
Revised Contract/Work Order Total I." $ 423,404.00 0.00% Change from Current BCC Approved Amoui m
Cumulative Changes S 0.00 0.00% Change from Current Amount E
et
Completion Date, Description of the Task(s)Change,and Rationale for the Change t
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Notice to Proceed 2/12/2021 Original 9/10/2021 Last Approved 9/10/2021 Revised Date TBD Z
Date Completion Date Date (Includes this change) a
Y
#of Days Added 95 Select Tasks ❑ Add new task(s) ❑ Delete task(s) ❑ Change task(s) ® Other Q
Provide a response to the following: 1.)detailed and specific explanation/rationale of the requested change(s)to the task(s)and I or m
the additional days added (if requested); 2.)why this change was not included in the original contract; and,3.) describe the impact -a
if this change is not processed. Attach additional information from the Design Professional and/or Contractor if needed. O`
This project is currently on a Stop work order with three (3) days remaining.
1. This change order will add 95 days to the contract to allow for the additional surveying of the 2
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waterways.
2. This was not included in the original contract because the site conditions did not indicate
additional surveying was needed. o
3. If the changes are not approved, quality of the pre-design plans will likely be inadequate to meet
the goals and requirements of this grant funded project.
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Prepared by: _--- _ -- N_-z:�_ $.o.x. Date:
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(Brittany Lazo,Project Manager,Capital Project Planning, Impact Fees&Program Mgt.)
Acceptance of this Change Order shall constitute a modification to contract/work order identified above and will be subject to all the same (.2
terms and conditions as contained in the contract/work order indicated above, as fully as if the same were stated in this acceptance. The U
adjustment, if any,to the Contract shall constitute a full and final settlement of any and all claims of the Contractor/Vendor/Consultant/ o
Design Professional arising out o ..r related to the cha -)e set forth herein,including claims for impact and delay costs.
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NAccepted by: _� tG�/f./ ��� i' Date: i f
(Mark Erw' ,PE,Projec g_, ,Atkins North America Inc.) Q
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Digitally signed by Gerald N. Kurtz
Approved by: Gerald N. Kurtz Date:2021.08.18 12:43:57-04 00' Date: E
(Gerald N. Kurtz,PE, Prinicple Project Mgr.,Capital Project Planning,Impact Fees&Program Mgt) rJ
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Revised:01/14/2021 (Divisions who may require additional signatures may include on separate sheet.) PROCUREMENT USE ONLY I\ Q
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Matthew McLean "C.US.1�°Yhew mcl McLean
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Approved by: oa;e zoz,.oe.ie,e,a<aoaco Date:
(Division Director) rn
Digitally signed by
:�%► ScottTrinity scaattTrinity °
Date 2021.09.0E1
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14:19:52-04'00' +'
Approved by: Date:
(Trinity Scott, Deputy Department Head)
SchneebergerSara Digitally signed by SchneebergerSara o
Date:2021.09.20 14:57:15 -04'00' ti
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ATTEST: BOARD O COUNTY COMMISSIONERS
rystai k.k; ,Viler of Courts COLLIE C TY, FLORID
By: A ,' 9 By:
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k r Penny Ta r, Chair
Dated: 081` _ •~ tea'
(SEAL) ; 1 es airman',
iM '!tP("!y Name of Firm Atkins North America Inc.
Approved and Legality:
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Signature Mark Erwin, P.E., CFM
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Page 3 of 3
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Change Order/Amendment Summary
COST I TIME
CO# AMD# Description Days New Justification
Additive(+) Deductive( ) Added Amount ca
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Additional time is requested to
1 Add 95 days 0 0 95 305 g
survey the waterways.
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A11111 K I N S Atkins North America,Inc.
4030 West Boy Scout Boulevard,Suite 700
Tampa, Florida 33607
Telephone:+1.813.282.7275
www.atkinsglobal.com/northamerica ri
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August 17, 2021
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Brittany Lazo
Associate Project Manager
Capital Project Planning, Impact Fees & Program Management Division
2685 South Horseshoe Dr.
Naples, FL 34104
RE: Plantation Island Waterways Pre-Design Study
Contract No. 20-7710
Purchase Order/Work Order No. 4500209451
Collier County Project No. 60238
Brittany, O
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This letter is to request Collier County for a time extension of 95 days for the above-mentioned
project. The reason for this request is to be sure we meet the County's grant expiration date after v
allowing for additional mangrove trimming (not known during project scoping) within the
project area which is being conducted as part of a separate County project. N
This project is as important to us as it is to the County and this extension will allow Atkins to
assist the County in successfully meeting the grant requirements while creating a pre-design
study for the citizens of Plantation Island that has the best opportunity to move forward. Please c
call me if you have any questions. Thank you for working with Atkins on this project.
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Sincerely, Q
ATKINS
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Mark Erwin, P.E., CFM v
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