Contract 2019-55A.12 - COF 04.27.2020CHANGE ORDER FORM
Contract / P.O. Number. 2019-55 Bid Number.
Change Order Number:12 Change Order Date: 4.27.2020
Project Name: STREETSCAPE PH 1 Department:
Job Location: WEST AVE AND W OSCEOLA ST
VENDOR INFORMATION:
Company Name: TRAVERSE GROUP, INC.
Address: PO BOX 121754 City, St., Zip: CLERMONT, FL 34712
Contact Name: ALICIA ROEHN Telephone: 352.409.6630
DESCRIPTION OF CHANGE:
Alteration, deviation, addition, ordeledon caused by conditions encountered dwing construction not covered by the specihcetiona and
draw/ngs of the project (attach additional pages !f necessery).
BENCHES AKA BOLLARDS AT MEET IN THE MIDDLEIVETERAN PARK INTERSECTION OF 8TH AND W
OSCEOLA ST.
SEE INDIVIDUAL BREAKDOWN
ITEM
-AMOUNT
A.
ORIGINAL CONTRACT VALUE
$ 3,997,913.13
B.
AMOUNT OF THIS CHANGE ORDER:
$. '22,46?00.
Must be within the overall scope of services in accordance with contract specifications
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (H/A)
°, 0<696
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 401,616.61
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D)
$ 424, 083.61
Council appnma! ulred Hover 549,999 (S100,000 !br consbucflon) of original conhact price OR H
funds are not ovals to in the awroved budget lbr the DeparftwL
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
96 '#
G.
NEW CONTRACT VALUE (A+E)
$ 4,421,996.74
— f
CONTRACTOR Date PROJECT ARCHITECT! ENGINEER DAte
DEPARTN ENT DIRECTOR Date PURCHASING DIRECTOR / CITY MANAGER Date
Change Orders over 10%, not to exceed $49, 999 ($100, 000 for construction projects) of the original contract OR not
budgeted, require the following signatures:
CITY OF RMONT ATTEST:
Gail L. Ash, Mayor Date Tracy Ackroyd 1,6we, City Clerk Date
Rev. 12-&19
Streetscape - Bollards Oth and W Osceola
CHANGE ORDER
IP General Description Q!t Price~ Extended Price 1
$ 22,467.00
3.19
Excavate Footing
4
EA
$ 300.00
$ 1,200.00
7.7
F & I Pull Boxes (12"X12"X12")
2
EA
$ 750.00
$ 1,500.00
7.16
Bench Lights
4
EA
$ 400.00
$ 1,600.00
7.17
Sealed Extension Wires
4
EA
$ 100.00
$ 400.00
7.18
Electrician - (1) hour per bench
4
HRS
$ 348.75
$ 1,395.00
8.30
Conduit for Bench/Bollard and Flagpole Lighting
80
LF
$ 20.00
$ 1,600.00
10.1
4" Concrete
144
SF
$ 6 75
$ 972.00
10.13
Form & Pour Benches/Bollards
4
EA
$ 3,450.00
$ 13,800.00
NOTE: Included in pricing Is grading of the area North of the benches for the monument and flagpole along with the
adjustment of Irrigation as needed.
$ 22,467.00
e . ;L t-I I1 4,14