Contract 2019-55A.19 - COF 08.12.2020DocuSign Envelope ID: C10A11 B3-9319-420E-86D3-FD560847F91 B
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051
Change Order Number 19 Change Order Date: Augut 12, 2020
Project Name: Streetscapes Phase 1 Department: Public Services
Job Location: West Ave. and W. Osceola
VENDOR INFORMATION:
Company Name: Traverse Group, Inc.
Address: P.O. Box 121754 City, St., Zip: Clermont, FL 34712
Contact Name: Alicia Roehn Telephone: 352-409-6630
DESCRIPTION OF CHANGE:
Alteration, deviation, addition, or deletion caused by conditions encountered during construction not covered by the specifications and
drawings of the project (attach additional pages if necessary).
Additive change order for sewer crossing at Minneola Street.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE
$ $ 4,866,278.23
B.
AMOUNT OF THIS CHANGE ORDER:
$ $ 16,960.75
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A)
% 0.349
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 165,995.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D)
$ 182,955.75
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 3.760
G.
NEW CONTRACT VALUE (A+E)
$ 5,049,233.98
This Change Order is not valid without the following signatures:
�DocuSignedby: DOCUSigned by:
8/12/2020 8/12/2020
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DEPARTMENT DIRECTOR Date PURCHASING DIRECTOR / CITY MANAGER Date
Council approval is required if change order(s): 1) exceeds $49, 999; 2) exceeds the greater of $100, 000 OR 10% of the original
contract amount for construction projects; 3) the funds are not available in the approved budget for the department.
CITY OF CLERMONT ATTEST:
Gail L. Ash, Mayor Date Tracy Ackroyd Howe, City Clerk Date
Rev. 3-30-2020
DocuSign Envelope ID: C10A11 B3-9319-420E-86D3-FD560847F91 B
GROUP,TRAVERSE OF •
ESTIMATE - SEWER FOR • • •
Qty. UnitUnit Price Extended Price
$ 16,960.75
6.8
Install 12" PVC Sewer (price increase due to depth)
113
LF
$ 32.75
$ 3,700.75
6.24
Remove Existing 12" Clay Sewer Line
101
LF
$ 10.00
$ 1,010.00
6.23
Core and Boot Existing San MH
3
EA
$ 1,250.00
$ 3,750.00
6.11
Sanitary Sewer Manholes (8-10 Cut) - No Charge
1
EA
$ -
$
6.22
Sanitary Bybass
1
EA
$ 6,500.00
$ 6,500.00
1.11
Survey (Stake) Layout
1
LS
$ 1,500.00
$ 1,500.00
1.6
As -Built Drawings
1
LS
$ 500.00
$ 500.00
$ 16,960.75