Contract 2019-55A.21 - COF 08.12.2020DocuSign Envelope ID: 9B9A47A2-120E-482B-8EC0-C6399DD8E03F
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051
Change Order Number 21 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).
Total cost to purchase six (6) additional bollards = $8,970.
Total cost to powder coat twenty-seven (27) bollards = $4,320.
Total cost to furnish and install electrical service rack and panel = $36,611.80
Total combined cost of this change order = $49,901.80
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE
$ $ 4,866,278.23
B.
AMOUNT OF THIS CHANGE ORDER:
$ $ 49,901.80
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A)
% 1.025
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 336,635.75
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D)
$ 386,537.55
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 7.943
G.
NEW CONTRACT VALUE (A+E)
$ 5,252,815.78
This Chanae Order is not valid without the followina sianatures:
,—DocuSigned by:
DocuSigned by:
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8/19/2020
8/19/2020
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Date
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DE XMIONYDIRECTOR
Date
PUR7VW9bIRECTOli_/dffTUMER 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: 9B9A47A2-120E-482B-8EC0-C6399DD8E03F
Unit Price I Extended Price
$ 8,970.00
13.1 Bollards (manf price increase 14-16 week lead time
pending weather) Per vendor price is valid for 15 6 LS $ 1,495.00 $ 8,970.00
days, there after, 10% deposit holds price for 30 days
8,970.00
DocuSign Envelope ID: 9B9A47A2-120E-482B-8EC0-C6399DD8E03F
Unit Price I Extended Price
4,320.00
Powder Coating Bollard(s) I 27 I EA I $ 160.00 I $ 4,320.001
4,320.00
DocuSign Envelope ID: 9B9A47A2-120E-482B-8EC0-C6399DD8E03F
Unit Price I Extended Price
$ 36,611.80
7.19
Furnish and Install Electrical Service Rack and Panel
P2 — Located per Plans (EA) QTY of 1 including
Additional Breakers, Enclosure, SS Unistrut,
Conrrptp Post
1
LS
$ 15,111.80
$ 15,111.80
8.2
IF & 1 1-2 In. Sch 40 Conduits Per Duke Energy
Specifications
300
LF
$ 20.00
$ 6,000.00
8.4
F & 1 1-4 In. Sch 40 Conduits Per Duke Energy
Specifications
600
LF
$ 20.00
$ 12,000.00
7.20
14" Conduit Bore
100
LF
$ 35.00
$ 3,500.00
$ 36,611.80