Contract 2020-067A.03DocuSign Envelope ID: 5705EEOA-37F6-4EF6-876D-ED53D4D4DA43
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051
Change Order Number: 3 Change Order Date: Apr 21, 2021
Project Name: Streetscape Phase 2 Department: Public Services
Job Location: Minneola Ave. and Osceola Street
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 - Minneola Ave. and 7th st., SW comer lot sewer lateral; revision to change intersection
crosswalks to concrete ribon curb vs. pavers; upstream GCFI devices in lieu of GFCI breakers.
ITEM
AMOUNT
A. ORIGINAL CONTRACT VALUE:
$ 4,310,565.37
B. AMOUNT OF THIS CHANGE ORDER:
$ 10,617.32
Must be within the overall scope of services in accordance with contract specifications.
C. PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% 0.2%
D. AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 46,177.30
E. TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$ 56,794.62
F. PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 1.3%
G.
NEW CONTRACT VALUE (A+E)
$ 4,367,359.99
This Change Order is not valid without the following signatures:
DocuSigned by: DocuSigned by:
&A -a r6G 1 4/23/2021 _ ___ 4/23/2021
CONTRACTOR Date PROJECT ARCHITECT / ENGINEER Date
DocuSigned by:
DocuSigned by:
}� Sfb WA,S6t& 4/26/2021
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d S LS 4/26/2021
DEPARTMENT DIRECTOR Date
PROCUREMENT DIRECTOR / Date
CITY MANAGER
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:
NOT REQUIRED
MAYOR Date
CITY CLERK Date
Rev. 1-1-2021
DocuSign Envelope ID: 5705EEOA-37F64EF6-876D-ED53D4D4DA43
ORDERTRAVERSE GROUP, INC. -CITY OF CLERMONT STREETSCAPE PHASE 2
CHANGE
Ribbon Curb vs Pavers; Upstream GFCI Devices in Lieu of GFCI Breakers AL-L
L.N. General Description Qty. U n ijUnit PNCa �x11
MINNEOLA AVE AND 7th STSW CORNER LOT SEWER LATERAL $ 2,610.85
6.2
CREDIT Install New 6" Lateral
1
EA
-$ 750.00
-$ 750.00
6.3
CREDIT Install 6" Cleanouts
1
EA
-$ 150.00
$ 150.00
6.4
CREDIT Install 6" Plugs
1
EA
-$ 100.00
4100.00
6.5
Install 8" PVC Sewer (6'-8' Cut)
50
FT
$ 40.00
$ 2,000.D0
6.6
Install 8" Plug
1
EA
$ 85.00
$ 85.00
6.18
Testing
1
LS
$ 250.00
$ 250.D0
6.231
Core Existing Manhole
1
1EA
1 $ 1,250.00
1$1,250.00
1.2
Payment and Performance Bond - Increase due to bonding
charge(s) by Bonding Company (1%)
1
1 LS
1 $25.85
$ 25.85
TOTAL S 2.610.85
REVISIONS: CHANGE INTERSECTION CROSSWALKS TO 12" RIBBON CURB IN LEIU OF PAVERS $ 2,664.28
11.5
CREDIT F&I 6x6 White Roadway Pavers
216
SF
-$ 27.00
.$ 5,832.00
10.8
12" Ribbon Curb (Intersection of 8th St / W Minneola &
West Ave / W Minneola)
282
LF
$ 30.00
$ 8.46D.00
1.2
Payment and Performance Band - Increase due to bonding
charge(s) by Bonding Company (19/6)
1
LS
$26.28
$ 26.28
,orw 2 tiaa_�x
REVISIONS: UPSTREAM GFCI DEVICES IN LIEU OF GFCI BREAKERS PER REVISED PLANS $ 5,352.19
7.16
Provide & Install Power Pedestals w/ Blank Face GFCI devices &
4
EA
Lockable Waterproof Covers (to be installed as shown on plans);
Final Conduit Terminations at Pedestals and Inground J Boxes;
$1.324.80
$ 5.299.20
Provide & Install four
1.2
Payment and Performance Bond - Increase due to bonding
1
LS
$ 52.99
$ 52.99
charge(s) by Bonding Company (1%)
TOTAL S 5352.19
RELOCATE LIGHT POLE @ INTERSECTION OF 8TH STREET & W OSCEOLA AVE - DENIED BY $ 0.00
7.17
Remove one existing light pole and reinstall at new location
(includes appx 20' of 1" PVC conduit and new
0
EA
$ 2,938.80
$ 0,00
1.2
Payment and Performance Bond - Increase due to bonding
charge(s) by Bonding Company (I%)
0
LS
$ 29.39
$ 0.00
CHANGE ORDER TOTAL 10,617.32