Contract 2020-067A.02DocuSign Envelope ID: 5705EEOA-37F6-4EF6-876D-ED53D4D4DA43
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051
Change Order Number: 2 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).
Deductive change order - Conduit for lighting at trail to East of Suncreek; signage package; brick and ribbon curb 8th
St. to West Ave.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$ 4,310,565.37
B.
AMOUNT OF THIS CHANGE ORDER:
Must be within the overall scope of services in accordance with contract specifications.
$-78,737.55
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% -1.8%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 124,914.85
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$ 46,177.30
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 1.1%
G.
NEW CONTRACT VALUE (A+E)
$ 4,356,742.67
This Change Order is not valid without the following signatures:
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4/23/2021
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4/23/2021
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CONTRACTOR
Date
PROJECT ARCHITECT / ENGINEER
Date
DocuSigned by: DocuSigned by:
�4= bV1"Sm 4/26/2021 �^ "�' Su"z 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 $100,000 OR 10% of the original
contract amount for construction projects; 3) the funds are not available in the approved budget for the department.
CITY OF CLERMONT
MAYOR
NOT REQUIRED
Date
ATTEST:
CITY CLERK
Date
Rev. 1-1-2021
DocuSign Envelope ID: 5705EEOA-37F6-4EF6-876D-ED53D4D4DA43
GROUP,TRAVERSE OF •
CHANGE ORDER -CREDIT
no . Ribbon
L.N. 1p General Description Qty. Uniti Priea Extendod Prlea
CREDIT: CONDUIT FOR LIGHTING ALONG TRAIL TO THE EAST OF SUNCREEK (TO 7th STREET) -$ 9,000.00
8.3
CREDIT: F & 12-1 In. Sch 40 Conduits Per Duke Energy
Specifications
-450
LF
$ 20.00
-$ 9,000.00
TOTAL
49,000.00
CREDIT: SIGNAGE PACKAGE -$ 37,500.00
14.2
CREDIT: Signage Package
-1
LS
$ 37500.00
-$ 37,500.00
TOTAL
-$ 37,500.00
CREDIT: BRICK AND RIBBON CURB 8TH STREET TO WEST AVE -$ 32,237.55
9.1
CREDIT: Mirafi 140n Geotextile Fabric For Paver
Roadway
-772
SF
$ 0.65
-$ 501.80
9.2
CREDIT: 6" Recycled Concrete For Paver Roadway
-86
SY
$ 15.00
-$1,290.00
10.12
CREDIT: 6" Ribbon Curb/6" Curb
-617
11 LF
$ 30.00
-$18,510.00
10.15
CREDIT: Type D Curb
-155
LF
$ 30.00
-$ 4,650.00
11.2
CREDIT: F & 12 1/4" Roadway Brick Pavers - K&W Red
2 1/4"X4"X8" - Manuf. By Glen-Gery Corporation
-965
SF
$ 7.55
-$ 7,285.75
TOTAL
-$ 32,237.55
CREDIT CHANGE ORDER #2 TOTALI
$ 78,737.55