Contract 2019-55A.31 - COF 01.07.2021DocuSign Envelope ID: 924CFD21-D286-4C81-8C7B-AACCA968066E
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55
Bid Number: RFB 19-051
Change Order Number: 31
Change Order Date: Jan 7, 2021
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).
Deductive Change Order: Credit for over billing line item 15.2.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$ 4,423,889.23
B.
AMOUNT OF THIS CHANGE ORDER:
$ -75.00
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% 0.0%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 524,840.50
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$ 524,765.50
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS
(E/A): 10% Maximum
% 11.9%
G.
NEW CONTRACT VALUE (A+E)
$ 4,948,654.73
This Change Order is not valid without the following
signatures:
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CONTRACTOR
Date
PROJECT ARCHITECT / ENGINEER
Date
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1/8/2021
Sign�ed�by:
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PAMMENT DIRECTOR
Date
PIRWORtMENT 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:
Tim Murray, Mayor Date Tracy Ackroyd Howe, City Clerk Date
Rev.12-04-2020
DocuSign Envelope ID: 924CFD21-D286-4C81-8C7B-AACCA968066E
Streetscape Phase 1: CSS PHASE 1 (WEST AVE) ESTIMATE CHANGE ORDE
ECredit for overbilling line item 15.2
Extended Price
ILA General Description Qty. �MM
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