Contract 2018-58A CODocuSign Envelope ID: C5041 D57-EE9B-4682-AD96-5105F47C8A94
CHANGE ORDER FORM
Contract / P.O. Number: 2018-58 / 20231599
Change Order Number: 5
Project Name: Construction Management Services
Job Location: 12838 Hancock Road, Clermont, FL
VENDOR INFORMATION:
Company Name: The A.D. Morgan Corporation
Address: 1953 E. Edgewood Drive
Contact Name: Jeremy Warner, Director of Preconst.
Bid Number: RFQ 18-021
Change Order Date: Dec 14, 2023
Department: Public Services
City, St., Zip: Lakeland, FL 33803
Telephone: (813) 832-3033
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).
Extended construction duration of three months for a total of $39,000. If the project finishes earlier than the anticipated
three month time addition, the amount deducted from Johnson-Laux contract will be modified to match the actual time
and cost incurred.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$
197,960.00
B.
AMOUNT OF THIS CHANGE ORDER:
$
39,000.00
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
%
19.7%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$
119,580.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$
158,580.00
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
%
80.1%
G.
NEW CONTRACT VALUE (A+E)
$
356,540.00
This Change
Order is not valid without the following signatures:
EDocuSigned by:
W � 00mu'r 1/10/2024
1479A1DD245545B.-
CONTRACTOR Date PROJECT ARCHITECT / ENGINEER Date
EsDocuSigned by: DS DocuSigned by:
fb" bl(WA Sb10, 1/10/2024 S � & S 1/10/2024
168 014063B8FF4140F... 534781A394C8... DC
DEPARTMENT DIRECTOR Date PROCUREMENT DIRECTOR / �a—te
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 oricinal
contract amount for construction projects; 3) the funds are not available in the approved budget for the department.
CITY OF CLERMONT ATTEST:
DocuSigned by: DocuSigned by:
- 1/10/2024 �` `� Ho�vc//10/2024
ET26A7692F758C492 3AD7F34905B344A...
MAYOR Date CITY CLERK Date
Rev. 1-1-2021
DocuSign Envelope ID: C5041 D57-EE9B-4682-AD96-5105F47C8A94
plp�Fp-
A.D. MEAN
General Contractors
Construction Managers
WE DO MORE
TAMPA
Corporate Headquarters
716 N. Renel€ie Drive
Tampa, Florida 33609
PH: 813 # 832 # 3033
FAX: 813 # 831 # 9860
PCCO #006
Prime Contract Change Order #006: Extend construction
duration 3 months @13,000.00/month
TO: City of Clermont FROM: The A.D. Morgan Corporation
400 12th Street
Clermont, Florida 34711
DATE CREATED: 9/ 22 /2023
CONTRACT STATUS:
Approved
DESIGNATED
REVIEWER:
DUE DATE:
INVOICED DATE:
SCHEDULE IMPACT,
90 days
CONTRACT FOR:
1:City of Clermont Public Works
Facility Prime Contract
DESCRIPTION:
Extend construction duration 3 months @13,000.00/month.
New Substantial Completion Date November 30, 2023.
ATTACHMENTS:
BRADENTON CHANGE ORDER REQUESTS IN THIS CHANGE ORDER:
2411-13 Manatee Ave W. COR # I Title
Bradenton, Florida 34205 005 I Extend construction duration 3 months
PH: 941 # 747 # 3001 @13,000.00/month
FAX: 941 # 747 # 3015
CHANGE ORDER LINE ITEMS:
716 Renellie Drive
Tampa Florida 33609
CREATED BY: Ricky Pena (The A.D. Morgan
Corporation)
REVISION: 0
REVIEWED BY:
REVIEW DATE: 09/22 /2023
PAID DATE:
EXECUTED: No
TOTAL $ 39,000.00
AMOUNT:
Schedule Impact
90 days
PCO # 005 : Extend construction duration 3 months @13,000.00/month
LAKELAND # I cost code Description
1453 E. Edgewcod Drive 1 00-705 - Project Managers Phase III Extend Construction Duration 3 Months
Lakeland, Florida 33803
PH: 863 # 450 # 4840
FAX: 863 # 450 # 4697
License # CGC044502
www.admorgan.com
The original (Contract Sum)
Net change by previously authorized Change Orders
The contract sum prior to this Change Order was
The contract sum will be increased by this Change Order in the amount of
The new contract sum including this Change Order will be
The contract time will be increased by this Change Order by 90 days
TOTAL:
Labor
Amount
$ 39,000.00
$39,000.00
Type I Amount
$ 39,000.00
Subtotal: $39,000.00
Grand Total: $39,000.00
$ 197,960.00
$ 119,580.00
$ 317,540.00
$ 39,000.00
$ 356,540.00
The A.D. Morgan Corporation
page 1 of 2
Printed On: 9/22/ 2023 08 :24 AM
DocuSign Envelope ID: C5041 D57-EE9B-4682-AD96-5105F47C8A94
PCCO #006
City of Clermont
400 12th Street
Clermont Florida 34711
The A.D. Morgan Corporation
716 N. Renellie Dr.
Tampa Florida 33609
SIGNATURE
DATE
SIGNATURE
DATE SIGNATURE DATE
The A.D. Morgan Corporation page 2 of 2 Printed On: 9/22/ 2023 08 :24 AM