Contract 2024-007A CODocuSign Envelope ID: Al 217274-9E6C-4E8D-8AE8-395A9C1 7127E
CHANGE ORDER FORM
Contract / P.O. Number: 2024-007 / 20243134
Change Order Number: 2
Project Name: Victory Pointe Parking Lot Const.
Job Location: Victory Pointe
VENDOR INFORMATION:
Company Name: Traverse Group, Inc.
Address: P.O. Box 121754
Contact Name: Alicia Roehn
Bid Number: N/A
Change Order Date: Apr 17, 2024
Department: Public Services
City, St., Zip: Clermont, FL 34711
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 - Victory Pointe, West Ave. and Osceola future parking lot design change in the total amount of
$8,197.80
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$
557,913.73
B.
AMOUNT OF THIS CHANGE ORDER:
$
8,197.80
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
%
1.5%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$
47,000.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$
55,197.80
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
%
9.9%
G.
NEW CONTRACT VALUE (A+E)
$
613,111.53
This Change
Order is not valid without the following signatures:
DocuSigned by:
DocuSigned by:
4/17/2024 EY�\I `— 4/18/2024
396EE3AC046D48F
6AA711E6BB654D8...
CONTRACTOR
Date PROJECT ARCHITECT / ENGINEER Date
EsDocuSigned by: DocuSigned by:
fbin" bVWASbV1 4/18/2024 4 a%k" 4/18/2024
014063B8FF4140F... 431F57D413554D6...
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:
MAYOR Date CITY CLERK
Date
Rev. 1-1-2021
DocuSign Envelope ID: Al 217274-9E6C-4E8D-8AE8-395A9C1 7127E
TRAVERSE GROUP, INC. -CITY OF CLERMONT STREETSCAPE PHASE 3
West and Osceola Future Parking Lot
kL.N. I General Description I Qty. I Unit IUnit Price Extended Price -
Victory Pointe West Ave and Osceola St Future Parking Lot (Due to no being on original design) $ 8,197.80
Historic Village ADA Sidewalk
D Curb for Grading Issue Near Victory Pointe Restrooms
Addt 18" RCP to upgrade unknown 15" Chokepoint
Manhole Tie-ins
270 LF $ 8.89
$ 2,400.30
50 LF $ 19.95
$ 997.50
24 LF $ 75.00
$ 1,800.00
2 EA $ 1,500.00
$ 3,000.00
TOTAL $ 8,197.80