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Contract 2024-050A CODocusign Envelope ID: 40ABBDF5-3B6C-4C65-9439-B9EBEBAFE957
CHANGE ORDER FORM
Contract / P.O. Number: 2024-050 / 20250196 Bid Number: RFB 24-100
Change Order Number: 1 Change Order Date: Jan 15, 2025
Project Name: Clermont Fire Prevention Facility Department: Fire
Job Location: 650 W. Montrose Street, Clermont
VENDOR INFORMATION:
Company Name: The Kinsmen Construction Company, Inc.
Address: 2205 Lauderdale Ct. City, St., Zip: Orlando, FL 32805
Contact Name: David Gonzalez Telephone:(386) 479-1612
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: Add TV outlet in conference room, add data outlet in office #2, add 3/4" conduit for fiber, add
receptacle for TV in conference room.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$ 395,556.00
B.
AMOUNT OF THIS CHANGE ORDER:
$ 2,478.39
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% 0.6%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 0.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$ 2,478.39
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 0.6%
G.
NEW CONTRACT VALUE (A+E)
$ 398,034.39
This Change Order is not valid without the following signatures:
DocuSigned by:
B41C20859F5E47B...
CONTRACTOR
1/15/2025
Date
PROJECT ARCHITECT / ENGINEER Date
ESigned by: Docu,S{ig{ned, by:
AW � 1/15/2025 �vvV-V-� S 1/15/2025
nAr)( i25C158496.. 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: 40ABBDF5-3B6C-4C65-9439-B9EBEBAFE957
r THE
KINSMEN CO# DATE
r
CONSTRUCTION 1 12/26/2024
COMPANY
CUSTOMER
City of Clermont
685 West Montrose Street
Clermont, FL 34711
DESCRIPTION
Electrical Contractor Change Order 01
Subject: Electrical & Low Voltage Changes
PROJECT
Clermont Fire Prevention Facility
650 West Montrose Street
Clermont, FL 34711
Add TV Outlet in Conference Rm, Add Data Outlet in Office #2, Add 3/4" conduit for Fiber,
Add Receptacle for TV in Conference Rm
Subcontractor Price: $2,253.08
General Contractor Management Fee (10%): $225.31
Change Order Grand Total: $2,478.39
Total $2,478.39
REVISED BALANCE SUMMARY
Original Contract Amount $395,556.00
Net Change by Previous Change Orders $0.00
Contract Amount Prior to this Change $395,556.00
Amount of this Change Order $2,478.39
Revised Contract Amount, Including this Change Order $398,034.39
APPROVAL
This CO has been accepted on by
Signature:
The Kinsmen Construction Company, Phone: (386) 479-1612
PO Box 1329, Orlando, FL 32802, License # CBC1261718
Page 1
Docusign Envelope ID: 40ABBDF5-3B6C-4C65-9439-B9EBEBAFE957
Change Order Request
Summary Form
Submitted By
Dalton & Owens Electric Services, Inc.
Project Name: CLERMONT FIRE PREVENTION OFFICE
Date: 12/23/2024
Contract No: 0001
Directive / Pending Item:
DIR #
Add TV Outlet in Conference Rm, Add Data Outlet in Office #2,
Add 3/4" conduit for Fiber,
Add Receptacle for TV in Conference Rm
Labor Classification Hourly Rate
Total Hours Total
Project Manager $ 50.00 @
2 100
Foreman $ 45.00 @
10 450
Skilled $ 38.50 @
10 385
Unskilled $ 28.95 @
0 0
Sub -Total Direct Labor:
$ 935.00
15% Mark- Up (OH&P):
$ 140.25
Direct Labor Burden:
$ 411.40
(taxes/insurance)
Benefits (if applicable)
$ 84.15
Total Labor:
$
1,570.80
Materials (itemize) Per Unit Cost
Subtotal Cost
QTY
1 Material $ 298.59 @
$ 298.59
Sub -Total Material:
$ 298.59
15% Mark- Up (OH&P:
$ 44.79
Sales Tax on Material:
$ 20.90
Total Materials:
$
364.28
Equipment (itemize and/or attach invoices) Per Unit Cost
Subtotal Cost
QTY
0 $ @
$
0 $ @
$
Sub -Total Equipment:
$
6% Mark -Up on Equip:
$
Total Equip:
$
Subcontractors (attach proposals)
Subtotal Cost
GPZ CABLING
$ 300.00
Sub -Total Subcontractors:
$ 300.00
6% Mark -Up on Subs:
$ 18.00
Total Subs:
$
318.00
Change Order Sub -total:
$
2,253.08
Permits:
(if applicable):
N/A
Bonds (if applicable):
N/A
Total Cost of this Change Order Request:
$
2,253.08
Docusign Envelope ID: 40ABBDF5-3B6C-4C65-9439-B9EBEBAFE957
Job ID: 2024-0104
Project: CLERMONT FIRE OFFICE
650 WEST MONTROSE STREET
CLERMONT FLORIDA 34711 IntelliBid
CO: CO-0001: 12/20/2024 CHANGES
Takeoff
Vendor: REX ORLANDO Labor Level: LABOR 1 23 Dec 2024 7:30:14
Phase: DEVICES
Material Material Labor Labor
Item # Qty U/M Q/M Size Description Unit Result Unit Result
0.00
1.00 ADD DUPLEX RECEPTACLE CONFERENCE ROOM
TITLE 1.00 EA M #12 MC 20A-1G-DX COMM 0.0000 0.00 0.0000 0.00
140012 1.00 EA M 20A DX RECEPT COMMERCIAL GRADE 3.7200 3.72 0.3000 0.30
140592 1.00 EA M 1-DUPLEX 1G PLASTIC PLATE 0.3400 0.34 0.1000 0.10
150015 1.00 EA M 1-1/2"D 4"SQ CMB- KO CV- BRKT 1.9500 1.95 0.3000 0.30
150064 1.00 EA M 5/8"RISE 4.8-CI 1G 4"SQ PLASTER -RING 1.7005 1.70 0.0800 0.08
161128 6.00 EA M #10 X 1" TEK SCREW 0.1244 0.75 0.0240 0.14
100143 1.00 EA M #12 SOL 8" PIGTAIL W/GRD SCREW 0.2558 0.26 0.0600 0.06
100159 1.00 EA M 18-12 PSH-IN 4-WIRE CONN 0.1322 0.13 0.0390 0.04
100158 1.00 EA M 18-12 PSH-IN 3-WIRE CONN 0.1202 0.12 0.0325 0.03
70337 35.00 FT M 12/2 MC CABLE - ALUM JKT W/G 0.6640 23.24 0.0242 0.85
630361 6.00 EA M 14>10-3 (2-CBL) AC/MC HMR-ON BOT-MTD 1/4-FLNG HGR PSH-IN 2.9510 17.71 0.0700 0.42
630327 2.00 EA M 14-2>10-3 & 3/8 AC/FLEX HGR PUSH -IN MTL/WOOD/STUD 1.0585 2.12 0.0700 0.14
670070 1.00 EA M 3/8 (38AST) AC/MC SNAP 2-IT INSUL 1.3821 1.38 0.0750 0.08
670091 1.00 EA M 3/8 (3838AST) AC/MC DX SNAP 2-IT INSUL 3.2333 3.23 0.0750 0.08
630342 1.00 EA M METAL/WOOD STUD PROTECTION PLATE 0.6652 0.67 0.0700 0.07
20A-1G-DX COMM Totals: 57.3080 57.31 2.6818 2.68
Phase Totals: 57.31 2.68
Phase: COMMUNICATIONS ROUGH -IN
Material Material Labor Labor
Item # Qty U/M Q/M Size Description Unit Result Unit Result
0.00
1.00 ADD DATA OUTLER IN CONFERENCE ROOM
TITLE 1.00 EA M 1" EMT/P-STRING 1G STUB/4"sq BOX /MTL-STD 0.0000 0.00 0.0000 0.00
150043 1.00 EA M 2-1/8"D 4"SQ 1"-KO NO BRKT 3.6283 3.63 0.3000 0.30
Dalton & Owens Electric Services, Inc. P.O. Box 491672 Phone: 352-787-1566
Leesburg, FL 34749-1672 Web: www.daltonowens.com
Page 1 of 3
Docusign Envelope ID: 40ABBDF5-3B6C-4C65-9439-B9EBEBAFE957
Takeoff Report: CLERMONT FIRE OFFICE
23 Dec 2024
7:30:14
Phase: COMMUNICATIONS ROUGH -IN
Material
Material
Labor
Labor
Item #
Qty U/M
Q/M
Size
Description
Unit
Result
Unit
Result
150064
1.00 EA
M
5/8"RISE 4.8-CI
1G 4"SQ PLASTER -RING
1.7005
1.70
0.0800
0.08
161128
5.00 EA
M
#10 X 1"
TEK SCREW
0.1244
0.62
0.0240
0.12
10055
10.00 FT
M
1
EMT
1.9243
19.24
0.0512
0.51
630063
2.00 EA
M
1
COND SNP -CLOSE HGR TO SCRW-ON STUD -WALL
2.9665
5.93
0.2500
0.50
30605
2.00 EA
M
1
EMT DI -CAST -COMP CONNECTOR
1.8826
3.77
0.3500
0.70
40238
2.00 EA
M
1
PLASTIC BUSHING
0.2501
0.50
0.1300
0.26
500123
12.00 FT
M
PULL LINE (STRING)
0.0304
0.36
0.0026
0.03
1G STUB/4"sq BOX/MTL-STD Totals:
35.7568
35.76
2.5027
2.50
0.00
1.00
ADD DATA OUTLET IN OFFICE 103
TITLE
1.00 EA
M
3/4" EMT/P-STRING
1G STUB/4"sq BOX /MTL-STD
0.0000
0.00
0.0000
0.00
150015
1.00 EA
M
1-1/2"D
4"SQ CMB- KO CV- BRKT
1.9500
1.95
0.3000
0.30
150064
1.00 EA
M
5/8"RISE 4.8-CI
1G 4"SQ PLASTER -RING
1.7005
1.70
0.0800
0.08
161128
5.00 EA
M
#10 X 1"
TEK SCREW
0.1244
0.62
0.0240
0.12
10054
10.00 FT
M
3/4
EMT
1.0777
10.78
0.0465
0.47
630062
2.00 EA
M
3/4
COND SNP -CLOSE HGR TO SCRW-ON STUD -WALL
2.6800
5.36
0.2500
0.50
30604
2.00 EA
M
3/4
EMT DI -CAST -COMP CONNECTOR
0.9874
1.97
0.3000
0.60
40237
2.00 EA
M
3/4
PLASTIC BUSHING
0.1569
0.31
0.1200
0.24
500123
12.00 FT
M
PULL LINE (STRING)
0.0304
0.36
0.0026
0.03
IG STUB/4"sq BOX /MTL-STD Totals:
23.0627
23.06
2.3362
2.34
Phase Totals:
58.82
4.84
Phase: CARD ACCESS
Material
Material
Labor
Labor
Item #
Qty U/M
Q/M
Size
Description
Unit
Result
Unit
Result
0.00
1.00
RECEPTION BUZZER
TITLE
35.00 EA
M
3/4 EMT EMPTY METAL -BUILDING
0.0000
0.00
0.0000
0.00
10054
35.00 FT
M
3/4
EMT
1.0777
37.72
0.0500
1.75
30498
4.00 EA
M
3/4
EMT DI -CAST -COMP COUPLING
1.2436
4.97
0.1400
0.56
30604
2.00 EA
M
3/4
EMT DI -CAST -COMP CONNECTOR
0.9874
1.97
0.3000
0.60
161559
5.00 EA
M
3/4
EMT 1-HOLE STEEL STRAP
0.3739
1.87
0.0400
0.20
500183
5.00 EA
M
1/8"
DRILL HOLE IN STEEL (UP TO 1/4" THICK)
0.0000
0.00
0.1250
0.63
161128
5.00 EA
M
#10 X 1"
TEK SCREW
0.1244
0.62
0.0240
0.12
Dalton & Owens Electric Services, Inc. P.O. Box 491672 Phone: 352-787-1566
Leesburg, FL 34749-1672 Web: www.daltonowens.com
Page 2 of 3
Docusign Envelope ID: 40ABBDF5-3B6C-4C65-9439-B9EBEBAFE957
Takeoff Report: CLERMONT FIRE OFFICE
23 Dec 2024
7:30:14
Phase: CARD ACCESS
Material
Material
Labor
Labor
Item # Qty U/M Q/M Size
Description
Unit
Result
Unit
Result
160390 5.00 EA M #10
PLTD FLAT WASHER
0.0405
0.20
0.0012
0.01
314 EMT EMPTY METAL -BUILDING Totals:
1.3532
47.36
0.1103
3.86
20737 4.00 EA M 3/4
EMT FLD-BEND
0.0000
0.00
0.1920
0.77
EMT FLD-BEND Totals:
0.0000
0.00
0.1920
0.77
90046 50.00 FT M 16/3
BELDON CABLE
0.7500
37.50
0.0130
0.65
Phase Totals:
84.86
5.28
Phase: SURVEILLANCE & CCTV
Material
Material
Labor
Labor
Item #
Qty U/M
Q/M
Size
Description
Unit
Result
Unit
Result
0.00
1.00
FIBER CONDUIT
TITLE
75.00 EA
M
3/4 EMT EMPTY METAL -BUILDING
0.0000
0.00
0.0000
0.00
10054
75.00 FT
M
3/4
EMT
1.0777
80.83
0.0500
3.75
30498
8.00 EA
M
3/4
EMT DI -CAST -COMP COUPLING
1.2436
9.95
0.1400
1.12
30604
2.00 EA
M
3/4
EMT DI -CAST -COMP CONNECTOR
0.9874
1.97
0.3000
0.60
161559
9.00 EA
M
3/4
EMT 1-HOLE STEEL STRAP
0.3739
3.37
0.0400
0.36
500183
9.00 EA
M
1/8"
DRILL HOLE IN STEEL (UP TO 1/4" THICK)
0.0000
0.00
0.1250
1.13
161128
9.00 EA
M
#10 x 1"
TEK SCREW
0.1244
1.12
0.0240
0.22
160390
9.00 EA
M
#10
PLTD FLAT WASHER
0.0405
0.36
0.0012
0.01
3/4 EMT EMPTY METAL -BUILDING Totals:
1.3013
97.60
0.0958
7.18
20737
4.00 EA
M
3/4
EMT FLD-BEND
0.0000
0.00
0.1920
0.77
EMT FLD-BEND Totals:
0.0000
0.00
0.1920
0.77
Phase Totals:
97.60
7.95
Job Totals:
298.59
20.75
Dalton & Owens Electric Services, Inc. P.O. Box 491672 Phone: 352-787-1566
Leesburg, FL 34749-1672 Web: www.daltonowens.com
Page 3 of 3