Contract 2024-050A CO 2Docusign Envelope ID: 8EA9835A-F3B9-45AF-89F2-F76AFCAD6899
CHANGE ORDER FORM
Contract / P.O. Number: 2024-050 / 20250196 Bid Number: RFB 24-100
Change Order Number: 2 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).
Deductive Change Order: Flooring credit for Owner Direct Purchase (ODP).
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$
395,556.00
B.
AMOUNT OF THIS CHANGE ORDER:
$
-3,970.11
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
%
-1.0%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$
2,478.39
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$
-1,491.72
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
%
-0.4%
G•
NEW CONTRACT VALUE (A+E)
$
394,064.28
This Change Order is not valid without the following signatures:
DocuSigned by:
B41C20859F5E47B...
CONTRACTOR
1/15/2025
Date
PROJECT ARCHITECT / ENGINEER Date
ESigned by: D,,ocu,S{ig{ned� by:
AW L") 1/15/2025 1431F57nAi3554n6" -� Sucre 1/15/2025
nADCR525C158496.. .
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: 8EA9835A-F3B9-45AF-89F2-F76AFCAD6899
r THE
KINSMEN CO# DATE
r
CONSTRUCTION 2 01/14/2025
COMPANY
CUSTOMER
City of Clermont
685 West Montrose Street
Clermont, FL 34711
DESCRIPTION
City to purchase directly from Mohawk
Subject: Flooring Direct Purchase
PROJECT
Clermont Fire Prevention Facility
650 West Montrose Street
Item Name
Qty
Price/Unit
Total
Flooring Credit
-1
$3,970.11
$-3,970.11
Total $-3,970.11
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 $-3,970.11
Revised Contract Amount, Including this Change Order $391,585.89
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
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