No preview available
Contract 2024-040A CO2Docusign Envelope ID: OA91D1 F9E-DF74-4CC3-BDFB-D13D3D833447 CHANGE ORDER FORM Contract / P.O. Number: 2024-040 / 20250596 Bid Number: RFB 24-095 Change Order Number: 2 Change Order Date: Mar 27, 2025 Project Name: Lake Winona Basin 12A Drainage Im Department: Public Services Job Location: Lake Winona VENDOR INFORMATION: Company Name: DB Civil Construction, LLC. Address: 4475 US-1 South, Suite 707 City, St., Zip: St. Agustine, FL 32086 Contact Name: John Robbins, Project Manager Telephone:386-256-7460 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: Includes the installation of a curb section to address a resident's concern, as well as the addition of a drainage flume to direct street runoff into the newly dredged drainage channe it in the total amount of $13,740 ITEM AMOUNT A. ORIGINAL CONTRACT VALUE: $ 378,920.00 B. AMOUNT OF THIS CHANGE ORDER: $ 13,740.00 Must be within the overall scope of services in accordance with contract specifications. C. PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A): % 3.6% D. AMOUNT OF PREVIOUS CHANGE ORDERS: $ 32,570.00 E. TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D): $ 46,310.00 F. PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum % 12.2% G. NEW CONTRACT VALUE (A+E) $ 425,230.00 This Change Order is not valid without the following signatures: Signed by: �Aabw E?A�(br 4/9/2025 6907C43629284A5_. CONTRACTOR Date PROJECT ARCHITECT / ENGINEER Date EsDocuSigned by: lr� Signed by: fbin,t,� �jV1�1n,w, 4/9/2025 K& Vat (W�ln.t,� 4/9/2025 014063RAFF414OF 33260A85R04 D4AF 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: Signed by: DocuSigned by: 4/9/2025 ETAdAo� Haws 4/10/2025 2BA7692F758C492... 3AD7F34905B344A.- MAYOR Date CITY CLERK Date Rev. 1-1-2021 Docusign Envelope ID: OA9D1F9E-DF74-4CC3-BDFB-D13D3D833447 DB Civil Construction LLC Pricing for Change Order - Lake Winona added Drainage Structures To: City of Clermont Date: 2/26/2025 Project: Lake Winona 12A Basin Drainage Project Pricing for Scope of Work ITEM NO. DESCRIPTION QUANTITY UM UNITPRICE TOTAL 1 SOIL TRACKING PREVENTION DEVICE (1.00) EA $2,000.00 ($2,000.00) 2 REGULAR EXCAVATION 68 CY $ 100.00 $6,800.00 3 ICONCRETE DITCH PAVEMENT, NON REINFORCED, 4" RIPRAP - RUBBLE, DITCH LINING BEDDING STONE Pipe Culvert 15" RCP 10 SY $ 200.00 $2,000.00 4 6 TN $ 500.00 $3,000.00 5 11 TN $ 500.00 $5,500.00 6 (8.00) LF $195.00 TOTAL: $13,740.00 Description Of Work: Item No. Explanation of Change 1 Not required 2 Actual Quantity required to meet plan grading 3 Owner added additional paved Flume 4 Owner added additional paved Flume, resulting in additional riprap required. Approved in field 5 Owner added additional paved Flume, resulting in additional riprap required. Approved in field 6 Change Order No 1 Quantity was 88 LF, only 80 LF required SUBMITED BY: John Robbins Page 1 of 1