HomeMy WebLinkAboutContract 2024-032A CODocusign Envelope ID: 8F2DBE1C-8BBE-4CCB-85FC-4lC54CB1586A
CHANGE ORDER FORM
Contract / P.O. Number: 2024-032 / 20245261 Bid Number: FSA 23-EQU21.0
Change Order Number: 1 Change Order Date: May 27, 2025
Project Name: Fire Stn. #1 Generator Replacement Department: Fire Department
Job Location: Fire Station #1, Clermont, FL
VENDOR INFORMATION:
Company Name: Genserve, LLC
Address: 11950 NW 39th Street City, St., Zip: Coral Springs, FL 33065
Contact Name: John Potts Telephone:954-440-3176
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).
Change order to extend the completion of work by Thirty -One (31) calendar days. The new completion date is June 30,
2025.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$ 253,810.00
B.
AMOUNT OF THIS CHANGE ORDER:
$
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% 0.0%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 0.0%
G.
NEW CONTRACT VALUE (A+E)
$ 253,810.00
This Change Order is not valid without the following signatures:
igned by:
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CONTRACTOR Date PROJECT ARCHITECT / ENGINEER Date
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Signed by: DocuSigned by:
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DADCB525C158496... 5/29/2025 431 F57D413554D6.- 5/29/2025
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