Contract 2019-55A.10 - COF 04.27.2020CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number.
Change Order Number:10 Change Order Date: 4.27.2020
Project Name: STREETSCAPE PH 1 Department:
Job Location: WEST AVE AND W OSCEOLA ST
VENDOR INFORMATION:
Company Name: TRAVERSE GROUP, INC.
Address: PO BOX 121754 City, St., Zip: CLERMONT, FL 34712
Contact Name.. ALICIA ROEHN Telephone: 352.409.6630
DESCRIPTION OF CHANGE:
Alleret/or, deviation, addition, or deletion caused by conditions encountered during construction not covered by the specftations and
drewings of the project (attach additional pages H necessary).
ADDT OF DRIVEWAY OFF W OSCEOLA ST INTO GRASS PARKING LOT ON THE SOUTH SIDE BETWEEN
7TH AND 8TH STREET AT THE CITY'S REQUEST. SEE INDIVIDUAL BREAKDOWN
jjEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE
$ 3,997,913.13
B
AMOUNT OF THIS CHANGE ORDER:
$
Must be ►within the overall scope of services in accordance with contract vecttications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A)
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 374,767.36
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D)
$
Council approval rreeqquired Hover $49,999 (S100 000 for construction) of original contract price OR if
378,069.61
funds are not avallabIs in the awtoved budget Ni the Devarlaml.
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
96 9,596
G.
NEW CONTRACT VALUE (A+E)
$ 4,375,982.74
CONTRACTOR Date
`I -Je'..2'G
DEPARTAIENT DIRECTOR Date
PROJECT ARCHITECT / ENGINEER
d.,$ZOZJ
Date
PURCHASING DIRECTOR / CITY MANAGER Date
Change Orders over 10%, not to exceed $49, 999 ($100,000 for construction projects) of the original contract OR not
budgeted, require the following signatures:
CITY OF C MONT ATTEST:
S'Iz'20
Gail L. Ash, Mayor Date Tracy Ackroyd Howe, City Clerk Date
Rev. 12-6-19
3W Earthwork and GradNg
EktrnArd Prirs '
5610.00
3.03
Crading (for Driveway Apron)
255
SY
$ 2.00
6 510.00
1000• ConcroW Curb and sidewalk
6 2,79L26
10.20
20'x10'xs' DAveway Ccncroh
255
1 SF
6 10.95
$2,792.25
3,302.25