Contract 2019-55A.15 - COF 06.04.2020DocuSign Envelope ID: 052A1 082-861 C-4B5A-8DF3-FCAD47877052
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051
Change Order Number 15 Change Order Date: June 4, 2020
Project Name: Streetscapes Phase 1 Department: Environmental Svcs.
Job Location: West Ave. and W. Osceola
VENDOR INFORMATION:
Company Name: Traverse Group, Inc.
Address: P.O. Box 121754 City, St., Zip: Clermont, FL 34712
Contact Name: Alicia Roehn Telephone: 352-409-6630
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).
Trapping 14" running services across West Ave.
Removal of cast iron and PVC pipes.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE
$ $ 4,866,278.23
B.
AMOUNT OF THIS CHANGE ORDER:
$ $ 178,345.00
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A)
% 3.665
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 0.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D)
$ 178,345.00
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 3.665
G.
NEW CONTRACT VALUE (A+E)
$ 5,044,623.23
This Chanae Order is not valid without the followina sianatures:
DocuSigned by: DocuSigned by:
C� 6/4/2020 [�— 6/4/2020
CONTRACTOR Date (PROJECT ARCHITECT / ENGINEER Date
ID—"Si,"ed by: 6/4/2O2O DocuSigned by: DocuSignetl by: f�vu�,sow [�In,c�o� Ste, � 6/5/2020
AAYWNT DIRECTOR Date PU%%%§)NG DIRECTOR YZ � R;4NAGER Date
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:
Gail L. Ash, Mayor Date Tracy Ackroyd Howe, City Clerk Date
Rev. 3-30-2020
DocuSign Envelope ID: 052A1 082-861 C-4B5A-8DF3-FCAD47877052
400 -WATER SUPPLY $ 178,345.00
4.03
Remove Water Service
300
LF
$ 10.00
$ 3,000.00
4.10
Adjust Water Valve boxes to grade
5
EA
$ 150.00
$ 750.00
4.16
14x2 Wet Tap
6
EA
$ 2,500.00
$ 15,000.00
4.17
2" Poly
235
LF
$ 10.00
$ 2,350.00
4.18
Connect Service to Existing Service
13
EA
$ 1,500.00
$ 19,500.00
4.19
14"x6" Wet Tap
1
LS
$ 8,500.00
$ 8,500.00
4.20
14"x10" Wet Tap
4
EA
$ 10,500.00
$ 42,000.00
4.24
10" DIP Water Main
320
LF
$ 65.00
$ 20,800.00
4.25
10" Gate Valve
3
EA
$ 2,750.00
$ 8,250.00
4.26
10" Cap/Plug
3
EA
$ 400.00
$ 1,200.00
4.28
Pressure Test
2
LS
$ 2,500.00
$ 5,000.00
4.29
Bact Tests
2
LS
$ 1,750.00
$ 3,500.00
4.32
8" Sleeves
2
EA
$ 400.00
$ 800.00
4.33
10x6 Reducer
3
EA
$ 250.00
$ 750.00
4.38
8" DIP Mega Lug Kit
6
EA
$ 95.00
$ 570.00
4.39
10" Fittings (Tees & Bends)
9
EA
$ 600.00
$ 5,400.00
4.41
10" Joint Restraint
10
EA
$ 350.00
$ 3,500.00
4.42
10" Mega Lug
31
EA
$ 125.00
$ 3,875.00
4.43
1" Poly
100
LF
$ 8.00
$ 800.00
4.44
10x8 Tie In Connect existing 8" to new 10"
2
EA
$ 1,500.00
$ 3,000.00
4.45
Water Main Removal
1470
LF
$ 10.00
$ 14,700.00
4.46
8" Joint Restraints
3
EA
$ 250.00
$ 750.00
4.47
Blow Off Assem
3
EA
$ 950.00
$ 2,850.00
4.48
8" Plug
2
EA
$ 300.00
$ 600.00
4.49
2" Jumper Assem
2
EA
$ 1,500.00
$ 3,000.00
4.50
Deadman Restraint (Minneola and Montrose)
2
EA
$ 3,950.00
$ 7,900.00
ADDITIONAL 21 DAYS TO CONTRACT
$ 178,345.00