Contract 2019-55A.17 - COF 06.04.2020DocuSign Envelope ID: C9D358D9-A22A-4945-8253-EB60DEAC1DCD
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051
Change Order Number 17 Change Order Date: July 24, 2020
Project Name: Streetscapes Phase 1 Department: Public Services
Job Location: Meet in the Middle Park
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).
Railing for steps at Meet in the Middle Park stairs.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE
$ $ 4,866,278.23
B.
AMOUNT OF THIS CHANGE ORDER:
$ $ 10,750.00
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A)
% 0.221
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 192,745.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D)
$ 203,495.00
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 4.182
G.
NEW CONTRACT VALUE (A+E)
$ 5,069,773.23
This Change Order is not valid without the following signatures:
�DocuSigned by: DocuSigned by:
7/24/2020 F
Sfb" bl(WA,S6101
DEPARTMENT DIRECTOR
Date
7/30/2020
Date
Fi
PUF
ECT / ENGINEER
s m"
7/28/2020
Date
7/30/2020
RECTOR / CITY MANAGER 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: C9D358D9-A22A-4945-8253-EB60DEAC1DCD
Unit Price
Extended Price
$ 10,750.00
7Allowance
Fabricate 30' of 2" diameter aluminum pipe two
strand railing with 6x4 base plates
1
LS
$ 7,800.00
$ 7,800.00
Instal Railing
1
LS
$ 1,950.00
$ 1,950.00
for Powder Coating
1
LS
$ 1,000.00
$ 1,000.00
$ 10,750.00