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Contract 2019-55A.23 - COF 09.02.2020DocuSign Envelope ID: CC4A8B69-6BCC-4BOE-8368-E466685F6903 CHANGE ORDER FORM Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051 Change Order Number 23 Change Order Date: Sept. 2, 2020 Project Name: Streetscapes Phase 1 Department: Public Services 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). Additive change order to remove and dispose of one Wateroak tree. ITEM AMOUNT A. ORIGINAL CONTRACT VALUE $ $ 4,866,278.23 B. AMOUNT OF THIS CHANGE ORDER: $ $ 1,500.00 Must be within the overall scope of services in accordance with contract specifications. C. PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A) % 0.031 D. AMOUNT OF PREVIOUS CHANGE ORDERS: $ 395,852.55 E. TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D) $ 397,352.55 F. PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum % 8.165 G. NEW CONTRACT VALUE (A+E) $ 5,263,603.78 This Change Order is not valid without the followi &A-6L rbt,U,In, 9/3/2020 rRAOTOR Date Mf6" bl(WA,S6101 9/3/2020 DEPARTMENT DIRECTOR Date sianatures: uocuaignea oy: 9/3/2020 (P$��6tnv: Date 7�i'yTie�CHITECT '�'`� S� �'^ �6 �AWt,ln, � . a� 9/8/2020 PURCHASING DIRECTOR / CITY MAf4AGER 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: CC4A8B69-6BCC-4BOE-8368-E466685F6903 Unit Price I Extended Price 1,500.00 2.14 I Remove and Dispose Existing Tree(s) I 1 I EA I $ 1,500.00 I $ 1,500.00 1,500.00