Contract 2019-55A.25 - 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 25 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 provide artwalk watermain revisions.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE
$ $ 4,866,278.23
B.
AMOUNT OF THIS CHANGE ORDER:
$ $ 35,670.00
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A)
% 0.733
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 415,302.55
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D)
$ 450,972.55
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 9.267
G.
NEW CONTRACT VALUE (A+E)
$ 5,317,250.78
This Change Order is not valid without the followin
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9/3/2020
signatures:
—DocuSigned by:
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9/3/2020
Date WI GTeARCHITECT / �by: Date
767;1xws6t& 9/3/2020 4"&U� S%k" I V,,m , S, i� 9/8/2020
DEPARTMENT DIRECTOR Date PUR H S09biRECTOR / bJWffA7UGER 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
L.N. General Description Oty. Unit Unit Price Extended Price
$ 35,670.00
4.24
10" DIP
85
LF
$ 65.00
$ 5,525.00
4.33
8X10 Reducer
1
EA
$ 250.00
$ 250.00
4.31
8X8 Wet Tap
1
EA
$ 9,500.00
$ 9,500.00
4.7
Fire Hydrant Assembly
1
EA
$ 3,500.00
$ 3,500.00
4.39
10x6 Tee (Fittings)
1
EA
$ 600.00
$ 600.00
4.25
10" Gate Valve
1
EA
$ 2,750.00
$ 2,750.00
Bore/Open Cut
70
LF
$ 60.00
$ 4,200.00
Remove and Replace Sidewalk
1
LS
$ 700.00
$ 700.00
4.17
2" Poly
180
LF
$ 10.00
$ 1,800.00
3" Chase
20
LF
$ 25.00
$ 500.00
2" Water Service
1
LS
$ 1,100.00
$ 1,100.00
4.38
8" Mega Lug
1
EA
$ 95.00
$ 95.00
4.42
10" Mega Lug
5
EA
$ 120.00
$ 600.00
4.41
10" Joint Restraint
3
EA
$ 350.00
$ 1,050.00
1.12
Testing
1
LS
$ 1,000.00
$ 1,000.00
1.6
As Builts
1
LS
$ 1,000.00
$ 1,000.00
Jumper Assembly
4.49 1 EA $ 1,500.00 $ 1,500.00
$ 35,670.00