Contract 2020-067A.05DocuSign Envelope ID: 37CB76A6-3CEE-4595-6073-B1 ECE6C68AA5
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55
Change Order Number: 5 .
Project Name: Streetscape Phase 2
Job Location: Minneola Ave. and Osceola Street
(—
VENDOR INFORMATION:
Company Name: Traverse Group, Inc.
Address: P.O. Box 121754
Contact Name: Alicia Roehn
Bid Number: RFB 19-051
Change Order Date: May 25, 2021
Department: Public Services
City, St., Zip. Clermont, FL 34712
Tele phone: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 - Remove and replace curb along the North side of West Minneola Ave, between 7th Street
and 8th Street.
ITEM
AMOUNT
A UKI(iINAL CONTRACT VALUE: I $ 4,310,565.37
MOUNT OF THIS CHANGE ORDER:
B.
Must be within the overall scope of services in accordance with contract specifications. $ 14,877.30
C. PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A): % 0.3%
D. AMOUNT OF PREVIOUS CHANGE ORDERS: $ 69,102.03
E. TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D): $ 83,979.33
F. PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum % 1.9%
G- NEW CONTRACT VALUE (A+E) 1 $ 4,394,544.70
This Chan a Order is not valid without the following signatures:
CDocu3igned by: UUa.�'et,(A 1
3g8EE3AC048D48F
5/25/2021
(�g
5/25/2021
CONTRACTOR
_ _ _
Date
PROJECT ARCHITECT / ENGINEER
Date
DMUSlgned by: [DocuSlgned by: fe 1Jvwn,saln, 5/25/2021 4M'd&1S"At?� 5/25/2021
aatEEnat'+tsene
DEPARTMENT DIRECTOR Date PROCUREMENT DIRECTOR / Date
CITY MANAGER
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
NOT REQUIRED
MAYOR Date
ATTEST:
U1 I T %,LtKK
Date
Rev. 1-1-2021
DocuSign Envelope ID: 37CB713A6-3CEE-4595-13073-131 ECE6C68AA5
GROUP,IPMNWVRAVERSE OF •
CHANGE ORDER 5 - REMOVE AND REPLACE CURB ALONG THE NORTH SIDE OF WEST MINNEOLA Z41
L.N. General Description • Unlf Sarica Extertdod Priee
R&R CURB ALONG NORTH SIDE OF W MINNEOLA AVE BETWEEN 7TH STREET AND 8TH STREET W14,877.30
2.7
Remove and Dispose of Existing Curb
330
LF
$ 10.00
$ 3,300.00
10.6
24" Valley Gutter
306
LF
$ 35.00
$ 10,710.00
10.40
Curb Transitions
24
LF
$ 30.00
$ 720.00
3.5
Curb Grading - No Charge ($1815.00)
330
LF
$ 5.50
$ 0.00
LID Grates (openings) 4
4
EA
$ 500.00
$ 0.00
1.2
Payment and Performance Bond - Increase due to bonding
1
LS
$147.30
$ 147.30
V 1 /iL a 1`+,a / /.Ju
CHANGE ORDER TOTAL $ 14,877.30