Contract 2020-063A.1DocuSign Envelope ID: E2856547-6DE9-4EB5-A791-A7FA12BF900B
CHANGE ORDER FORM #2020-63A.1
Contract / P.O. Number:
Bid Number:
Change Order Number: 1
Change Order Date: Dec 7, 2021
Project Name: Streetscape Phase 3 - Design
Department: Public Services
Job Location: Montrose Street phase 3 streetscape
VENDOR INFORMATION:
Company Name: Halff
Address: 902 N. Sinclair Ave
City, St., Zip:Tavares,FL 32778
Contact Name: Duane Booth
Telephone:352-343-8481
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).
Additional work on 7th street to include water main, and locates.
Additional work on Montrose to include water main.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$ 306,385.00
B.
AMOUNT OF THIS CHANGE ORDER:
$ 13,738.50
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% 4.5%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 0.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$ 13,738.50
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS
(E/A): 10% Maximum
% 4.5%
G.
NEW CONTRACT VALUE (A+E)
$ 320,123.50
This Change Order is not valid without the following signatures:
EDocuSigned by:
E 2/17/2022
97CC96F6EBA64F2...
CONTRACTOR Date PROJECT ARCHITECT / ENGINEER Date
5J
^DocuSigned by: DocuSigned by:
r" �IWOVtat 2/17/2022 S 2/17/2022
96EC958C84E7... 6D1E431F57D413554D6...
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 ATTEST:
MAYOR Date CITY CLERK Date
Rev. 1-1-2021
DocuSign Envelope ID: E2856547-6DE9-4EB5-A791-A7FA12BF900B
B0zo-�3-�+
902 N. Sinclair Avenue
Tavares, Fl- 32778
(352) 343-8481
ADDITIONAL SERVICES CONFIRMATION
TO: James Maiworm DATE: November 30, 2021,
Assistant Director Environmental Services revised December 7, 2021
City of Clermont
3335 Hancock Road AVO: 043826.158
Clermont, Florida 34711
FROM: HALFF
Duane K. Booth, P.E.
Operations Manager, VP
dboothgb-halff.com
VIA: imaiworm, Oxiermontfl.om
PROJECT: Clermont Downtown
Streetscape Phase 3
As per your request we understand that you would like HALFF to provide the additional services
described below.
PHASE 1400 SUBSURFACE UTILITY LOCATING ADDITIONAL 7TH STREET (PRECISE
LOCATING SERVICES, INC.)
Designate the horizontal positions for but not limited to Gas, Buried Power, Water, CAN, Fiber and
Telephone R/W to R/W along 7th Street north from Montrose Street to Minneola Avenue and east
on Minneola Ave for 50 feet. This does not include lane closures, permits, or bonds. Utility
locates are for proposed water main design.
FEE: $1,633.50
PHASE 1500 ADDITIONAL UTILITY LOCATES FOR PORTION OF 7T" STREET
Existing utility lines as flagged by underground locator will be field surveyed and delivered in cad to
engineering department for proposed water main design.
FEE: $2,485.00
Additional Services confirmation Halff Associates, Inc. (200611a)
DocuSign Envelope ID: E2856547-6DE9-4EB5-A791-A7FA12BF900B
ONE HALFFA
902 N. Sinclair Avenue
Tavares, FL 32778
(352)343-8481
GENERAL AREA FOR UTILITY LOCATIONS 7TH STREET
0-
11. 118
6W 644G7,
O in
Additional Services Confirmation Halff Associates, Inc. (200611 a)
DocuSign Envelope ID: E2856547-6DE9-4EB5-A791-A7FA12BF900B
:01
: HA I F F
902 N. Sinclair Avenue
Tavares, Fl- 32778
(352) 343-8481
ESTIMATED START DATE AND COMPLETION TIME FRAME:
We are currently experiencing a heavy workload and backlog in our survey department and we are
trying to finish projects in the order in which we received signed proposals. Currently we estimate
our start date for new projects to be about the 2nd week of December. At this time, we cannot
guarantee a start date due to our current backlog, weather delays and COVID. Please be aware
that we have several outstanding proposals, and some are being executed and returned that may
impact the start date." After "START DATE" this project will take an estimated 30 TO 35 business
days to complete.
PHASE 1600 7T" STREET WATERMAIN DESIGN
Design +/-380 LF of 10" DIP water main from Minneola Street to Montrose Street and tie into
proposed 10" water main on Montrose Street.
FEE: $2,320.00
PHASE 1700 MONTROSE STREET WATERMAIN DESIGN
Provide services to design +/-1,750 LF of 10" DIP watermain from West Avenue to Lake Street
along Montrose Street.
FEE: $5,800.00
PHASE 1800 FDEP WATER PERMIT
Prepare and submit FDEP General Permit application for water distribution system. Coordinate
with the City of Clermont for review of potable water system and signing of FDEP application as
utility provider, attend meeting(s) with City, and respond to request for additional information (RAI)
from City or FDEP.
FEE: $1500.00
SCHEDULE FEE SUMMARY
[PHASE
AMOUNT
PHASE 1400
$1,633.50
114-Ld
PHASE 1500
$2,485.00
NJ-VJ
PHASE 1600
PHASE 1700
$2,320.00
KJLAJ
$5,800.00
NkA�
PHASE 1800
$1,500.00
TOTAL
$13,738.50
Additional Services Confirmation HaHfAssociates, Inc. (200611a)
DocuSign Envelope ID: E2856547-6DE9-4EB5-A791-A7FA12BF900B
US HALFF
902 N. Sinclair Avenue
Tavares, FL 32778
(352)343-8481
We request your signature below to confirm the scope and fees.
By.—
rint name)
Title: Aist`f _
Signature: �i•,,'A-Q_� 14 0,;-Jod --
Date: 12-/ 7 2-
(_
r
❑ Attachments:
SIGNED: �'`�----
Duane K. Booth, P.E.
COPIES:
❑ File ❑ Owner ❑ Contractor ❑ Other:
Additional Services Confirmation Haft Associates, Inc. (200611a)