Contract 2020-067A.08DocuSign Envelope ID: 47F52677-DF6D-4056-B572-AEBOA7BO508E
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55
Bid Number: RFB 19-051
Change Order Number: 8
Change Order Date: Aug 19, 2021
Project Name: Streetscape Phase 2
Department: Public Services
Job Location: Minneola Ave. and Osceola Street
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 - Graff additions as
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$ 4,310,565.37
B.
AMOUNT OF THIS CHANGE ORDER:
$ 14,151.11
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% 0.3%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 88,653.88
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$ 102,804.99
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS
(E/A): 10% Maximum
% 2.4%
G.
NEW CONTRACT VALUE (A+E)
$ 4,413,370.36
This Change Order is not valid without the following signatures:
DocuSigned by: DocuSigned by:
8/19/2021
396EE3AC046D48F_---64F2...
CONTRACTOR Date PROJECT ARCHITECT / ENGINEER
EDocuSigned by:
fb" bVt"S6V'
014063B8FF414OF...
DEPARTMENT DIRECTOR
8/20/2021
Date
DocuSigned by:
431F57D413554D6...
PROCUREMENT DIRECTOR /
CITY MANAGER
8/19/2021
Date
8/20/2021
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:
MAYOR Date CITY CLERK Date
Rev. 1-1-2021
DocuSign Envelope ID: 47F52677-DF6D-4056-B572-AEBOA7B0508E
TRAVERSE GROUP, INC. - CITY OF CLERMONT STREETSCAPE PH����
CHANGE •-DAdditions
GeneralDescription Qty. UnftjUnit Price Extended Price
Graff Additions $ 14,151.11
5.13
18" RCP
40
LF
$ 42.50
$ 1,700.00
5.26
Core Existing Manhole
1
EA
$ 3,750.00
$ 3,750.00
1.11
Survey
1
LS
$ 250.00
$ 250.00
1.12
Testing
1
LS
$ 150.00
$ 150.00
10.02
6" Concrete Driveway Widen 10'
380
SF
$ 10.95
$ 4,161.00
8.40
F&I 1-4 In. Sch 40 Conduit per Duke Energy
200
LF
$ 20.00
$ 4,000.00
Pland & Specs
1.2
Payment and Performance Bond - Increase due
LS
to bonding charge(s) by Bonding Company (1%)
1
$140.11
$ 140.11
TOTAL $ 14,151.11
CHANGE ORDER TOTAL $ 14,151.11