Contract 2020-067A.14DocuSign Envelope ID: FCCAA24A-2D91-44A6-8F96-74C250CDD8BB
CHANGE ORDER FORM
Contract / P.O. Number: 2019-55 Bid Number: RFB 19-051
Change Order Number: 14 Change Order Date: Nov 1, 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).
Deductive Change Order - Drainage Improvements Becker Funeral Home (Partial CO 10 Deleted from scope of
change order).
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$ 4,310,565.37
B.
AMOUNT OF THIS CHANGE ORDER:
$-5,082.32
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
% -0.1%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$ 170,289.41
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$ 165,207.09
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
% 3.8%
G.
NEW CONTRACT VALUE (A+E)
$ 4,475,772.46
This Change Order is not valid without the following signatures:
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CONTRACTOR
Date PROJECT ARCHITECT / ENGINEER
Date
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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: FCCAA24A-2D91-44A6-8F96-74C250CDD8BB
7 • Unit Price Extended Price
CREDIT Drainage Improvements Becker Funeral Home (Partial CO10 Deleted $ (5,082.32)
from scope of Change Order)
2.13
Remove existing concrete
160
SF
$ (1.95)
$ (312.00)
2.19
Saw cut concrete
56
LF
$ (1.25)
$ (70.00)
5.43
10x6 Sewer Wye
2
EA
$ (250.00)
$ (500.00)
6.3
6" Cleanouts
3
EA
$ (150.00)
$ (450.00)
6.2
6" Laterals
2
EA
$ (750.00)
$ (1,500.00)
5.44
4" Trench Drains
20
LF
1.20
Payment and Performance Bond
1
LS
$ (50.32)
$ (50.32)
$ (5,082.32)
DocuSign Envelope ID: FCCAA24A-2D91-44A6-8F96-74C250CDD8BB
pp; HALFF
VIA EMAIL jmaiworm(a)clermontfl.or
October 27, 2021
James Maiworm
Assistant Director Public Services
City of Clermont
3335 Hancock Road
Clermont, Florida 34711
RE: DOWNTOWN STREETSCAPE PHASE 2 (AVO #043826.078)
CHANGE ORDER #14 CREDIT, DRAINAGE IMPROVEMENTS BECKER FUNERAL
HOME
Dear Mr. Maiworm:
I have reviewed Change Order #14 Credit by Traverse Group, Inc., for drainage improvements
Becker Funeral Home and recommend approval for a credit in the amount of $5,082.32. Traverse
Group, Inc., was instructed by the City not to complete this portion of change order. Should you
have any questions, please feel free to contact our office.
Sincerely,
HALFF
Duane K. Booth, P.E.
Operations Manager, VP
dboothahalff.com
DKB:am
cc: Stoney Brunson, City of Clermont (via email)
George Beach, City of Clermont (via email)
Alicia Roehn, Traverse Group, Inc. (via email)
Halff Associates, Inc. 1902 N. Sinclair Avenue I Tavares, FL 32778 1 (352) 343-8481