Contract 2023-064A RDocuSign Envelope ID: 63C9D755-A3EF-403F-BBCC-160A9EE6547D
CHANGE ORDER FORM
Contract / P.O. Number: 2023-064 / 20237619
Change Order Number: 2
Project Name: Osceola Street Sidewalk Improv.
Job Location: Osceola Street from Lake Avenue to 5th Street
VENDOR INFORMATION:
Company Name: B & B Outdoor, LLC.
Address: P.O. Box 805
Contact Name: Debbie LeBlanc
Bid Number: RFB 23-084
Change Order Date: Nov 22, 2023
Department:
City, St., Zip: Pierson, FL 32180
Telephone:(386) 736-4000
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 for additional mobilization fees.
ITEM
AMOUNT
A.
ORIGINAL CONTRACT VALUE:
$
66,125.00
B
AMOUNT OF THIS CHANGE ORDER:
$
4,000.00
Must be within the overall scope of services in accordance with contract specifications.
C.
PERCENT OF CONTRACT VALUE THIS CHANGE ORDER (B/A):
%
6.0%
D.
AMOUNT OF PREVIOUS CHANGE ORDERS:
$
6,550.00
E.
TOTAL AMOUNT OF ALL CHANGE ORDERS (B+D):
$
10,550.00
F.
PERCENT OF CONTRACT OF ALL CHANGE ORDERS (E/A): 10% Maximum
%
16.0%
G.
NEW CONTRACT VALUE (A+E)
$
76,675.00
This Change
Order is not valid without the following signatures:
Ef
DocuSigned by:
6 ft&w 12/13/2023
707BAC185238403...
CONTRACTOR Date PROJECT ARCHITECT / ENGINEER Date
EsDocuSigned by: DocuSigned by: SS
fbin" bVWASbV1 12/13/2023 4 Su"6 2/13/2523
014063B8FF4140F... 431F57D413554D6...
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 crigina.
contract amount for construction projects; 3) the funds are not available in the approved budget for the department.
CITY OF CLERMONT ATTEST:
DocuSigned by: DocuSigned by:
12/13/2023 ET'.IAn7F.�tAWFRIAAA
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MAYOR Date CITY CLERK Date
Rev. 1-1-2021
DocuSign Envelope ID: 63C9D755-A3EF-403F-BBCC-160A9EE6547D
B&B Outdoor, LLC
117 W Palmetto Ave
Pierson, FL 32180 US
+1 3867364000
Debbie@bb-outdoor.com
ESTIMATE #
1101
r-IF]
Auummz-J
City of Clermont
3335 Hancock Road
Clermont, FL 34711
DATF
_.. _111 /07/2023
ACTIVITY
Change Order
Mobilization
Mobilization
Estimate
Location: RFB 23-084
Osceola Sidewalk
Improvements,
un-billed Mobilization fees
based on conversation with
James Maiworm.
Mobilization Fee 1: fee for
false start date week of
9/ 12/2023.
Mobilization Fee 2: Start Date
11 /06/2023
SUBTOTAL
TAX
TOTAL
Accepted By Accepted Date
[3 & 13
J�pJo�
0
')TY RATE AM01 INT
1 0.00 0.00
1 3,000.00
1 1,000.00
3,000.00
1,000.00
4,000.00
0.00
$4,000.00