1404* American Infrastructure Change Order No. 1i�
I
PURCHASING DEPARTMENT
T RANSMITTAL MEMORANDUM
To:
RE:
City Manager /City Clerk
The item(s) noted below is /are attached and forwarded to your office for the following action(s):
❑ Mayor's signature
❑ RP!:awj&�-
American Infrastructure Change Order No. 1 PO 32522 Increase for $24,490.00
Development Order
Final Plat (original mylars)
Letter of Credit
Maintenance Bond
Ordinance
Performance Bond
Resolution
�-n et , e:
/ Return originals to rchasing
Return co
Special Instructions:
Safe keeping (V
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Payment Bond
City Manager Signature
City Clerk Attest/Signature
Marisol Ordonez
From
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Date
TADept_forms \City Clerk Transmittal Memo - 2009.doc
DATE: 07/21/11
PURCHASE ORDER
CITY OF SANFORD
P.O. BOX 1788
PURCHASING OFFICE: 407.688.5030 (300 NORTH PARK AVENUE)
ACCOUNTS PAYABLE: 407.688.5020 SANFORD, FLORIDA 32772
FACSIMILE: 407.688.5021 FLORIDA TAX EXEMPT NO.: 858012621681C -8
VENDOR NO.: 11155
TO:
AMERICAN INFRASTRUCTURE TECH C
8799 US HWY 31
HANCEVILE, AL 35077
PO NUMBER 032522
CHANGE #: 2
DATE CHG: 11/28/11
SUBMIT INVOICES TO: ACCOUNTS PAYABLE
FINANCE DEPT.
P.O. BOX 1788
SANFORD, FL 32772
SHIP TO:
CITY OF SANFORD
LOCATIONS AND QUANTITIES
SPECIFIED FOLLOWING ITEM
DELIVER BY
TERMS
F.O.B. DESTINATION
BID OR QUOTATION NO.
REQUISITION NO.
UNLESS OTHERWISE INDICATED
09/30/11
NET /30
ACCOUNT NO.: SEE BELOW PROJECT NO.:
NO DEVIATION FROM THIS PURCHASE ORDER WILL BE ALLOWED UNLESS AUTHORIZED BY THE PURCHASING MANAGER - CITY OF SANFORD
ITEM NO.
DESCRIPTION
QUANTITY
UNIT OF
ISSUE
UNIT COST
EXTENDED COST
*
* CHANGE ORDER
*
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
ITEMS 1 THRU 3 ON CHANGE ORDER
NO. 1
-----------------------------------
SHIP
ING INSTRUC
--------------------------
IONS
**
300 N. PARK AVENUE
TO:
SANFORD, FL 32771
-----------------------------------
- - - --
SUB
--------------------
TOTAL
308340.00
TOT
308340.00
REMARKS:
---------------------------- - - - - --
EQ /ACCT DATE REQ. BY
----- - - - - --
- - - --
PR
- - - - - --
JECT
- - - - - --
-- - - - - --
AMOUNT
-- - - - - --
---------------------------- - - - - --
000062793 07/19/11 MIGDALIA H
----- - - - - --
RNANDEZ
- - - --
WQ
704 2E3850.00-
5145645366300
2793 11/28/11 RYAN OSSOW
KI
WQ
704 2E3850.00
5245405366300
000063042 12/27/11 MIGDALIA H
RNANDEZ
WQ
704
4490.00
5245405366300
---------------------------- - - - - --
----- - - - - --
- - - --
- - - - - --
-- - - - - --
APPROVED BY: APPROVED BY:
� z PURCHASING ZGE16 MANA
ALL PACKAGES AND INVOICES ASSOCIATED WITH THIS P.O. MUST BEAR THIS PURCHASE ORDER NUMBER. THE VENDOR IS RESPONSIBLE TO CAREFULLY
READ AND COMPLY WITH ALL'OF THE STANDARD TERMS AND CONDITIONS PROVIDED ON THE REVERSE SIDE OF THIS PURCHASE ORDER
AND AT HTTP:N WWW. SANFORDFL. GOVIDEPARTMENTS /PURCHASE/TERMS.HTML
COPIES TO: VENDOR ORIGINATING DEPARTMENT PURCHASING
DATE: 07/21/11
PURCHASING OFFICE: 407.688.5030
ACCOUNTS PAYABLE: 407.688.5020
FACSIMILE: 407.688.5021
VENDOR NO.: 11155
TO:
PURCHASE ORDER
CITY OF SANFORD
P.O. BOX 1788
(300 NORTH PARK AVENUE)
SANFORD, FLORIDA 32772
FLORIDA TAX EXEMPT NO.: 858012621681 C -8
AMERICAN INFRASTRUCTURE TECH C
8799 US HWY 31
HANCEVILE, AL 35077
LOCATIONS AND QUANTITIES
SPECIFIED FOLLOWING ITEM
DELIVER BY
TERMS
F.O.B. DESTINATION
BID OR QUOTATION NO.
REQUISITION NO.
UNLESS OTHERWISE INDICATED
09/30/11
NET /30
ACCOUNT NO.: SEE BELOW PROJECT NO.:
NO DEVIA TION FROM THIS PURCHASE ORDER WILL BE ALLOWED UNLESS AUTHORIZED BY THE PURCHASING MANAGER - CITY OF SANFORD
ITEM N0.
DESCRIPTION
QUANTITY
UNIT OF
ISSUE
UNIT COST
EXTENDED COST
*
* CHANGE ORDER
*
*** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
1
SEWER REHAB /REPLACEMENT PROJECT
.00
.00
.00
I/I CORRECTIONS
ALONG HIGHWAY 17
GRANT NO. WW590101
---- ------------- - - - - --
SHIP
----- - - - - --
ING INSTRUCTIONS
--------------------------
**
412 W. 14TH STREET
TO:
SANFORD, FL 32771
2
-----------------------------------
CHANGE ACCT NO TO A CAPITAL FUND
283850.00
- - - --
NA
--------------------
1.00
283850.00
ACCT
--------------------------------------------------------------
---------------- - - - - --
SHIP
----- - - - - --
ING INSTRUCTIONS
- - - --
- - - - - --
**
------ - - - - --
412 W. 14TH STREET
TO:
SANFORD, FL 32771
3
---------------------------------------------------------------
INCREASE AMERICAN INFRASTRUCTURE
24490.00
NA
1.00
24490.00
PO 32522
TAP UPSIZING, STUB OUT, AND 8"
VALVE
APPROVED BY: I APPROVED BY:
PURCHASING AGENT
PO NUMBER 032522
CHANGE #: 2
DATE CHG: 11/28/11
SUBMIT INVOICES TO: ACCOUNTS PAYABLE
FINANCE DEPT.
P.O. BOX 1788
SANFORD, FL 32772
SHIP TO:
CITY OF SANFORD
CITY MANAGER
ALL PACKAGES AND INVOICES ASSOCIATED WITH THIS P.O. MUST BEAR THIS PURCHASE ORDER NUMBER. THE VENDOR IS RESPONSIBLE TO CAREFULLY
READ AND COMPLY WITH ALL OF THE STANDARD TERMS AND CONDITIONS PROVIDED ON THE REVERSE SIDE OF THIS PURCHASE ORDER
AND AT HTTP:// WWW. SANFORDFL. GOV/ DEPARTMENTSIPURCHASE/TERMS.HTML
COPIES TO: VENDOR ORIGINATING DEPARTMENT PURCHASING
PROJECT NO. W00704
SECTION 00850
CHANGE ORDER FORM
Change Order No. 1
Project Title Highway 17 -92 Lining Project
Bid No. IFB 09/10 -10
Owner: City of Sanford. Florida
Contractor: American Infrastructure Technolooies Corporation
Agreement Date: PO Dated July 21, 2011 3 R-�cA oZ
This Change Order is necessary to cover changes in the work to be
performed under this Agreement. The GENERAL CONDITIONS,
SUPPLEMENTARY CONDITIONS, and STANDARD SPECIFICATIONS
apply to and govern all work under this Change Order.
THE FOLLOWING CHANGES ARE MADE TO THE CONTRACT DOCUMENTS:
(1) Original Contract Price
(2) Current Contract Price (Adjusted by Previous Change Orders)
(3) Total Proposed Change in Contract Price
(4) New Contract Price (Item 2 + Item 3)
(5) Original Contract Time
(6) Current Contract Time (Adjusted by Previous Change Orders)
(7) Total Proposed Change in Contract Time
(8) New Contract Time (Item 6 + Item 7)
(9) Original Contract Substantial Completion Date
(10) New Contract Substantial Completion Date
283.850.00
$ 283.850.00
$ 24.490.00
$ 308.340.00
71 Days
71 Days
6 Days
77 Days
September 30, 2011
January 16, 2012
00850 -1
PROJECT NO. W00704
CHANGES ORDERED
ITEM 1
Description of Change: Upsize to 6" in lieu of 4" as bid at the water plant to include 60 psi
liquid filled gauge, meter box, and additional piping for Budget Car Rental tie -in.
Reason for Change: To provide adequate capacity for both water plant and Budget future
connections and to provide means of measuring force main pressure at water plant. Pressure
gauge to be located within meter box.
Change in Contract Price: $4,990.00
Change in Contract Time: 2 Days
ITEM 2
Description of Change: New 6" service stub out as well as excavation point located at
341:8 (vacant lot).
Reason for Change: To provide connection to force main and ten foot pipe stub (6 ")
and plug for future connections of two vacant lots.
Change in Contract Price: $14,100.00. This includes $10,200 for excavation and $3,900.00
for service line.
Change in Contract Time: 2 Days
ITEM 3
Description of Change: 8" Gate Valve located in the vicinity of the Racetrac as well as the
associated paving of about 4 feet by 6 feet.
Reason for Change: To provide valved control of the force main at that location.
Change in Contract Price: $6,400.00
Change in Contract Time: 2 Days
00850 -2
r ..
PROJECT NO. WQ0704
ITEM 4
Description of Change:
Reason for Change:
Change in Contract Price:
Change in Contract Time:
ITEM 5
Description of Change:
Reason for Change:
Change in Contract Price:
Change in Contract Time:
CHANGE ORDER SUMMARY
No.
Description
Change in
Contract Price
Change in
Contract Time
1
Tap U sizin , Stub Out, and 8" Valve
$24,490.00
6 Days
2
3
4
5
TOTAL
$ 24,490.00
6 Days
WAIVER This Change Order constitutes full and mutual accord and satisfaction for the
adjustment of the Contract Price and Contract Time as a result of increases or decreases in
cost and time of performance caused directly and indirectly from the change. Acceptance of
this Waiver constitutes an agreement between OWNER and CONTRACTOR that the Change
Order represents an equitable adjustment to the Agreement and that CONTRACTOR shall
waive all rights to file a Contract Claim or claim of any nature on this Change Order. Execution
of this Change Order shall constitute CONTRACTOR's complete acceptance and satisfaction
that it is entitled to no more costs or time (direct, indirect, impact, etc.) pursuant to this Change
Order.
APPROVAL AND CHANGE ORDER AUTHORIZATION
00850 -3
P
PROJECT NO. W00704
ACKNOWLEDGMENTS
The aforementioned change, and work affected thereby, is subject to all provisions of the
original Agreement and specifically changed by this Change Order; and
00850 -4
PROJECT NO. W00704
It is expressly understood and agreed that the approval of the Change Order shall have no
effect on the original Agreement other than matters expressly provided herein.
ATTEST:
( ecreta
///ib�/ //
Date
(Corporate Seal)
ATTEST:
_
/a -
-�l
Date
American Infrastructure Technologies
Corporation
Contractor
EX E7H 6DbEAJ5 , aO
Printed Na a and Title Qf.Wicer
(Signature)
1
Date
City of Sanford, Florida
Owner
Norton N- Bona a= ri-P, .7r _
Printed Name and Title City Manager
By (Signatur
♦2.7,��
(Seal)
Date
END OF SECTION
00850 -5