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1121-Prime Const-Cloud Branch PH 1-Change Order Form-lid-( CHANGE ORDER FORM Change Order No Project Title Bid No. Owner: Contractor: Agreement Date: Cloud Branch Drainage Improvements - Ph. 1 IFB 05/06 -08 City of Sanford Prime Construction Group, Inc. June 1, 2006 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) New Contract Substantial Completion Date $ 3,560,619.15 $ 3,560,619.15 $ ($133,057.33) $ 3,427,561.82 330 Days 330 Days 17 Days 347 Days July 13, 2007 Page 1 of 5 Change Order #1 CHANGES ORDERED ITEM 1 Description of Change: Work Directive No. 1 — Box Culvert and Structure Modifications Reason for Change: See Work Directive No. 1 (Copy attached) Change in Contract Price: ($57,417.00) Change in Contract Time: 0 Days ITEM 2 Description of Change: Work Directive No. 2 — Modify 4 x 11 box culvert at 11 th St. for existing gravity sewer crossing Reason for Change: See Work Directive No. 2 (Copy attached) Change in Contract Price: $8,934.71 Change in Contract Time: 1 Day ITEM 3 Description of Change: Work Directive No. 3 — New Ditch Bottom Inlet S-1 5A Reason for Change: See Work Directive No. 3 (Copy attached) Change in Contract Price: $8,136.12 Change in Contract Time: 1 Day ITEM 4 Description of Change: Work Directive No. 4 — Dispose of contaminated soil Reason for Change: See Work Directive No. 4 (Copy attached) Change in Contract Price: $42,374.04 Change in Contract Time: 3 Days Page 2 of 5 Change Order #1 ITEM 5 Description of Change Reason for Change: Change in Contract Price: Change in Contract Time: Work Directive No. 5 — Modify 5x5 box culvert and S -21 for existing gravity sewer crossing See Work Directive No. 5 (Copy attached) $8,766.53 1 Day ITEM 6 Description of Change: Reason for Change: Change in Contract Price: Change in Contract Time: Work Directive No. 6 — Modify 3x8 box culvert and install 12" PVC storm at 20 St ditch crossing See Work Directive No. 6 (Copy attached) $5,352.46 1 Day ITEM 7 Description of Change: Reason for Change: Change in Contract Price Change in Contract Time Work Directive No. 7 — Modify 3x9 box culvert to accommodate existing gravity sewer at 16 St See Work Directive No. 7 (Copy attached) $11,003.67 1 Day ITEM 8 Description of Change: Reason for Change: Change in Contract Price: Change in Contract Time: Contract Quantity Adjustments Incorporate actual constructed quantities into the contract ($196,689.45) 0 Days Change Order #1 Page 3 of 5 ITEM 9 Description of Change: Reason for Change: Change in Contract Price Change in Contract Time Contract Additions Work added to the contract per City's request, due to plan revisions or due to unforeseen conditions. $36,481.59 9 Days CHANGE ORDER SUMMARY No. Description Change In Contract Price Change In Contract Time 1 Work Directive No. 1 ($57,417.00) 0 Days 2 Work Directive No. 2 $8,934.71 1 Day 3 Work Directive No. 3 $8,136.12 1 Day 4 Work Directive No. 4 $42,374.04 3 Days 5 Work Directive No. 5 $8,766.53 1 Day 6 Work Directive No. 6 $5,352.46 1 Day 7 Work Directive No. 7 $11,003.67 1 Day 8 Contract Quantity Adjustments ($196,689.45) 0 Days 9 Contract Additions $36,481.59 9 Days TOTAL ($133,057.33) 17 Days Page 4 of 5 Change Order #1 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 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 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: Prime Construction Grauo. Inc. (Secretary) Thomas M. Pe 6 I - O� Date (Corporate Seal) Contractor Roy W. Smi Printed Name ai By (Signature) Jr., President of Officer — Date ATTEST: ✓ / / - r / UZ4 tate (Seal) Change Order #1 City of Sanford Owner Robert P. Yehl – City Manager Printed Name and Title By (Signature) P END OF SECTION Page 5 of 5 CITY OF SANFORD CLOUD BRANCH DRAINAGE IMPROVEMENTS - PHASE 1 (IFB 05/06 -08) CHANGE ORDER NO. 1 ATTACHMENT ITFM 1 - WORK nIRFCTIVF NO 1 DESCRIPTION UNITS QUANTITY UNIT COST TOTAL COST � Work Directive No. 1 1 LS 1 1 1 $ (57,417.00) ($57,417.00) PJ IIDlq ITEM 2 - WORK DIRECTIVE NO. 2 ($51,41 1.UU) DESCRIPTION UNITS QUANTITY I UNIT COSTI TOTAL COST � 6 H W,rk Directive No. 2 LS 1 $ 8,934.71 $8,934.71 IUTAL ITFM 3 - WORK DIRFCTIVF NO. 3 $t3,y34.71 DESCRIPTION UNITS QuANTITY I UNIT COSTI TOTAL COST � 6 Staked Silt Fence Work Directive No. 3 LS 1 $8,136.12 $8,136.12 Ww Araw- ITEM 4 - WORK DIRECTIVE NO. 4 $tf,13b.12 I DESCRIPTION UNITS QUANTITY I UNIT COSTI TOTAL COST � 6 Staked Silt Fence Work Directive No. 4 LS 1 $42,374.04 $42,374.04 IUTAL ITEM 5 - WORK DIRFCTIVF NO. 5 $42,374.04 DESCRIPTION UNITS QUANTITY UNIT COSTI TOTAL COST �j 6 Staked Silt Fence Work Directive No. 5 LS 1 $8,766.53 $8,766.53 IUTAL ITEMS -WORK DIRFCTIVF NO. 6 $ tf, ! bb.53 DESCRIPTION UNITS QUANTITY UNIT COST TOTAL COST �j 6 Staked Silt Fence Work Directive No. 6 LS 1 $5,352.46 $5,352.46 IUJAL ITEM 7 -WORK DIRECTIVE NO. 7 $5,352.46 DESCRIPTION UNITS QUANTITY UNIT COST TOTAL COST 20TH STREET CROSSING (STA. 10 +30 +/- TO 19 +75 + / -) 6 Staked Silt Fence Work Directive No. 7 LS 1 $11,003.67 $11,003.67 W ITEM 8 - QUANTITY ADJUSTMENTS $ i 1,UU3.0/ DESCRIPTION UNITS I QUANTITY UNIT COST TOTAL COST 20TH STREET CROSSING (STA. 10 +30 +/- TO 19 +75 + / -) 6 Staked Silt Fence LF -1496 $1.50 ($2,244.00) 8 Sodding (Bahia) Along Ditch Top of Bank (Two 15' Wide Paths) SY - 1000.0 $2.00 ($2,000.00) 11 Seed Ditch Side Banks and Install Erosion Control Mat SF -3441 $0.10 ($344.10) 12 Concrete Ditch Paving in Ditch Near Sta. 12 +70, 15 +60 SY -39 $70.00 ($2,730.00) 13 Connect to Existing 15" Culvert, Clean Pipe Near Sta. 12 +70 LS -1 $1,600.00 ($1,600.00) 15 New 15' RCP Pipe Near Station 12 +70 LF 1 -12 $160.00 ($1.920.00) 16 1 New 24" RCP Pipe Near Station 15 +60 LF 47 $170.001 $7,990.00 17 15" MES EA -1 $1,500.00 ($1,500.00) 25 1 Remove and Replace Existing 12" Sewer with 12" D. 1. Sewer Near Sta, I L 2U j $150.00 ( SUBTOTAL ($7,348.10) 19TH PLACE CROSSING (STA. 19 +75 +/- TO 23 +10 + / -) 38 1 Staked Silt Fence LF 1 -598 1 $1.50 ($897.00) j: \50620.17 \excel \Change Order 1 attachment - 5 -22 -07 5/29/2007 9:10 AM 40 Sodding (Bahia) Along Ditch Top of Bank (Two 15' Wide Paths) SY -400.0 $3.00 ($1,200.00) 42 Seed Ditch Side Banks and Install Erosion Control Mat SF 2444 $3.00 ($7,332.00) 45 Concrete Flume at Crossing LS 1 $3,000.001 $3,000.00 50 Remove and Replace Existing 12" Sewer with 12" D.I. Sewer Near Sta. 20 LF -32 1 $150.00 ($4,800.00) SUBTOTAL ($11,229.00) 16TH STREET CROSSING (STA. 23 +10 +/- TO 33 +20 + / -) 54 Staked Silt Fence LF -1992 $1.50 ($2,988.00) 56 Sodding (Bahia) Along Ditch Top of Bank (Two 15' Wide Paths) SY - 1493.3 $2.50 ($3,733.25) 57 Re -grade and Reshape Existing Ditch Between 19th Pl. and 16th St. LF 15 $20.00 $300.00 58 Seed Ditch Side Banks and Install Erosion Control Mat SF -5858 $2.50 ($14,645.00) 59 Concrete Ditch Paving in Ditch Near Sta. 26 +30, 29 +30 SY -57 $60.00 ($3,420.00) 60 Install 12" MES at Culvert Near Sta. 26 +30 LS -1 $1,200.00 ($1,200.00) SUBTOTAL ($25,686.25) 14TH STREET CROSSING (STA. 33+20 +/- TO POND 5) 65 Remove 42" RCP at 16th St. LF 35 $30.00 $1,050.00 75 Staked Silt Fence LF -1634 $1.50 ($2,451.00) 78 Re -grade and Reshape Existing Ditch Between 16th St. and Pond 5 LF 17 $15.00 $255.00 79 Seed Ditch Side Banks and Install Erosion Control Mat SF -3747 $2.50 ($9,367.50) 82 New Stop Signs at 14th St./Williams St. /Roundtree St. (Sign and Post) EA -1 $150.00 ($150.00 SUBTOTAL ($10,663.50) POND 5 CONSTRUCTION 102 1 New 15" MES at Pond 5 1 EA -1 1 $1,200.00 ($1,200.00) 104 lRemove and Replace 4" Concrete Sidewalk along Pond 5 1 SY 1 231 1 $40.001 $9,240.00 SUBTOTAL $8,040.00 POND OUTFALL / LAKE AVE. CONSTRUCTION TO 12TH ST. (STA. 200 +60 +/- TO 211 +40 + / -) 115 Open Cut Remove /Replace Lake Ave. (Pond 5 to 13th Street) SY -90 $120.00 ($10,800.00) 116 Open Cut Remove /Replace 12th St. Intersection at New Culvert SY -10 $120.00 ($1,200.00) 117 Remove and Replace Dirt Road w/ New Shell Road (13th St. to 12th St.) SY -266 $18.00 ($4,788.00) 124 New 24" RCP Pipe from New Inlet Structure to Junction Structure LF 6 $100.00 $600.00 129 Remove Existing Fence and Install New 4 -Ft High Chain Link Fence LF 174 $5.00 $870.00 130 Cut and Cap Existing 6" Water Main w/ Conc. Thrust Collar EA -4 $200.00 ($800.00) 131 6" x 6" Tapping Sleeve and Valve EA -4 $3,000.00 ($12,000.00) 137 Install New 10" D.I. Water Main and Fittings LF 42 $50.00 $2,100.00 138 6" Linestop EA -4 $4,000.00 ($16,000.00) 140 Air Relief Valve (Offset) EA -1 $3,000.00 ($3,000.00) 141 Install New 1" PE Service Line LF -140 $4.00 ($560.00) 142 10 "x1" Service Saddle and Corporation Stop EA -3 $300.00 ($900.00) 144 Replace 8" San. Sewer with New 8" D.I. (Polyethylene Lined) Sewer at Jun LF 1 -12 1 $120.00 ($1,440.00) SUBTOTAL ($47,918.00) DITCH ENCLOSURE - 13TH ST. TO 12TH ST. (STA. 45 +10 +/- TO 51 +40 +l -) 146 Staked Silt Fence LF -1130 $1.00 ($1,130.00) 159 Connect 4" PVC to New Inlet with Cleanout and 45 Degree Bend LS -1 $150.00 ($150.00) 164 Open Cut Remove /Replace 12th St. at Culvert Crossing SY -13 $120.00 ($1,560.00) TT Remove and Replace Curb and Gutter at 19th PI. LF 50 $25.00 $1,250.00 165 Remove and Replace Concrete Ribbon Curb LF 149.0 $20.00 $2,980.00 167 10" Linestop EA -2 $4.000.00 ($8.000.00) 168 ICut and Cap Existing 10" Water Main w/ Conc. Thrust Collar EA 1 -2 1 $300.00 ($600.00) 169 Remove Existing 10" Water Main LF -23 $50.00 ($1,150.00) 170 llnstall New 10" Water Main and Fittings LF -36 $60.00 ($2,160.00) 171 10" Tapping Sleeve and Valve EA -2 $3,000.00 ($6,000.00) SUBTOTAL ($16,520.00) DITCH ENCLOSURE 12TH ST. TO COASTLINE PARK (STA. 51 +40 +l- TO 57 +50 + / -, AND 101 +40 +l- TO 104 +20 +l -) 174 Staked Silt Fence LF -960 $1.00 ($960.00) 180 Junction Structure (At 3' x 11' BC) EA -1 $9,000.00 ($9,000.00) 186 Cut and Cap Existing 10" Water Main w/ Conc. Thrust Collar EA -2 $200.00 ($400.00) 187 10" x 10" Tapping Sleeve and Valve EA -2 $4,000.00 ($8,000.00) 188 Remove Existing 10" Water Main LF -60 $30.00 ($1,800.00) 189 Install New 10" D.I. Water Main and Fittings LF -60 $30.00 ($1,800.00) 190 10" Linestop EA -2 $8,000.00 ($16,000.00) 191 New 3' x 11 Box Culvert at 11th Street LF -49 $1,000.00 ($49,000.00 196 lRemove 2 -48" RCP and Endwall at Coastline Park LS -1 $8,000.00 $8,000.00) 197 lConcrete Ditch Paving in Ditch at Coastline Park SY -300 $50.00 ($15,000.00) SUBTOTAL ($109,960.00) j:\s0620.17 \excel \Change Order 1 attachment - 5 -22 -07 5/29/2007 9:10 AM ITEM 9 - CONTRACT ADDITIONS ($196,689.45) DESCRIPTION Work Directive No. 1 QUANTITY UNIT COST TOTAL COST $8,136.12 Modify S -31 FG elevation 5 X 5 BOX CULVERT 1 $ 499.13 $499.13 $5,352.46 Modify Pond 5 Slopes on South side from 6:1 to 4:1 Add - Modified Box Culvert with manhole riser and ring & cover EA -1 $7,195.00 ($7,195.00) 132 Delete - Remove exisitng 6" water main on Lake Ave. LF -35 $5.00 ($175.00) 133 Delete - Install new 6" DI water main & fittings on Lake Ave. LF -35 $25.00 ($875.00) 115 Delete - Open cut remove/replace Lake Ave (northbound lane) SY 273.67 $120.00 $32,840.40 SUBTOTAL $24,595.40 ITEM 9 - CONTRACT ADDITIONS ($196,689.45) DESCRIPTION UNITS QUANTITY UNIT COST TOTAL COST $8,136.12 Modify S -31 FG elevation LS 1 $ 499.13 $499.13 $5,352.46 Modify Pond 5 Slopes on South side from 6:1 to 4:1 LS 1 $ 14,917.10 $14,917.10 $36,481.59 Modify S -16 Endwall LS 1 $ 6,069.30 $6,069.30 Handicap Ramps on 13th St at Lake Ave. EA 4 $ 500.00 $2,000.00 Gates on 13th and 12th LS 1 $ 993.75 $993.75 Rubble Ri ra at S -16 - Pond 5 TN 1 $ 12,002.31 $12,002.31 (VIAL CHANGE ORDER SUMMARY Item 1 ($57,417.00) Item 2 $8,934.71 Item 3 $8,136.12 Item 4 $42,374.04 Item 5 $8,766.53 Item 6 $5,352.46 Item 7 $11,003.67 Item 8 ($196,689.45) Item 9 $36,481.59 TOTAL ($133,057.33) Original Contract Amount $3,560,619.15 Proposed C.O. No. 1 ($133,057.33) Proposed New Contract Amount $3,427,561.82 $36,481.59 ;:\s0620.17\excel \Change Order 1 attachment - 5 -22 -07 5129/2007 9:10 AM CITY OF SANFORD CLOUD BRANCH DRAINAGE IMPROVEMENTS - PHASE 1 (IFB 05/06 -08) CHANGE ORDER NO. 1 ATTACHMENT TIME SUMMARY TOTAL 17 Days CONTRACT TIME SUMMARY Contract Time 330 Days Proposed Change Order No. 1 Change in Contract Time 17 Days New Contract Time 347 Days Date of Notice to Proceed 7/31/2006 Total Adjusted Contract Time 347 Days Revised Substantial Completion Date 7/13/2007 Contract Time From Substantial Completion to Final Completion 30 Days Revised Final Completion Date 8/12/2007 j: \s0620.17 \exce1\Change Order 1 attachment - 5 -22 -07 5/29/2007 9:10 AM TIME CHANGE ITEM 1 - WORK DIRECTIVE NO. 1 Days ITEM 2 - WORK DIRECTIVE NO. 2 1 Days ITEM 3 - WORK DIRECTIVE NO. 3 1 Days ITEM 4 - WORK DIRECTIVE NO. 4 3 Days ITEM 5- WORK DIRECTIVE NO. 5 1 Days ITEM 6 - WORK DIRECTIVE NO. 6 1 Days ITEM 7 - WORK DIRECTIVE NO. 7 1 Days ITEM 8 - QUANTITY ADJUSTMENTS Days ITEM 9 - CONTRACT ADDITIONS 9 Days TOTAL 17 Days CONTRACT TIME SUMMARY Contract Time 330 Days Proposed Change Order No. 1 Change in Contract Time 17 Days New Contract Time 347 Days Date of Notice to Proceed 7/31/2006 Total Adjusted Contract Time 347 Days Revised Substantial Completion Date 7/13/2007 Contract Time From Substantial Completion to Final Completion 30 Days Revised Final Completion Date 8/12/2007 j: \s0620.17 \exce1\Change Order 1 attachment - 5 -22 -07 5/29/2007 9:10 AM