Halivax Paving-Persimmon AveE: Request for Services
The item(s) noted below is/are attached and forwarded to your office for the following action(s):
I M
U
Development Order
Final Plat (original mylars)
Letter of Credit
Maintenance Bond
Ordinance
Performance Bond
Resolution
City Comm Item
Mayor's signature
Recording
Rendering
Safe keeping (Vault)
0 City Attorney's Initials _
® Finance Director's Initials
® Purchase Manager Initials
Change Order — Persimmon Ave road widening; — CC 15-032.1)
Once completed, please:
❑ Return original
Return copy
for your files
Special Instructions:
Please advise if you have any questions regarding the above.
Thank you!
kris / Public Works 3/11/2015
From Date
SECTION 00950
WRLIUM:1111)*1V 11:1 za Vivi'll
Change Order No.
Project Name: Persimmon Ave Widening Project
Bid No.: I FB 13/14-10
Owner: - City of Sanford, Florida
Contractor: - Halifax Pavipg, Inc.
Agreement Date: 8/11/14
This Change Order is necessary to cover changes in the work to be performed under
this Agreement. The Agreement, General Conditions, Supplementary Conditions, and
Technical Specifications contained in the Project Manual 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
10. New Contract Final Completion Date
$ 843,588.50
$843,588.50
$72,890.05
$916,478.55
180 Days
0 Days
45 Days
225 Days
July 13, 2015
August 12, 2015
Persimmon Ave Widening Project, IFB 13/14-10 CHANGE ORDER FORM
00950-1
CHANGES ORDERED
JWK
Description of Change: Connect to existing mains
Reason for Change: Unanticipated small service Main adjustments along 31d St. with
additional improvements on 2 service main crossing on
Persimmon.
Change in Contract Price: $2,415.00
Change in Contract Time: Days 1
ITEM 2
Description of Change:
Reason for Change:
Change in Contract Price:
Change in Contract Time:
ITEM 3
Description of Change:
Reason for Change:
6" X 2" tap
Unanticipated small service Main adjustments along 3rd St. with
additional improvements on 2 service main crossing on
Persimmon.
$3,795.00
Days 1
2" poly -tubing water main
Unanticipated small service Main adjustments along 31 St. with
additional improvements on 2 service main crossing on
Persimmon.
Change in Contract Price: $20,700.00
Change in Contract Time: Days 8
Persimmon Ave Widening Project IFB 13/14-10
00950-2
CHANGE ORDER FORM
ITEM 4
Description of Change:
Directional drill crossing
Reason for Change: Unanticipated small service Main adjustments along 31d St. with
additional improvements on 2 service main crossing on
Persimmon.
Change in Contract Price: $6,900.00
Change in Contract Time: Days 2
ITEM 5
Description of Change: Blowoff assembly
Reason for Change: Unanticipated small service Main adjustments along 31 St. with
additional improvements on 2 service main crossing on
Persimmon.
Change in Contract Price: $977.50
Change in Contract Time: Days 10
ITEM 6
Description of Change: 1" service
Reason for Change: Unanticipated small service Main adjustments along 3rd St. with
additional improvements on 2 service main crossing on
Persimmon.
Change in Contract Price: $7,848.75
Change in Contract Time: Days 10
ItAIAVA
Description of Change: Sample Point
Reason for Change: Unanticipated small service Main adjustments along 31d St. with
additional improvements on 2 service main crossing on
Persimmon Ave Widening Project, IFB 13114-10 CHANGE ORDER FORM
00950-3
Persimmon.
Change in Contract Price: $2,530.00
Change in Contract Time: Days 3
ITEM 8
Description of Change: Christmas 4 days, New Year 1 day, Martin Luther King day 1,
rain Feb. 17; 1 day, rain Feb. 18; 1 day.
Reason for Change: Add contract time for rain and holidays
Change in Contract Price: $0.00
Change in Contract Time: Days 8
ITEM 9
Description of Change: Sod
Reason for Change: Sod for Pond 1 not shown on plans
Change in Contract Price: $3,723.80
Change in Contract Time: Days
ITEM 10
Description of Change:
Reason for Change:
Change in Contract Price:
8" Water Main (80 LF @ $300.00 = $24,000.00)
Extension of water main on Persimmon & 31d.
$24,000.00
Change in Contract Time: Days 2
CHANGE ORDER SUMMARY
No. Description Change in
Contract Price
Change in
Contract Time
1 Potable Water System, 8" water main, sod $72,890.05
37
Holiday and rain days 0.00
8
Persimmon Ave Widening Project, IFB 13/14-10 CHANGE ORDER FORM
00950-4
TOTAL $72,890.05 45 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.
Persimmon Ave Widening Project, IFB 13/14-10 CHANGE ORDER FORM
00950-6
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.
WITNESS to CONTRACTOR: Halifax Paving, Inc.
Contractor
Date
ATTEST:
r
(Signa re)
Printed Na e and Title of Officer
By §igna—tureT—�
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Date
(Corporate Seal)`
City of Sanford
Owner
Je// 7/tipieY-Y, I Nayo/z
Printed Nam
3-t <)- 1S'
Date By (Signz
3-9
(Seal) Date
END OF SECTION
ToA uze and zeiiancg o/ .the
San,,PolLd Cii-y Commizzion only
APPAOVed az i-O'ZoAffl andiegai-ii-y.
11L4
Persimmon Ave Widening Project, IFB 13/14-10 CHANGE ORDER FORM
00950-6