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CHANGE ORDER FORM pate. 4/22/2014 contract No. _C12-1995-FM Change Order No.:_14-01 Owner: __ OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS Contractor:___ Lord & Son Construction, Inc. Original Contract Price: 904,667.00 Net change by previously authorized Change Orders: 0.00 Present Contract Price: 904,667.00 This Change Order will (add/deduct): 170,854.54 1,075,521.54 New Contract Price: Original Contract Time: TBD TBD Original Substantial Completion Date: TBD Net change by previously authorized Change Orders: N/A This Change Order will (add/dedtuct): N/A New Contract Time: N/A N/A New Substantial Completion Date: APPROVALS REQUESTED AEBS \pancr pare: 4| zel Zarq PROIEC ENE Ne DATE: 3] 4 [aal4 Y —_) CONTRACTOR: Leven D. Lord, CFO hun oO DATE: ___ 4/22/2014 OWNER: DATE: This Change Order is an amendment to the Contract/Agreement between Contractor and the Owner, and all other contract provisions shall remain in full force and effect unless specifically amended in writing, signed by both parties, CG-C008942 P.O. Box 1808 Ft. Walton Beach, FL 32549 (850) 863-5158 FAX: (850) 862-4904 TO Qkaloosa County Board of County Commissioners 1 CONSTRUCTION, INC. LETTER OF TRANSMITTAL DATE: 12 May 2014 | JOB NO: 1217 ATTENTION: Don Turner RE: Shalimar Administration Complex— C12-1995-FM 5489 Old Bethel Road Crestview, FL 32536 WE ARE SENDING YOU RAttached LJ Under separate cover via the following items: CJ Invoice (1 Prints OC Plans LJ Samples CA Copy of letter [1] Change order (J Submittal Data L] Specifications COPIES DATE DESCRIPTION 4/22/14 Change Order Number 14-01 4/29/14 | Change Order Number 14-02 THESE ARE TRANSMITTED as checked below: DXlFor approval (Approved as submitted LResubmit copies for approval [For your signature [Approved as noted LJsubmit copies for distribution [As requested (Returned for your use Return corrected prints (For review and comment [J REMARKS Please return a fully executed copy of each Change Order to Lord & Son Construction, Inc. cc: FILE — Thank You, Steven M. Christopher Preconstruction Manager TRANSMIT.DOT If enclosures are not as noted, kindly notify us at once. ATA. document 6701/¢Ma" - 1992 Change Order - Construction Manager-Adviser Edition PROJECT (Name.and address): CHANGE ORDER NUMBER: 001 OWNER: Shalimar Courthouse Annéx Repurpose INITIATION DATE: 04/15/2014 CONSTRUCTION MANAGER: Now known as: Okaloosa, County ARCHITECT: Administration Building CONTRACTOR: [ ] Shalimar, FL. FIELD: [J TO CONTRACTOR (Name and address): PROJECT NUMBERS: 12009 / 1217 OTHER: [] Lord & Son Construction, Inc. CONTRACT DATE: 10/16/2012 19 David Street: CONTRACT FOR: General Fort Walton Beach, FL 32547 Construction THE CONTRACT IS CHANGED AS FOLLOWS: Additions 'to. orginal contract, scope (see attached Change Order ] Breakdown and Exhibits A & B) The original Contract Sum was $ 904,667.00 Net change: by previously authorized Change Orders $ 0.00 The Contract Sum prior to this. Change Order was $ 904,667.00 The Cofittact Sum will be iticreased by this Change Order in the amount of $ 170,854.54 The new Contract Sui including this Change Order will be $ 1,075,521.54 The Contract Time will be increased by Zero (0) days. The date of Substantial Conipletion as of the date of this Change Order therefore is NOTE: This sumrary’does not reflect changes in the Contract Sum, Contract Time or Guaranteed Maximum Price which have been authorized by Construction Change Directive.. NOT VALID UNTIL. SIGNED BY THE OWNER, CONSTRUCTION MANAGER, ARCHITECT AND CONTRACTOR. Leord.& Son Construction, Inc. DAG Architects, Inc. CONSTRUCTION MANAGER (Firm name) ARCHITECT (Firm name) 19 David Suyget? Fort Walton Beach, FL_32547 1223 AirpOn. Road, Destin! in, Destin pi/32541 OF SNL _ ioe Bh Aba BY (Signature) BY (Steviature) Leven D. Lord IT Charles W. Clary Ill, FAIA (Lyped name} DATE: 4 {23/2014 (Typed name) DATE: im 14 + on! Okaloosa County Board of County Commissioners CONTRACTOR (Firm name) OWNER (Firm name) 1804 Lewis Turner Blvd, Ste. 1005 Ely alton Beach, FL 32547 ADDRESS ADDRESS = BY (Signature) BY Gienature) ” (Typed name) DATE: (Typed name) DATE: AIA Document G701/CMa™ — 1992. Copyright © 1992 by The American institute of Architects. All rights reserved. WARNING: This AIA® Document is protected by U.S. Copyright Law and international Treaties. Unauthorized reproduction or distribution ofthis AIA® Document, or any portion of it, ay result in severe civil and criminal penalties, and will be prosecuted to the maximum extent possible under the law. This document was produced by AIA. software at 13:45:26 on 04/22/2014 under Order No.§773739723_1 which expires on 01/15/2015, and is not for resale. User Notes: (1496330605) 1. Change Order 1 - Breakdown Additional work to remove asbestos-containing materials from existing structures at the existing Shalimar Courthouse Complex, as directed by the County Administrator. ARES Contracting Inc. Exhibit A dated 4/10/2014 Southern Earth Sciences Exhibit B dated 3/11/2014 Lord & Son Supervision Exhibit C dated 4/11/2014 Bond .009117 $144,890.93 $13,050.00 $11,370.00 Subtotal $169,310.93 $1,543.61 Total Change Order 1| ‘$170,854.54 Addition for Bond (2.59) $ 3,533.93 Base Bid S14L,357.09 Total $144,890.93 BID PACKAGE NUMBER: General Tradework Deacription:_ Asbestos Removal Company Addrese: PhonalFax: _ 251-375-2100 (P)_ 251-375-2139 (F) Estimator Name & Phone; Michael J. Brown 251-379-7038 Authorized Agent Name & Phone:__Michael J. Brown 251-378-7036 _ Contact e-mall: aresbrown@hellsouth.net 1. We hereby propose to furniah all labor, materiale, equipment (temporary or permanent), shipping, fuel, taxes, trade permits, and related appurtenances as neceseary to Provide @ complete job per the Project Bid Documents enumerated In detail below, for the Stipulated Lump Sur Total Price eelg & 441,357, 20 ) 2. We hereby provide altemate pricing items es raquired by the Bid Documents and/or voluntarily offered relating te our proposed price and scope of services: (Reference form for “Propesal Attachment ‘ht » Alkemete Pricing", provided herewith) 3. We hereby provide unit pricing Rems as required by the Bid Documents and/or voluntarily offered talating to our proposed price and scope of services: (Referense form for Proposel Adieckment 'S' - Unit Pricing provided herewith) 4, We hereby certify that our Bid (price and terms) is based upon ail of the Bid Documents In their entirely as enumerated below, with only the following expressed clarifications and/or excaptions: (Reference form for "Proposal Atizchment ‘C’ - Comments end Clarificetions”, provided hennsith) 5. By submitting this Bid, Subcontractor is representing that It is duly registered and licensed to perform all work of this bid and Is presentty in full compliance with current Contracting Ucensure, Business Licensure, and Bid Lawe that govern at the location of the project site. License Numbers applicable to this Project are listed as follows: Page | lof? Okaloosa County Administration Building EXHIBIT B Lend & Son Construction, Inc. Mare, 1), 2014 P.O. Box 1808 Prop. No: P14058.03 Soy aeviews Wil include preperation of ecbestos cbeument specifications and monticting af the abatement spertions, ‘They will not include detafled floor plans tut will include the plpn provided in cur survey. Inchould be noted thet quantities are apgronimate, Our fees flar these services follow: A. Preparntion of plane and gpecificstions $ 2000.00 Approx. 20 days 'B, Abstmment monitnring, pee § hour dey SBOday |_ 1. Overtins, 28 howe, weeliendp $ 607new '=$9.000.00 2, Glearance testing: 8. By TEM, 24 bour tumanmtad, week days $ 125/ea Approx. 10 each b. By TEM, 24 hour turneround, weekends $18M/en |= $4,950.00 s. By PCM NE CG. Final Closeout Report & 800,09 ‘Total Estimate = $13,050.00 Momus « Montomamy » Cimmempau » Dans « Pamash 7 « TAAwAnOnE » BATGHROUOM » LAPAMETTE kemewute Hayy Gmina « Harramwims Aesdtiote reaches femme Bote Yoting B lanpestion, tra, Michel K. Verner, PE, LAC Asbesees Consultant No. EA0000023 hls Seate of Floxidn EXHIBIT C Supervision — Asbestos Abatement Okaloosa County Admin. Building Superintendent — 6 Weeks at $1,500/Week $ 9,000.00 Project Manager — 6 Weeks at 1 Day/Week $ 2,160.00 Superintendent Cell Phone — 6 Weeks at $35/Week $210.00 Total: $ 11,370.00

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