Okaloosa County BOCC — July 1, 2014 — Change Order #4

CHANGE ORDER FORM Date: 6/23/14 Contract No: C-/4/-Z2!7)/ - HD Change Order No.:__7/ Owner: __ OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS Contractor;_Jimm v Henderson IE Constcuction Inc. CHANGE TO CONTRACT PRICE DESCRIPTION AMOUNT Original Contract Price: &R 943 rial “ Net change by previously authorized Change Orders: & 10, 737 ~ Present Contract Price: & loo, 551- This Change Order will (add/deduct): # 730 ~ New Contract Price: * LOS, 30 | CHANGE TO CONTRACT TIME DESCRIPTION DATE or NUMBER OF DAYS Original Contract Time: Original Substantial Completion Date: 5/6 /Zoly Net change by previously authorized Change Orders: AS days This Change Order will (add/deduct): Z| days New Contract Time: New Substantial Completion Date: 7 /[z l / ! ed APPROVALS REQUESTED BY: J —f— pate: @/ 23/14 PROJECT ENGINEER: DATE:_ @/%2 3/144 1 é CONTRACTOR: 22 aA DATE: S/Z23//% OWNER: NO. DATE: ula | 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. Signature Date Okaloosa County Board of County Commissioners Charles K. Windes, Jr., Chairman JIMMY HENDERSON II CONSTRUCTION COMPANY, INC. 714-B Bob Sikes Boulevard, Fort Walton Beach, Florida 32547 (850) 864-5426 Fax (850) 864-5428 JimmyHendersonConst.com License # CG-C062300 Proposal Date: Friday June 20th, 2014 Owner: Okaloosa County Health Dept. 221 Hospital Dr. Fort Walton Beach, FL 32548 Contact: Shaun May Phone: (850) 699-4225 Property Location: Modular Building @ 221 Hospital Dr. NW We Propose to complete the following items at the above stated property location as per the following scope of work. Additional Pickets to be installed at ramps Furnish and install wooden pickets to match existing at outside of both ramps... $750