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CHANGE ORDER FORM
Date: 5/28/2014 Contract No.; _C12-1995-FM Change Order No.: _ 14-03
Owner: __ OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS
Contractor: Lord & Son Construction, Inc.
CHANGE TO CONTRACT PRICE
DESCRIPTION AMOUNT
Original Contract Price: $ 904,667.00
Net change by previously authorized Change Orders: 729,734.54
Present Contract Price: 1,634,401.54
This Change Order will (add/deduct): 178,784.69
New Contract Price: $1,813,186.23
CHANGE TO CONTRACT TIME
DESCRIPTION DATE or NUMBER OF DAYS
Original Contract Time: TBD TBD
Original Substantial Completion Date: TBD
Net change by previously authorized Change Orders: N/A
This Change Order will (add/deduct): N/A
New Contract Time: N/A
New Substantial Completion Date: N/A
APPROVALS
REQUESTED BY: DATE:
PROJECT ENGINEER: a — DATE:
CONTRACTOR: nn wih _ DATE: 5/28/2014
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.
LETTER OF
: TRANSMITTAL
SON construction, Inc.
CG-C008942 DATE: 10 Jun 2014 JOB NO: 1217
P.O. Box 1808
Ft. Walton Beach, FL 32549 ATTENTION: Rick Owen
(850) 863-5158
FAX: (850) 862-4904 RE: Shalimar Administration
Complex— C12-1995-FM
TO Mr. Rick Owen, Administrative Manager
Okaloosa County
1804 Lewis Turner Blvd., Suite 400
Fort Walton Beach, FL 32547
WE ARE SENDING YOU Attached _] Under separate cover via the following items:
[] Invoice _] Prints L] Plans [_] Samples
L_] Copy of letter [_] Change order —[_] Submittal Data L] Specifications
COPIES DATE DESCRIPTION
3 5/28/14 Change Order Number 3
THESE ARE TRANSMITTED as checked below:
[_]For approval [Approved as submitted [_]Resubmit copies for approval
[X]For your signature L_]Approved as noted _]Submit copies for distribution
LJAs requested [_]Returned for your use XJReturn corrected prints
[_]For review andcomment []
REMARKS
The attached Change Order is submitted for final approval.
cc: & FILE- Thank You, Steven M. Christopher
Preconstruction Manager
TRANSMIT.DOT If enclosures are not as noted, kindly notify us at once.
CHANGE
OWNER
ORDER ARCHITECT
CONTRACTOR
FIELD
AIA DOCUMENT G701 (Modified) OTHER
HOoOoOoOd oO
PROJECT: Shalimar Courthouse Annex Repurpose
1250 Eglin Parkway
Shalimar, FL 32579
TO CONTRACTOR:
(name, address)
(name, address)
ARCHITECT'S PROJECT NO:
CHANGE ORDER NUMBER: Three (3)
DATE: 28 May 2014
12009
Lord & Son Construction, Inc. CONTRACT DATE: October 16, 2012
Post Office Box 1808
Fort Walton Beach, FL 32549 CONTRACT FOR: CM @ Risk Services
The Contract is changed as follows:
Additional work to remove all buildings, structures, sidewalks, utilities, etc. within the limits of the existing
asphalt pavement at the existing Shalimar Courthouse Complex (see attached breakdown).
Not valid until signed by the Owner and Contractor.
The original (Contract Sum) Was........0......cccccecceccecceaeeseeceacececeeeeecaeeeeseneuss
4
Net change by previously authorized Change Ordelrs...................0ceceeeeees
The (Contract Sum) prior to this Change Order was
The (Contract Sum)) will be (decreased) by this Change Order in the amount of
The new (Contract Sum) including this Change Order will be
The Contract Time will be changed by: N/A
The date of Substantial Completion as of the date of this Change Order therefore is:
$904,667.00
$729,734.54
$1,634,401.54
$178,784.69
$1,813,186.23
Per Contract
NOTE: This summary does not reflect changes in the Contract Sum, Contract Time or Guaranteed Maximum Price which have been authorized
by Construction Change Directive.
DAG Architects, Inc. Lord & Son Construction, Inc. Okaloosa County BOCC
Architect Contractor Owner
1223 Airport Road Post Office Box 1808 1804 Lewis Turner Blvd., Ste. 100
Destin, FL 32541 Fort Walton Beach, FL 32549
Fort Walton Beach, FL 32547
Oe
Address
By
“even D. Lord Il
President C4] jf
Charles W. Clary lll, FAIA
Architect “GA, / tf
ae: Date:
Kelly Windes
Chairman
Date:
AIA DOCUMERT arbi: * CHANGE ORDER = 1987 EDITION « AIA « 1987 * THE AMERICAN INSTITUTE OF ARCHITECTS
1755 NEW YORK AVE, NW., WASHINGTON, DC. 20006 G701-1987 (Modified)
Breakdown
Change Order 3
Additional work to remove all buildings, structures, sidewalks, utilities, etc. within the
limits of the existing asphalt pavement at the existing Shalimar Courthouse Complex.
Virginia Wrecking Company $143,399.00
Exhibit A dated 5/14/2014
National Construction Rentals
Exhibit C dated 5/9/2014 $ 8696.13
Supervision/General Conditions $ 17,445.00
Exhibit B dated 5/28/2014
Subtotal: $ 169,540.13
CMFee4.5% $ 7,629.31
Subtotal: $ 177,169.44
Bond .009117. $ 1,615.25
Total Change Order 3 $ 178,784.69
Project Location: SHALIMAR, FLORIDA
Exhibit A
beontractor Bid Form
SONSTRUCTION. INC.
Date:__5-14-2014
Project Name: OKALOOSA COUNTY ADMINISTRATION BUILDING
BID PACKAGE NUMBER: __ BP - 02
General Trade work Description:___ Demolition
Company Name:_Virginia Wrecking Co., Inc.
Company Address: P.O. Box 2730 Daphne, AL 36526
Company Fax & Phone:_251-626~-3907 Fax 251-626-3908
Estimator Name & Phone: Kyle Maddox 251-370-7991
Authorized Agent Name & Phone:_ Same
Contact e-mail: kmaddoxevirginiawrecking.com
We hereby propose to furnish alt labor, materials, equipment (temporary or permanent), shipping,
fuel, taxes, trade permits, and related appurtenances as necessary to provide a complete job per
the Project Bid Documents enumerated in detail below, for the Stipulated Lump Sum Total Price
ofOne hundred forty-three thousand, three hundred ninety-nine and
no/100 dollars ($ 143,399.00)
. We hereby provide alternate pricing items as required by the Bid Documents and/or voluntarily
offered relating to our proposed price and scope of services: (Reference form for “Proposal
Attachment ‘A’ — Alternate Pricing”, provided horewlth)
. We hereby provide unit pricing items as required by the Bid Documents and/or voluntarily offered
relating to our proposed price and scope of services: (Reference form for Proposal Attachment
‘B’ — Unit Pricing provided herewith)
. We hereby certify that our Bid (price and terms) Is based upon all of the Bid Documents in their
sntirety as enumerated below, with only the following expressed clarifications and/or exceptions:
(Reference form for “Proposal Attachment 'C’ - Comments and Clarifications”, provided
herewlth)
Page | 1 of 7 OKALOOSA COUNTY ADMINISTRATION BUILDING
10,
11.
12.
13.
lyse .
CS
CONSTRUCTION, INC:
Subcontractor Bid Form
N'
fee) 2G ES
Rid?
By submitting this Bid, Subcontractor is representing that it is duly registered and licensed to
perform all work of this bid and is presently in full compliance with current Contracting Licensure,
Business Licensure, and Bid Laws that govern at the location of the project site.
We hereby acknowledge receipt and review of the Project Bid Documents enumerated as follows:
a) Lord & Son Construction, inc.'s Bid Package and Scope of work dated 30 April 20714
in its entirety, including all exhibits and attachments referenced therein.
b) The Drawings and specifications as noted the list of contract documents noted in the
enclosed subcontract form.
c) Addenda Numbers;_1
d) US Department of Justice, Immigration and Naturalization Service's "Handbook for
Employers”, Instructions for Completing Form |-9 (Employment Eligibility Verification
Form) M-274 (Rev.11/21/91) N
Immigration Laws: Subcontractor agrees that it will comply with the Immigration Reform and
Control Act of 1986, as amended by the Immigration Act of 1990, which makes it unlawtul for an
employer to hire or continue to employ an allen knowing the alien is or has become unauthorized
with respect to such employment or to fail to comply with the |-9 requirements. Subcontractor
incorporates any duties that Contractor has to Owner regarding the employment of any itlegal or
undocumented aliens. Subcontractor will not knowingly employ or knowingly allow any of Its Sub-
subcontractors to employ, any illegal or undocumented alians to perform any Work in connections
with the Project. Subcontractor will retain and make available for inspection, at the jobsite, upon
reasonable notice a completed |-9 Employment Eligibility Verification Form for each person that
Subcontractor directly employs on the jobsite. If Subcontractor receives actual knowledge of the
unauthorized status of one of its jobsite employees, Subcontractor will remove that employee
from the jobsite and shall require each subcontractor to act in a similar fashion with respect to
such Sub-subcontractor’s employees. Subcontractor agrees to have a provision in its
subcontracts stating that each Sub-subcontractor will have the duties and responsibilities with
regard to its employees that the Subcontractor has agreed to in this paragraph.
By submitting this Bid, Subcontractor represents that it has familiarized itself with the Project's
and Lord & Son Construction’s Insurance requirements and that this Bid includes any/all
necessary measures to meet these requirements. Such measures include without limitation; a)
providing all coverages required at or in excess of the minimum stated limits; b) naming of Lord &
Son Construction, inc and Owner related entities as Additional Insureds (except for Workers
Comp); and c) statement of Waiver’s of Subrogation in Favor of Lord & Son Construction, Inc.
By submitting this Bid, Subcontractor acknowledges that it is familiar with OSHA safety standards
relating generally to construction projects and more specifically to any/all safety standards relative
to the performance of the work covered by this Bid, and expressly agreas to comply with the
OSHA safety standards applicable to this Project.
Applicable Sales/Use Taxes are included in the Bid price.
Page | 20f7 OKALOOSA COUNTY ADMINISTRATION BUILDING
Subcontractor Bld Form
cS CIN!
GCORSTALCTION, HC,
14, This Proposal in its entirety is good and valid for a minimum of thirty (30) calendar days from the
latter of the date of this Bid, or the published Lord & Son Construction Sub/Vendor Bid Deadline
for the project. Adjustments to the price, basis and/or extensions of the date through which the
Bid is still valid, may occur only through mutual written consent of the Subcontractor and Lord &
Son.
Company: Virginia Wrecking Co., Inc.
' Vice President 5/13/14
Signature VA Title Date
py Kyle M. Maddox
(Printed Name)
Page | 3 0f7 OKALOOSA COUNTY ADMINISTRATION BUILDING
ubcontractor Bid Form
Fas!
=. yi
GONSTRUCTION IE.
SUBCONTRACTOR BID
ATTACHMENT ‘A’
Alternate Pricing
(indicate “Not Applicable” or provide as Ilated below)
Company: Virginia Wrecking Co., Inc. Date:_5/13/14
Not Applicable
Page | 4 of 7 OKALOOSA COUNTY ADMINISTRATION BUILDING
ntractor Bid Form
Bown
CONSTRUCTION, INC,
SUBCONTRACTOR BID
ATTACHMENT ‘B'
Unit Pricing
{indleate “Not Appilcabie” or provide a listing below)
Company:_Virginia Wrecking Co., Inc. Date: 5/13/14
4. Materials and labor to install silt fencing per LF $__3 - 59
Page | 5 of 7 OKALOOSA COUNTY ADMINISTRATION BUILDING
Subcontractor Bid Form
fa Y .
NE St
“F SOR
molt a
CONSTRUCTION, ING.
SUBCONTRACTOR BID
ATTACHMENT ‘C’
Comments and Clarifications
(Indicate “Not Applicable” or provide a listing balow)
Company:_ Virginia Wrecking Co., Inc. Date:_5/13/14
Not Applicable
Page | 6 of 7 OKALOOSA COUNTY ADMINISTRATION BUILDING
EXHIBIT B
Supervision/General Conditions — Demolition
Okaloosa County Admin. Building
5/28/2014
Superintendent — 9 Weeks at $1,500/Week
Project Manager — 9 Weeks at 1 Day/Week
Superintendent Cell Phone — 9 Weeks at $35/Veek
Toilet — 9 Weeks at $25/Week
Permit
Total:
$_13,500.00
$3,240.00
$ 315.00
$___ 225.00
$ 165.00
$ 17,445.00
EXHIBIT C
6356 Narcoossee Rd
Orlando, FL 32822
407-381-2727
g
CONSTRUCTION RENTALS
Good People. Great Service.”
Ia,
Prepared by: Patty Nelson
To Place Order Contact:
Email Address:
