Okaloosa County BOCC — December 1, 2015 — tanglewood co 5

CHANGE ORDER FORM Date: November 10, 2015 Contract No.: Owner: C15-2238-PW __ Change Order No.: __ 05 OKALOOSA COUNTY BOARD OF COUNTY COMMISSIONERS Contractor: _H&T Coniractors, LLC Summary:_For the addition of concrete shoulder slope on the downstream side of new spillway at Tanglewood Pond. (See attached price proposal for cost breakdown.) CHANGE TO CONTRACT PRICE DESCRIPTION AMOUNT Original Contract Price: $401,621.50 Net change by previously authorized Change Orders: $7689.80 Present Contract Price: $409,311.30 This Change Order will add: $4,198.00 New Contract Price: $413,509.30 CHANGE TO CONTRACT TIME DESCRIPTION DATE or NUMBER OF DAYS Original Contract Time: 180 Days Original Substantial Completion Date: 5/30/2015 Net change by previously authorized Change Orders: 143 Days This Change Order will add: -Bay g) Dq,,l,: f&}/j New Contract Time: SADOK 374 Do s New Substantial Completion Date: (Final Acceptance By) 13-£24/205 'Z/|0/ZOI‘5 APPROVALS REQUESTED BY; PROJECT ENGINFEBMZ/ PLTT CONTRAM J /"¢ OWNER: DATE: % ‘| \’-Y\\‘ DATE: //,// Z/ zZal5” DATE: [/ /)5 DATE: This Change Order is an amendment to the Contract/Agreement between Conftracfor and the Owner, and all other contract provisions shall remain in full force and effect unless specifically amended in writing, signed by both parties. o Freeport, FL 32439 850-835-0231 850-835-5123 Fax Spillway at Tanglewood 11-10-2015 NO. ITEM OTY UNIT PRICE TOTAL PRICE 1 Foreman 12 HR $ 95.00 $ 1,140.00 2 Labor (2 men) 24 HR $ 45.00 § 1,080.00 3 4,000 PSI Concrete 5 CY $ 120.00 $ 600.00 4 Spread & Backfill 10 CY $ 12.50 $ 125.00 5 Dowel into Concrete LS § 353.00 $ 353.00 6 Form Materials, Demo & Clean Up LS $ 900.00 $ 900.00 $ 4,198.00 Submitted by: Jerry George #FCALL IF YOU HAVE ANY QUESTIONS . ##*SIGN AND RETURN IF ESTIMATE IS ACCEPTABLE. - Accepted By: < 1.0y /fl?// ATU A Page 1 of 1