Florida Department of Environmental Protection

TASK ASSIGNMENT CHANGE ORDER FORM

Required Signatures: Adobe Signature

FDEP Contract No.: I Task Assignment No.: Change Order No.: I Project No.:

CN217 JO 01 61139

Project Location: Project Name:

Gasparilla Island State Park Lighthouse Structural Repairs Consultant Name:

JGP Structural Group, Inc.

Consultant Representative: Phone: Email:

Jeff Parzych 850-574-2888 jeff@jgpstructural.com FDEP Contract Manager: Phone: Email:

Mae Roth 850-245-2781 mae.roth@dep.state.fl.us Description and Justification of Change:

Change Order for additional construction administration services and additional detailed drawings. See attached proposal dated 11/27/2017.

Ch an2ein as . T, kA mount:

fua » · ·~· .. -·· · Jt~-F~ Total .;,._.

Original Task Amount: $ 275.55 $ 8.100.00 $ 8.375.55 Task amount including all previous Change Orders: $ 275.55 $ 8.100.00 $ 8.375.55 Net increase/decrease in task amount for this Change Order: $ 81.65 $ 2.895.00 $ 2.976.65 Total Amounts with all Change Orders: $ 357.20 $ 10.995.00 $ 11.352.20

Ch an2e in as ,me: . T, k r,· Original Task Execution Date: 11/14/16

Original Task End Date: 3/14/18

Present Task End Date: 3/14/18

Net Change in Days: 0

New Task End Date: 3/14/18

Approval Signatures:

Greg Turral Greg Tu rra I Digitally signed by Greg Turral Date: 2017.12.07 16:15:58-05'00' 12-7-2017

Budget Representative, FDEP

C Hewitt Project Manager, FDEP

Mae Roth Contract Manager, FDEP

Jeff Parzych Consultant

Michael W. Foster Jr., P.E.

Contract Authority, FDEP

Protect# Grant# Ore Code 61139 37504003191

29 Di2it FLAIR Code:

000- 012 (Effective 5-19-2016)

Signature

C Hewitt Signature

Mae Roth Signature

Dlgltally signed by C Hewitt Date: 2017,11.30 09:09:22 -05'00'

Digitally signed by Mae Roth Dale: 2017.12.1314:12:59-05'00'

Dlgltally signed by Jeffrey G

Jeffrey G Parzych Parzych Date: 2017.12.2216:29:11-05'00'

Date

11/30/2017 Date

12/13/2017 Date

12/22/2017

D#~ Dit

Cat/Year Fund Module Object Code EO Amount

080039/17 423001 U3200 134000 QK S 2,976,65

Total: S 2,976.65

Page 1 ofl ll~IJII JGP STRUCTURAL GROUP, INC.

November 27, 2017

Mr. C. B. Hewitt

Project Manager Bureau of Design and Construction Florida Department of Environmental Protection 3900 Commonwealth Boulevard 260K, MS 520

Tallahassee, FL 32399

RE: CN217 - Task Assignment 10, CO #1

Engineering Solutions

Gasparilla Island State Park Lighthouse Repairs - Additional Services

Dear Mr. Hewitt;

For your review, JGP Structural Group, Inc., has provided a proposal summary and man-hour documentation for the services and tasks identified below:

Please review the attached Proposal Summary and deliverables and return the signed authorization at your earliest convenience.

Jeffrey G. Parzych, PE JGP Structural Group, Inc.

1221 W. Tharpe Street, Tallahassee, Florida 32303 1 E-mail: contact@jgpstructural.com

Phone: 850-574-2888, Fax: 850-574-2788

Lighthouse Repairs Gasparilla Island State Park

CN217 -Task Assignment No. 10, CO #1

Subtask 4: Construction Administration Services Description: JGP will provide additional limited construction administration for this project. JGP will perform one additional site visit during construction and review. JGP will develop a field observation report for this task based on information collected during our site visit. Additionally, JGP will provide supplemental details for the attachment of the existing beam members at the west elevation stair and will perform a final review of the installed steel brackets and members.

JGP will not be responsible for additional time and expenses that could be incurred due to contractor errors, delays, mistakes, etc. that would extend the project completion date. Additional time required by JGP to address any re-engineering, additional correspondence and re-inspection of any work will be submitted as an additional service to the project. These fees will be billed at our standard hourly rates.

Deliverable: Construction Administration services include the following deliverable items:

• Provide one (1) site visit and provide on-site observation report within 5 days after visiting the site during construction. Site report to be provided in pdf format ·

• Supplemental details provided within 5 days of on-site review with the contractor. Revised details to be provided in pdf format.

Performance Measure: Deliverables will be reviewed by the Department to confirm they are complete, accurate, and timely.

Fixed Price Cost:

Subtask4

Firm Name Position Classification ·, Hourly Rate Hours Total Fixed · ' Price Cost

JGP Structural Group, Inc. Principal Engineer $160.00 11 $1,760.00 Project Engineer $95.00 8 $760.00 CADD Des/Tech $60.00 4 $240.00 Clerical $45.00 3 $135.00

$2,895.00

Reimbursable Cost:

Mileage (@$0.445 per mile) 170 mi @ $0.445/mi x 1 trip=$75.65 ToHs ·, .. Bridge toll $6.00 x 1 trip=$6.00 Reimbursable Total Cost · $81.65

Total for Subtask 4: $2,895.00 + $81.65=$2,976.65

Proiect Schedule· .

Activity ,,./. Duratio11 (Calendar Days) . . .. , ,, . . . , Subtask 4: Construction Based on contractor's schedule Administration Services

Summarv of Fees:

Subtask Subtask Fixed Price Cost Subtask Reimbursable Subtask 4: Construction $2,895.00 $81.65

Administration Services

Total Fixed Price Cost: $2,895.00 Total Reimbursable Cost: $81.65

Overall Total Cost: (Subtask 4, $2,976.65 CO#l)

Payment will be made upon approval of deliverables for each subtask by the FDEP in the amount specified.