FDACS-01046 Rev 12/23

STATE PROJECT NO.: _____________________________

STATE MINORITY VENDOR DESIGNATION:

FDACS PROJECT NAME AND LOCATION:

THIS AGREEMENT is effective upon the established date of commencement in the Notice to Proceed (FDACS-01506) and is

BY AND BETWEEN

The Florida Department of Agriculture and Consumer Services hereinafter called the Department, and

_________________________________________hereinafter called the Contractor.

The Department and the Contractor agree as set forth below.

ARTICLE 1. THE CONTRACT DOCUMENTS The Contract Documents consists of (1) The Purchase Order (if any), (2) this Agreement, (3) the Contractor’s proposal, (4) all terms, conditions, and specifications of the Invitation to Bid or Sealed Quotation, Drawings, and (5) all Addenda issued prior to execution of this Agreement. These documents form the Contract and are as fully a part of the Contract as if attached to this Agreement or repeated herein. An enumeration of the drawings, specifications and addenda is as follows:

CONTRACTOR

APPROVED:

By:

Authorized Signature

AS WITNESSED:

By:

Witness

DRAWINGS: _______________________________________

SPECIFICATIONS: __________________________________

ADDENDA: ________________________________________

In the event of a conflict in the provisions of said Contract Documents, or any of them that are not an allowed and intentional modification or Change Order, that provisions of the Invitation to Bid shall control.

ARTICLE 2. THE WORK: The Contractor shall perform all the work required by the Contract Documents for items as specified in the Solicitation, number;

ARTICLE 3. CONTRACT SUM – The Department shall pay the Contractor for the performance of work, subject to additions and deductions by Change Order as provided in the Conditions of the Invitation to Bid, in current funds, the Contract Sum of:

FLORIDA DEPARTMENT OF AGRICULTURE AND

CONSUMER SERVICES

APPROVED:

By:

Authorized Signature

AS WITNESSED:

By:

Witness

IN WITNESS WHEREOF, the parties hereto have executed this agreement as stated above.

Florida Department of Agriculture and Consumer Services Bureau of General Services

AGREEMENT BETWEEN DEPARTMENT AND CONTRACTOR

WILTON SIMPSON

COMMISSIONER

DRAFT

From: Date From:

Date To:

To:

Florida Department of Agriculture and Consumer Services Division of Administration Bureau of General Services 407 South Calhoun Street Tallahassee, Florida 32399

The Contract is changed as follows:

DESCRIPTION OF CHANGE (Attach additional pages if required) Decrease Increase

Subtotal -$ -$ Total Net Add/(Deduct)

Days SUBSTANTIAL

COMPLETION

FINAL

COMPLETION Original Contract Sum -$

Original Contract Period Net Change By Previous Approved CO Contract Period Prior To This CO Contract Sum Prior To This CO -$ Change Requested Add/(Deduct) This CO Add/(Deduct) -$ New Contract Period Including This CO New Contract Sum Including This CO -$

FDACS-02023 Rev. 03/20

Print Name

This Change Order Request will become an Amendment to the Contract Agreement between Contractor and the Owner, and all contract provisions shall apply unless specifically exempted. The amount and time change designated are the maximum agreed to by both the Owner and the Contractor for this change. In consideration of the foregoing adjustments in contract time and contract sum, the Contractor hereby releases Owner from all claims, demands or causes of action arising out of the transactions, events and occurrences giving rise to this Change Order. Execpt as provided by this Change Order, the contract remains in full force and effect.

Contract AmountsContract Time

FDACS Contract or PO No:

Florida Department of Agriculture and Consumer Services Division of Administration

Bureau of General Services

MM/DD/YYYY

00000

(Contractor) Change Order No:

MM/DD/YYYY

WILTON SIMPSON

COMMISSIONER

CHANGE ORDER REQUEST

(Project Manager) FDACS Complete Project Name:

Date

Signature

Date

Signature

FLORIDA DEPARTMENT OF AGRICULTURE & CONSUMER SERVICESCONTRACTOR

Project Manager

From:

To:

Florida Department of Agriculture and Consumer Services Division of Administration Bureau of General Services 407 South Calhoun Street Tallahassee, Florida 32399

TO BE COMPLETED BY ARCHITECT/ENGINEER THROUGH FINAL COMPLETION DATE DAYS LIQUIDATED DAMAGES

1.

2.

3. Time Extension Granted by Change Orders

4. 0.00

5.

6. 0.00 -$

Total Liquidated Damages (Substantial + Final Completion) -$

CONTRACTOR'S AFFIDAVIT ARCHITECT- ENGINEER CERTIFICATE DEPARTMENT'S CERTIFICATE

STATE OF: __________________________

COUNTY OF: ________________________

The foregoing instrument was acknowledged before me this __________day of _____________________________ by _____________________________________________ who is personally known to me or has produced __________________________________ as identification.

I solemnly swear (or affirm): That the work under the above named contract and all amendments thereto have been satisfactorily completed; that all amounts payable for materials, labor and other charges attributable to the project have been paid; that no liens have been attached against the project; that no suits are pending by reason of work on the project under the contract; that all Workman’s Compensation claims are covered by Workman’s Compensation Insurance as required by law; and that all public liability claims are covered by insurance.

I CERTIFY that the work under the above contract has been satisfactorily completed on the date set forth in accordance with the terms of the contract.

Florida Department of Agriculture and Consumer Services Division of Administration

Bureau of General Services

CERTIFICATE OF CONTRACT COMPLETION

(Architect/Engineer)

(Division Contract Manager)

WILTON SIMPSON

COMMISSIONER

DATE

FDACS Contract or PO No:

Date of Final Completion:

Print Name Print Name

Signature

Title

Date

Print Name

Signature

Title

Date

Signature

Title

Date

I CERTIFY that the work on the above named project has been satisfactorily completed under the terms of the contract.

Final Contract or PO Total Amount INCLUDING Total Liquidated Damages Below:

FDACS Complete Project Name:

FDACS-01316 Rev. 02/16

Amount of Liquidated Damages at Substantial Completion date

Enter Number Only For

Damages Per Day Contract Complete date & actual days between Substantial and Final

Completion

(Notary signature)

(Notary name or stamp)

Time Specified in Original Contract between Substantial Completion & Final Completion

Total Days Allowed Between Substantial & Final Completion (Add Lines 2 and 3)

(name & title of officer/agent)

Final Completion Overrun (Subtract Line 4 from 5 and Enter Overrun. If line 5 less than line 4, enter 0.)

From:

(Architect/Engineer)

To: (Division Contract Manager) Florida Department of Agriculture and Consumer Services Division of Administration Bureau of General Services 407 South Calhoun Street Tallahassee, Florida 32399

THE PROJECT OR DESIGNATED PORTION SHALL INCLUDE:

TO BE COMPLETED BY ARHITECT/ENGINEER THROUGH SUBSTANTIAL COMPLETION DATE DAYS LIQUIDATED DAMAGES

1. Notice to Proceed (N.T.P)

2. Time Specified in Original Contract for Substantial Completion

3. Time Extension Granted by Change Orders

4. Total Days Allowed to Substantial completion (Add Lines 2 and 3) 0.00

5. 0.00

6. 0.00 -$

ARCHITECT- ENGINEER CONTRACTOR OWNER

Print Name

Signature

Title

Date

Print Name

Title

SignatureN/A - No consultant on this project

Title

Date

FDACS-02021 Rev. 02/16

Below (or attached hereto) is a list of items to be completed or corrected by the Contractor. The ommission of items on such list does not alter the responsibility of the Contractor to complete all work in accordance with the Contract Documents.

Substantial Completion Date Overrun (Subtract Line 4 from 5 and Enter Overrun. If line 5 less than line 4, enter 0.)

Substantial Completion date & actual days from N.T.P.

through Substantial Completion date

DATE

Certificate of Occupancy Date:

(OR COMPLETION CERTIF. DATE)

Date of Substantial Completion:

FDACS Contract or PO No:

FDACS Complete Project Name:

Print Name

Date

WILTON SIMPSON

COMMISSIONER

The work performed under this Contract has been reviewed and found to be substantially complete. The Date of Substantial Completion of the project or portion thereof designated below is hereby established as entered above.

Insert Number Only for Damages

Per Day

The Owner acknowledges the work or designated portion thereof as substantially complete on the date indicated above..

The work under this contract as stated above is Substantially Complete on the Date set above in accordance with the terms of the contract.

The work under this contract as stated above is Substantially Complete on the Date set above in accordance with the terms of the contract.The Contractor will complete or correct the work on the list of items above (or attached hereto) within the time prescribed in the contract from the above Date of Substantial Completion.

Florida Department of Agriculture and Consumer Services Division of Administration

Bureau of General Services

CERTIFICATE OF SUBSTANTIAL COMPLETION

From: Date From:

Date To:

To:

Florida Department of Agriculture and Consumer Services Division of Administration Bureau of General Services 407 South Calhoun Street Tallahassee, Florida 32399

CHANGE ORDER SUMMARY CONTRACT AMOUNT SUMMARY

ADDITIONS DEDUCTIONS

Date Approved -$ (column G on continuation sheet)

PERCENT COMPLETE

5. Retainage:

a. 5% WORK COMPLETED

b. 5% STORED MATERIALS

CURRENT TOTALS -$ -$ (line 5a + 5b or total in column I on continuation sheet)

Net change by Change Orders -$ (line 4 less line 5)

CONTRACT TIME SUMMARY

Base Contract Calendar Days: (line 6 from prior certificate)

Adjusted Days by Change Order:

Revised Contract Days:

Elapsed Days to Date:

Net Days Remaining: 9. Balance To Complete Including Retainage Estimated Days Ahead (+) or Behind (-): (line 3 less line 6)

CONTRACTOR

(Signature)

Date

FDACS-02022 Rev. 02/16

WILTON SIMPSON

COMMISSIONER

(Contractor)

Total Approved this Request

(Print Division Contract Manager Name)

Florida Department of Agriculture and Consumer Services

CONTRACTOR'S REQUEST FOR PAYMENT

Print Architect/Engineer Name

Division of Administration Bureau of General Services

Signature of Architect/Engineer Date Signature of Division Contract Manager

APPROVEDARCHITECT- ENGINEER CERTIFICATE FOR PAYMENT

I certify that I have investigated and verified this Progress Payment Application; that to the best of my knowledge and belief, the above application is a true statement of the value of the work performed and the materials suitable stored on the site; that all work and materials included in this Certificate have been observed by me or by my authorized assistants; that all work has been performed and material supplied in full accordance with the terms of this Contract; and I approve for payment the amount noted above.

I certify, by evidence of signature below, that I am the Contract Manager and the provided information is true and correct; the goods and services have been satisfactorily received and payment is now due. I understand that the office of the State Chief Financial Officer reserves the right to require additional documentation and/or to conduct periodic post-audits of any agreements.

CERTIFICATION BY THE CONTRACTOR: I certify that all items and amounts on this Application are correct, that all work has been performed and material supplied in full accordance with the terms and conditions of the Contract, and that all materialmen, laborers and subcontractors, as defined in Chapter 713.01, Florida Statutes, have been paid the amounts due them out of any previous payments made to the contractor by the Owner. Further, I agree to promptly pay each materialmen, laborer and subcontractor, as defined in Chapter 713.01, Florida Statutes, upon receipt of payment from the Owner, out of the amount paid to me on, account of such materialman's laborer's or subcontractor's work, the amount to which said materialman, laborer and subcontractor is entitled, reflecting the percentage actually retained, if any, from payments to myself on account of such materialman's, laborer's and subcontractor's work.

FDACS Contract or PO No:

Pay Request No:

(Title, company name, date)

1. Original Contract Sum……………………………………

2. Net Change by Change Orders….………………………

3. CONTRACT SUM TO DATE (line 1 ± 2)……………………

4. Total Completed & Stored to Date (EARNED)……………

-$ 8. CURRENT PAYMENT DUE

(Division Contract Manager)

Change Order totals previously approved by Owner

Number

FDACS Complete Project Name:

Total Retainage…………………………………….

6. Total Earned Less Retainage……………………………

7. Less Previous Billings……………………………………