Exhibits_Combined.pdf

EXHIBIT B – 1: PUBLIC PAYMENT BOND

Bond No. Contract No.

KNOW ALL MEN BY THESE PRESENTS: That as Principal/Contractor, located at , Telephone: (Business Address and Telephone Number), and , as Surety, located at , Telephone: (Business Address and Telephone Number) a duly organized corporation, nationally recognized surety company licensed and/or registered to engage in the surety business in the State of Florida and enter into agreements of surety with a resident or non-resident agent licensed to conduct business in the State of Florida and existing under and by virtue of the laws of the State of Florida, are held and firmly bound to Collier County Board of County Commissioners, located at 3299 Tamiami Trail East, Suite 102, Naples, FL 34112-5746, Telephone: (239) 252-8999 as Obligee in the sum of ), this includes allowance, lawful money of the United States of America, for the payment of which, well and truly be made to the Obligee. The Principal/Contractor and the Surety bind themselves and each of their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents as follows:

WHEREAS, Principal/Contractor has entered into a contract dated as of the day of

, 20 with Obligee for (Project) with the

Obligee, to furnish at Principal/Contractor’s own cost, charges, and expense all the necessary materials, equipment, and/or labor, in strict and express accordance with the Contract, which

Contract and all exhibits, is made a part of this Bond as fully and completely as if said Contract were set forth herein, is referred to as the Contract.

NOW, THEREFORE, the conditions of this obligation are such that, the above bounded

Principal/Contractor shall promptly make payments to all persons supplying materials, equipment, services and/or labor used directly or indirectly by said Principal/Contractor or subcontractors in the prosecution of the work provided for in the Contract in accordance with Sections 255.05 or

713.23, Florida Statutes; then this obligation shall be null and void and of no further force and effect; otherwise to remain in full force and effect;

AND, the said SURETY for value received, hereby stipulates and agrees that no change involving any extension of time, or addition to the terms of the Contract or to the services to be performed, or materials to be furnished thereunder, shall effect said obligation of the SURETY on this bond, and the SURETY does hereby waive notice of any such changes, extension of time, alterations, or additions of the terms of the Contract, or to the work, or to the scope of services, or any other changes, compliance or noncompliance to the terms of the Contract as to the work or scope of services. The Surety agrees that modifications and changes to the terms and conditions of the

Agreement that increase the total amount to be paid the Contractor shall automatically increase the obligation of the Surety on this bond and notice to the Surety is not required for such increased obligation. Claimant shall give written notice to the Principal/Contractor and to the SURETY as requested by Sections 255.05 or 713.23, Florida Statutes. Any actions against the

Principal/Contractor or the SURETY shall be brought within the time specified by Section 255.05 or Section 713.23, Florida Statutes.

IN WITNESS WHEREOF, the above parties have executed this instrument this day of

, 20 , the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body.

Signed, sealed and delivered in the presence of:

PRINCIPAL/CONTRACTOR:

Signature Name and Title

STATE OF _________

COUNTY OF _________

The foregoing instrument was acknowledged before me by means of ___ physical presence or ___ online notarization, this ___ day of _________ 20___ by ___________________________, as _______________________________ of _________________________________ a _____________________corporation, on behalf of the corporation. He/She is personally known to me OR has produced ___________________________________ identification and did (did not) take an oath.

My Commission Expires: ________________________________________ (Signature of Notary)

(AFFIX OFFICIAL SEAL) __________________________________

(Legibly Printed) Notary Public, State of _______________________

Commission No.: ___________________________

SURETY:

Authorized Signature ________________________________________

(Printed Name ) (Business Address)

Attest:

CORPORATE ACKNOWLEDGMENT

STATE OF

COUNTY OF

The foregoing instrument was acknowledged before me this day of , 20 by (name of officer or agent, title of officer or agent), of (name of corporation acknowledging), a (state or place of incorporation) corporation, on behalf of the corporation. He/She is (personally known to me) (or has produced identification) ______________________________(type of identification) (as identification) and (did/did not) take an oath.

Signature of Person Taking

Acknowledgment

Name of Acknowledger Typed, Printed or Stamped

EXHIBIT B – 2: PUBLIC PERFORMANCE BOND

Bond No. Contract No.

KNOW ALL MEN BY THESE PRESENTS: That as Principal/Contractor, located at , Telephone: (Business Address and Telephone Number), and , as Surety, located at , Telephone: (Business Address and Telephone Number) a duly organized corporation, nationally recognized surety company licensed and/or registered to engage in the surety business in the State of Florida and enter into agreements of surety with a resident or non-resident agent licensed to conduct business in the State of Florida and existing under and by virtue of the laws of the State of Florida, are held and firmly bound to Collier County Board of County Commissioners , located at 3299 Tamiami Trail East, Suite 102, Naples, FL 34112-5746, Telephone: (239) 252-8999 as Obligee in the sum of ($ ), lawful money of the United States of America, for the payment of which, well and truly be made to the Obligee. The Principal/Contractor and the Surety bind themselves and each of their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents as follows: In the event of a default by the Principal/Contractor, the Surety shall assume all obligations of the Principal/Contractor under the Contract including providing the required scope of services set forth in the Contract assuming all warranties, providing all as built drawings, meeting all indemnification and insurance requirements, payment of royalties and license fees, providing for the safety of persons and property and all other obligations of the Principal/Contractor under the Contract.

WHEREAS, Principal has entered into a contract dated as of the day of , 20 with Obligee for (Project) with the Obligee, to furnish at Principal/Contractor own cost, charges, and expense all the necessary materials, equipment, and/or labor, in strict and express accordance with the Contract, which Contract and all exhibits, is made a part of this Bond as fully and completely as if said Contract were set forth herein, is referred to as the Contract.

NOW THEREFORE, THE CONDITION OF THIS BOND and obligation is such that, the above bonded Principal/Contractor shall in all respects fully, promptly, and faithfully comply with the terms and conditions of the Contract, including all exhibits, and shall indemnify and save harmless the Obligee against and from all costs, expenses, damages, including but not limited to damages for delay due to the Principal/Contractor’s default, attorney's fees, including appellate proceedings, injury, or loss of which said Obligee may be subject by reason of any wrongdoing, misconduct, want of care or skill, negligence, failure to petition within the prescribed time, delay or default, including patent infringements, on the part of said Principal/Contractor, its agents, or employees, in the execution or performance of the Contract; then this obligation shall be void;

otherwise, to remain in full force and effect for the term of the Contract, including any and all guarantee periods as specifically mentioned in the Contract;

AND, the Surety, for value received, hereby stipulates and agrees that no changes, extensions of time, alterations or additions to the terms of the Contract or other work and service to be performed hereunder, or materials to be furnished thereunder or the specifications referred to therein shall in anywise affect the Surety’s obligations under this bond, and the Surety does hereby waive notice of any such changes, extensions of time, alterations or additions to the terms of the Contract, or to the scope of services including the work, or to work or to the specifications to be provided by the Principal/Contractor or any other changes, compliance or noncompliance to the terms of the Contract as to the scope of services. The Surety shall be responsible for delay, damages or liquidated damages due to Principal/Contractor’s default and consequential damages for Surety's failure to fulfill its responsibilities as set forth herein. The Surety agrees that modifications and changes to the terms and conditions of the Agreement that increase the total amount to be paid the Contractor shall automatically increase the obligation of the Surety on this bond and notice to the Surety is not required for such increased obligation.

This instrument shall be construed in all respects as a common law bond. It is expressly understood that the time provisions and statute of limitations under Section 255.05, Florida

Statutes, shall not apply to this bond. Any suit under this bond must be instituted within five years from the date Obligee obtained actual knowledge of the cause of action.

IN WITNESS WHEREOF, the above parties have executed this instrument this _____ day of _______________, 20 ____, the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representative, pursuant to authority of its governing body.

Signed, sealed and delivered in the presence of:

PRINCIPAL/CONTRACTOR:

Signature

Name and Title

STATE OF _________

COUNTY OF _________

The foregoing instrument was acknowledged before me by means of ___ physical presence or ___ online notarization, this ___ day of _________ 20___ by ___________________________, as _______________________________ of _________________________________ a _____________________corporation, on behalf of the corporation. He/She is personally known to me OR has produced ___________________________________ identification and did (did not) take an oath.

My Commission Expires: ________________________________________ (Signature of Notary)

(AFFIX OFFICIAL SEAL) __________________________________

(Legibly Printed) Notary Public, State of _______________________

SURETY:

Authorized Signature ________________________________________ (Printed Name ) (Business Address)

ATTEST:

CORPORATE ACKNOWLEDGMENT

STATE OF

COUNTY OF

The foregoing instrument was acknowledged before me this day of , 20 by (name of officer or agent, title of officer or agent), of (name of corporation acknowledging), a (state or place of incorporation) corporation, on behalf of the corporation. He/She is (personally known to me) (or has produced identification) ______________________________(type of identification) (as identification) and (did/did not) take an oath.

Signature of Person Taking

Acknowledgment

Name of Acknowledger Typed, Printed or Stamped

EXHIBIT B-3: INSURANCE REQUIREMENTS

The Contractor shall at its own expense, carry and maintain insurance coverage from responsible companies duly authorized to do business in the State of Florida as set forth herein. The Contractor shall procure and maintain property insurance upon the entire project, if required, to the full insurable value of the scope of work.

The County and the Contractor waive against each other and the County’s separate Contractors, Design Consultant, Subcontractors, agents and employees of each and all of them, all damages covered by property insurance provided herein, except such rights as they may have to the proceeds of such insurance. The Contractor and County shall, where appropriate, require similar waivers of subrogation from the County’s separate Contractors, Design Consultants and Subcontractors and shall require each of them to include similar waivers in their contracts. Collier County shall be responsible for purchasing and maintaining its own liability insurance. Certificates issued as a result of the award of this solicitation must identify “For any and all work performed on behalf of Collier County”, or the specific solicitation number/contract number and title. The General Liability Policy provided by Contractor to meet the requirements of this solicitation shall name Collier County, Florida, as an additional insured as to the operations of Contractor under this solicitation and shall contain a severability of interests provisions. The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The Certificates of Insurance must state the Contract Number, or Project Number, or specific Project description, or must read: For any and all work performed on behalf of Collier County.

The amounts and types of insurance coverage shall conform to the minimum requirements set forth herein with the use of Insurance Services Office (ISO) forms and endorsements or their equivalents. If Contractor has any self-insured retentions or deductibles under any of the below listed minimum required coverage, Contractor must identify on the Certificate of Insurance the nature and amount of such self- insured retentions or deductibles and provide satisfactory evidence of financial responsibility for such obligations. All self-insured retentions or deductibles will be Contractor’s sole responsibility. Coverage(s) shall be maintained without interruption from the date of commencement of the Work until the date of completion and acceptance of the scope of work by the County or as specified in this solicitation, whichever is longer. The Contractor and/or its insurance carrier shall provide thirty (30) days written notice to the County of policy cancellation or non-renewal on the part of the insurance carrier or the Contractor. The Contractor shall also notify the County, in a like manner, within twenty-four (24) hours after receipt, of any notices of expiration, cancellation, non-renewal or material change in coverage or limits received by Contractor from its insurer and nothing contained herein shall relieve Contractor of this requirement to provide notice. In the event of a reduction in the aggregate limit of any policy to be provided by Contractor hereunder, Contractor shall immediately take steps to have the aggregate limit reinstated to the full extent permitted under such policy.

Should at any time the Contractor not maintain the insurance coverage(s) required herein, the County may terminate the Agreement or at its sole discretion shall be authorized to purchase such coverage(s) and charge the Contractor for such coverage(s) purchased. If Contractor fails to reimburse the County for such costs within thirty (30) days after demand, the County has the right to offset these costs from any amount due Contractor under this Agreement or any other agreement between the County and Contractor. The County shall be under no obligation to purchase such insurance, nor shall it be responsible for the coverage(s) purchased or the insurance company or companies used. The decision of the County to purchase such insurance coverage(s) shall in no way be construed to be a waiver of any of its rights under the Contract Documents. If the initial or any subsequently issued Certificate of Insurance expires prior to the completion of the scope of work, the Contractor shall furnish to the County renewal or replacement Certificate(s) of Insurance not later than ten (10) calendar days after the expiration date on the certificate. Failure of the Contractor to provide the County with such renewal certificate(s) shall be considered justification for the County to terminate any and all contracts.

[2024_ver.1]

INSURANCE AND BONDING REQUIREMENTS

Insurance / Bond Type Required Limits

1. Worker’s Compensation Statutory Limits of Florida Statutes, Chapter 440 and all Federal Government

Statutory Limits and Requirements

Evidence of Workers’ Compensation coverage or a Certificate of Exemption issued by the State of Florida is required. Entities that are formed as Sole Proprietorships shall not be required to provide a proof of exemption. An application for exemption can be obtained online at https://apps.fldfs.com/bocexempt/

2. Employer’s Liability $___________ single limit per occurrence

3. Commercial General Liability (Occurrence Form) patterned after the current ISO form

Bodily Injury and Property Damage

$_______________single limit per occurrence, $2,000,000 aggregate for Bodily Injury Liability and Property Damage Liability. The General Aggregate Limit shall be endorsed to apply per project. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability.

4. Indemnification To the maximum extent permitted by Florida law, the Contractor/Vendor shall defend, indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys’ fees and paralegals’ fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the Contractor/ Vendor or anyone employed or utilized by the Contractor/Vendor in the performance of this Agreement.

5. Automobile Liability $_________ Each Occurrence; Bodily Injury & Property Damage, Owned/Non-owned/Hired; Automobile Included

6. Other insurance as noted: Watercraft $ __________ Per Occurrence

United States Longshoreman's and Harborworker's Act coverage shall be maintained where applicable to the completion of the work.

$ __________ Per Occurrence

Maritime Coverage (Jones Act) shall be maintained where applicable to the completion of the work.

$ __________ Per Occurrence

Aircraft Liability coverage shall be carried in limits of not less than $5,000,000 each occurrence if applicable to the completion of the Services under this Agreement.

$ __________ Per Occurrence

Pollution $ __________ Per Occurrence

Professional Liability $ ___________ Per claim & in the aggregate

Project Professional Liability $__________ Per Occurrence

Valuable Papers Insurance $__________ Per Occurrence

Cyber Liability $__________ Per Occurrence

Technology Errors & Omissions $__________ Per Occurrence

7. Bid bond Shall be submitted with proposal response in the form of certified funds, cashiers’ check or an irrevocable letter of credit, a cash bond posted with the County Clerk, or proposal bond in a sum equal to 5% of the cost proposal. All checks shall be made payable to the Collier County Board of County Commissioners on a bank or trust company located in the State of Florida and insured by the Federal Deposit Insurance Corporation.

https://apps.fldfs.com/bocexempt/

8. Performance and Payment Bonds

For projects in excess of $200,000, bonds shall be submitted with the executed contract by Proposers receiving award, and written for 100% of the Contract award amount, the cost borne by the Proposer receiving an award. The Performance and Payment Bonds shall be underwritten by a surety authorized to do business in the State of Florida and otherwise acceptable to Owner; provided, however, the surety shall be rated as “A-“ or better as to general policy holders rating and Class V or higher rating as to financial size category and the amount required shall not exceed 5% of the reported policy holders’ surplus, all as reported in the most current Best Key Rating Guide, published by A.M.

Best Company, Inc. of 75 Fulton Street, New York, New York 10038.

9. Vendor shall ensure that all subcontractors comply with the same insurance requirements that he is required to meet. The same Vendor shall provide County with certificates of insurance meeting the required insurance provisions.

10. Collier County must be named as "ADDITIONAL INSURED" on the Insurance Certificate for Commercial General Liability where required. This insurance shall be primary and non-contributory with respect to any other insurance maintained by, or available for the benefit of, the Additional Insured and the Vendor’s policy shall be endorsed accordingly.

11. The Certificate Holder shall be named as Collier County Board of County Commissioners, OR, Board of County Commissioners in Collier County, OR Collier County Government, OR Collier County. The Certificates of Insurance must state the Contract Number, or Project Number, or specific Project description, or must read: For any and all work performed on behalf of Collier County.

12. On all certificates, the Certificate Holder must read: Collier County Board of County Commissioners, 3295 Tamiami Trail East, Naples, FL 34112

13. Thirty (30) Days Cancellation Notice required.

14. Collier County shall procure and maintain Builders Risk Insurance on all construction projects where it is deemed necessary. Such coverage shall be endorsed to cover the interests of Collier County as well as the Contractor. Premiums shall be billed to the project and the Contractor shall not include Builders Risk premiums in its project proposal or project billings. All questions regarding Builder’s Risk Insurance will be addressed by the Collier County Risk Management Division.

EXHIBIT C: RELEASE AND AFFIDAVIT FORM

COUNTY OF (____________)

STATE OF (______________)

Before me, the undersigned authority, personally appeared who after being duly sworn, deposes and says:

(1) In accordance with the Contract Documents and in consideration of $_____________________ to be received, ______________________________________ ("Contractor") releases and waives for itself and its subcontractors, material-men, successors and assigns, all claims demands, damages, costs and expenses, whether in contract or in tort, against the Board of County Commissioners of Collier County, Florida, relating in any way to the performance of the Agreement between Contractor and Owner, dated _________________, 20____ for the period from ____________________ to _______________________. This partial waiver and release is conditioned upon payment of the consideration described above. It is not effective until said payment is received in paid funds.

(2) Contractor certifies for itself and its subcontractors, material-men, successors and assigns, that all charges for labor, materials, supplies, lands, licenses and other expenses for which Owner might be sued or for which a lien or a demand against any payment bond might be filed, shall be fully satisfied and paid upon Owner’s payment to Contractor.

(3) Contractor agrees to indemnify, defend and save harmless Owner from all demands or suits, actions, claims of liens or other charges filed or asserted against the Owner arising out of the performance by Contractor of the Work covered by this Release and Affidavit.

(4) This Release and Affidavit is given in connection with Contractor's [monthly/final] Application for Payment No. _____.

Contractor’s Signature

Name and Title

STATE OF _________

COUNTY OF _________

The foregoing instrument was acknowledged before me by means of ___ physical presence or ___ online notarization, this ___ day of _________ 20___ by ___________________________, as _______________________________ of _________________________________ a _____________________corporation, on behalf of the corporation. He/She is personally known to me OR has produced ___________________________________ identification and did (did not) take an oath.

My Commission Expires: ________________________________________ (Signature of Notary)

(AFFIX OFFICIAL SEAL) __________________________________

(Legibly Printed)

Notary Public, State of _______________________

EXHIBIT D-1

FORM OF CONTRACT APPLICATION FOR PAYMENT

Collier County Board of County Commissioners (the OWNER) or Collier County Water-Sewer

Owner’s Project Manager’s Name:

Bid No.

Project No.

County’s Division Name Purchase Order No.

Submitted by Contractor Representative: Name

Application Date:

Contractor’s Name & Address:

Payment Application No.

Original Contract Time: Original Contract Price: $ Revised Contract Time: Total Change Orders to Date: $ Revised Contract Amount: $

Total Value of Work Completed & Stored to Date:

Retainage @5% through [Insert Date] ______

$ Retainage @ 5% through [Insert date] ______

Retainage @ _____% after [Insert date] ______

$ Less Retainage $

Total Earned Less Retainage $ Less previous payment(s)

Percent Work Completed to Date:

% AMOUNT DUE THIS

APPLICATION:

Percent Contract Time Completed to Date:

Liquidated Damages to Be Accrued

$ Remaining Contract Balance $

ATTACH SCHEDULE OF VALUES AND ACCOMPANYING DOCUMENTATION TO THIS APPLICATION

CONTRACTOR’S CERTIFICATION:

The undersigned CONTRACTOR certifies that: (1) all previous progress payments received from OWNER on account of Work done under the Contract referred to above have been applied to discharge in full all obligations of CONTRACTOR incurred in connection with Work covered by prior Applications for Payment numbered 1 through _____ inclusive; (2) title to all materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to OWNER at time of payment free and clear of all liens, claims, security interests and encumbrances (except such as covered by Bond acceptable to OWNER); (3) all amounts have been paid for work which previous payments were issued and received from the OWNER and that current payment is now due; and (4) CONTRACTOR has only included amounts in this Application for Payment properly due and owing and CONTRACTOR has not included within the above referenced amount any claims for unauthorized or changed Work that has not been properly approved by Owner in writing and in advance of such Work.

Contractor’s Name Contractor’s Signature: Date:

Type Title: Shall be signed by an authorized representative of the Contractor.

Payment to the CONTRACTOR for the above AMOUNT DUE THIS APPLICATION is recommended by:

Design Professional’s Name:

Signature: Date:

Payment to the CONTRACTOR for the above AMOUNT DUE THIS APPLICATION is recommended by:

Owner’s Project Manager Name:

Signature: Date:

PR

O

JE

C

T N

AM

E:

PR

O

JE

C

T N

U M

B

ER

DA

TE

PE

R

IO

D

T O

IT

EM

D

ES

C R

IP

TI

O N

SC

H

ED

U

LE

D

ST

O

R

ED

TO

TA

L

PE

R C

EN

T

B

AL

AN

C

E 5%

TO

TA

L

N U

M B

ER

VA

LU

E

M

AT

ER

IA

LS

C

O M

PL

ET

ED

C O

M

PL

ET

E

TO

F

IN

IS

H R

ET

AI

N

AG

E R

ET

AI

N

AG

E R

ET

AI

N

AG

E

TH

IS

ST

O R

ED

T

O (re du ce d ra te

W

IT

H H

EL

D

TH

R

U D

AT

E*

SI

N

C E

D

AT

E

PE

R

IO

D D

AT

E

*T he

T hr u D at e is w he re y ou w ill p la ce a ll in fo rm at io n un til th e co nt ra ct is c om pl et e un le ss a re le as e or re du ct io n of re ta in ag e is su e co m es in to p la y.

If th is h ap pe ns , a ll in fo rm at io n up to th e da te o f t he c ha ng e in re ta in ag e is p la ce d in th e Th ru D at e co lu m n.

In fo rm at io n af te r t ha t d at e is p la ce d in th e Si nc e

D at e co lu m n.

T hi s st at es w ha t h as h ap pe nd ed s in ce th e ch an ge in re ta in ag e.

W O

R K

C O

M

PL

ET

ED

PR

EV

IO

U

S

AP

PL

IC

AT

IO

N S

Ex hi bi t D

Sc he du le o f V al ue s

PR

O

JE

C

T N

AM

E:

PR

O

JE

C

T N

U M

B

ER

D

AT

E:

PE

R

IO

D

T O

D

AT

E D

ES

C

R

IP

TI

O

N

SU

PP

LI

ER

IN

VO

IC

E N

U M

B

ER

PR

EV

IO

U

SL

Y

R

EC

O R

D

ED

R

EC

EI

VE

D T

H

IS

PE

R

IO

D

PR

EV

IO

U

SL

Y

IN

ST

A

LL

ED

IN

ST

A

LL

ED

T

H

IS

PE

R

IO

D B

A

LA

N C

E

TO

IN

ST

A

LL

Ex hi bi t D

St or ed

M at er ia ls R ec or d

Contract# CO# PO# Project #:

Project Name:

Contractor/Consultant Name:

Change Order Form (2025_ver.1) r

Select One: Contract Modification (Construction or Project Specific) Work Order/Purchase Order Modification

Project Manager Name: Division Name:

Original Contract/Work Order Approved Amount (excluding Owner’s Allowance)

BCC Approved Date & Agenda Item:

Original Approved Owner’s Allowance Current Contract / Work Order Approved Amount Dollar Amount of this Change Revised Contract / Work Order Total Total Cumulative Changes (Including all change orders)

# of Days Added Revised Final Date Current Substantial Completion Date

(includes this change) (if applicable)

Check if applicable: Per Florida Statute 218.755 Prompt processing of change orders: For any contract for construction services entered on or after July 1, 2025, the local governmental entity must approve or deny the price quote and send written notice of that decision within 35 days after receipt of such quote.

Quote Date of Response Due Date Receipt (35 days from Date of Receipt)

Provide responses after each question in box below (Responses should be brief and specific). Attach additional information and/or documentation from the Design Professional and/or Contractor, if needed, with your submission of this Change Order and complete summary on next page.

Check all that apply to this Change Order request: Add Time (Include Affidavit Regarding Labor and Services); Add funds;

Use of Allowance; Modify/Delete existing Task(s); Add new Task(s); Reallocate funds; Other (must be explained in detail below)

Notice to Proceed Original NTP Original Final Last Final Date # of Days Completion Date Approved Date

1.) Detail of change/s to be made through this Change Order.

2.) If this Change Order is currently under a Stop Work, please identify the date issued and number of days remaining or "N/A" if not applicable.

3.) Explain why this change was not included in the original contract/Work Order.

4.) Describe the impact if this change is not processed.

Contractor/Consultant Name:

Change Order/Amendment Summary (If additional spaces needed, attached a separate Summary page to this amendment request)

CO#

AMD#

Description

COST TIME

Justification Additive

Deductive

Days

Added Total New

Time

Check here if additional summary page/s are attached to this Change Order

Contractor/Consultant Name:

Acceptance of this Change Order shall constitute a modification to contract / work order identified above and will be subject to all the same terms and conditions as contained in the contract / work order indicated above, as fully as if the same were stated in this acceptance. The adjustment, if any, to the Contract shall constitute a full and final settlement of any and all claims of the Contractor / Vendor / Consultant / Design Professional arising out of or related to the change set forth herein, including claims for impact and delay costs.

Contractor/Consultant/Design Professional signature below must be from an authorized person/officer/director of the Company or listed as the qualified licensed Professional “Project Coordinator” or Design/Engineer Professional under the agreement. Signature authority of person signing will be verified through the contract OR through the Florida Department of State, Division of Corporations (Sunbiz) website (https://dos.myflorida.com/sunbiz/search/).

If the person signing is not listed, we will require signature authority by one of the listed officers/directors of the company giving that person signature authority.

Prepared by: Date:

Signature-Division Project Manager

Printed Name

Accepted by: Date:

Signature- Design/Engineer Professional (if applicable)

Printed Name/Title/Company Name

Accepted by: Date:

Signature- Contractor/Consultant/Vendor

Printed Name/Title/ Company Name

Approved by: Date:

Signature-Division Manager or Designee (Optional)

Signature-Division Director or Designee (Optional)

Signature-Division Administrator or Designee (Optional) https://dos.myflorida.com/sunbiz/search/

Contractor/Consultant Name:

FY _____ CO Request # _____ PUR-_____

Approved by:

Signature-Procurement Professional Signature/Date

Approved by:

Signature-Procurement Manager/Director (OPTIONAL)

APPROVAL TYPE:

Administrative Administrative-BCC Report BCC Stand-Alone ES

ATTEST:

Crystal K. Kinzel, Clerk of the Circuit Court BOARD OF COUNTY COMMISSIONERS and Comptroller COLLIER COUNTY, FLORIDA

By: By:

, Chairman Dated:

Date:

(SEAL) Agenda #

Approved as to Form and Legality:

Deputy County Attorney

Print Name

BCC APPROVAL

FOR PROCUREMENT USE ONLY

EXHIBIT E-2

WORK DIRECTIVE CHANGE

PROJECT NAME: CHANGE #

DATE OF ISSUANCE: EFFECTIVE DATE:

OWNER: Collier County Board of Commissioners PROJECT#:

CONTRACTOR: ENGINEER:

You are directed to proceed promptly with the following change(s):

Description:

Purpose of Work Directive Change:

Attachments:

If a claim is made that the above change(s) have affected Contract amount or Contract Times any claim for a Change Order based thereon will involve one or more of the following methods of determining the effect of the changes(s).

Method of determining change in Contract amount: Method of determining change in Contract

Times:

Unit Prices Unit Prices Lump Sum Lump Sum Other Other

A not-to-exceed itemized estimated increase Estimated change in Contract Time:

(decrease) in Contract amount:

$ Increase or decrease by calendar days.

RECOMMENDED: AUTHORIZED:

By: By:

Engineer OWNER’s Representative

*An itemized cost proposal(s)/quote(s) shall be submitted with the Change Order.

EXHIBIT F-1

CERTIFICATE OF SUBSTANTIAL COMPLETION

OWNER’S Project No. Design Professional Project No.

PROJECT:

CONTRACTOR

Contract For Contract Date

This Certificate of Substantial completion applies to all Work under the Contract documents or to the following specified parts thereof:

To

OWNER

And To

Substantial Completion is the status of completion of the Work which, in the opinion of the Project Manager as evidenced by a definitive Certificate of Substantial Completion, is complete in accordance with the Contract Documents, except for minor outstanding items listed on the Punch List. Substantial Completion includes, but is not limited to, the following occurring: (1) the Work can be safely utilized for the purposes for which it was intended; (2) all regulatory agency requirements are satisfied, including occupancy permits, operating certificates and similar releases, (3) all operational testing has successfully occurred; (4) all required training has successfully occurred; (5) all close-out documents (such as as-built drawings, certifications, warranties, guaranties, test reports, test logs, operational manuals, etc.) have been provided by the Contractor and accepted by the Owner, and permit acceptance by permitting agencies, if applicable. The Work to which this Certificate applies has been inspected by authorized representatives of OWNER, CONTRACTOR AND DESIGN PROFESSIONAL, and that Work is hereby declared to be substantially complete in accordance with the requirements of the Contract Documents on:

DATE OF SUBSTANTIAL COMPLETION

A Contractor generated punch list of items to be completed or corrected is attached (i.e., a list of all items required to render the Project complete, satisfactory, and acceptable, for submission with the request for inspection and issuance of a certificate of Substantial Completion), which shall include and list separately the estimated cost to complete each remaining unfinished item included on the list with an explanation as to the basis for those costs, substantiated by the Schedule of Values. A final Punch List Exhibit F-3 (“Punch List”) will be developed, by the Owner and Contractor, with the Owner having the final say on the items included on the Punch List. The Punch List must include all items required to render the Project complete, satisfactory, and acceptable. This list may not be all-inclusive, and the failure to include an item in it does not alter the responsibility of CONTRACTOR to complete all the Work in accordance with the Contract Documents. The items in the Punch List must be completed or corrected by CONTRACTOR within 30 days from the delivery date of the Punch List and Contractor shall provide Owner with written notice that all Punch List items have been completed.

The responsibilities between OWNER and CONTRACTOR for security, operation, safety, maintenance, heat, utilities, insurance, and warranties shall be as follows:

RESPONSIBILITIES:

OWNER: __________________________________________________________________

CONTRACTOR:

The following documents are attached to and made a part of this Certificate:

This certificate does not constitute an acceptance of Work not in accordance with the Contract Documents nor is it a release of CONTRACTOR’S obligation to complete the Work in accordance with the Contract Documents.

Executed by Design Professional on , 20_____.

Signature of Design Professional Type Name and Title

CONTRACTOR accepts this Certificate of Substantial Completion on , 20__ and will submit within five calendar days, an approved pay application to bccapclerk@collierclerk.com.

The pay application will include regular schedule of value scope work to be billed and all work to be billed for all change orders.

Signature of Contractor Type Name and Title

OWNER accepts this Certificate of Substantial Completion on , 20_____.

mailto:bccapclerk@collierclerk.com

Signature of Owner Type Name and Title

EXHIBIT F-2

CERTIFICATE OF FINAL COMPLETION

OWNER’S Project No. Design Professional Project No.

PROJECT:

CONTRACTOR

Contract For Contract Date

This Certificate of Final completion applies to all Work under the Contract documents. The warranty in Exhibit G-2 is attached to and made a part of this Certificate.

To

OWNER

And To

The Work to which this Certificate applies has been inspected by authorized representatives of OWNER, CONTRACTOR AND DESIGN PROFESSIONAL, and that Work is hereby declared to be finally complete in accordance with the contract documents on:

DATE OF FINAL

COMPLETION

Intentionally left blank

Signature of Design Professional Type Name and Title

CONTRACTOR accepts this Certificate of Final Substantial on this , 20__ .

Signature of Contractor Type Name and Title

OWNER accepts this Certificate of Final Substantial on this , 20_____.

EXHIBIT F-3 PUNCH LIST FORM

Item No.

Description Value Completion Date Dated Approved by Owner

Subtotal x 150%

Delivery Date of Punch List from Owner to Contractor: _________ (date of final Punch List).

Final Completion Date: _______.

(30 days from the delivery of Punch List)

EXHIBIT G-1: FINAL PAYMENT CHECKLIST

Bid No.: Project No.: PO No.______________ Date:

Contractor: ____________________________

The following items have been secured by the for the Project known as and have been reviewed and found to comply with the requirements of the Contract Documents.

Original Contract Amount: Final Contract Amount:

Commencement Date:

Substantial Completion Time as set forth in the Agreement: Calendar Days.

Actual Date of Substantial Completion: _________ Final Completion Time as set forth in the F-3 Punch List: Calendar Days.

Actual Final Completion Date: ________.

YES NO

_____ ______ 1. All Punch List items completed on _____ ______ 2. Warranties and Guarantees assigned to Owner (attach to this form).

3. Effective date of General one year warranty from Contractor is:

4. 2 copies of Operation and Maintenance manuals for equipment and _____ ______ system submitted (list manuals in attachment to this form).

_____ ______ 5. As-Built drawings obtained and dated: _________ _____ ______ 6. Owner personnel trained on system and equipment operation.

7. Certificate of Occupancy No.:

_____ issued on (attach to this form).

_____ ______ 8. Certificate of Substantial Completion issued on

9. Final Payment Application and Affidavits received from Contractor on:

_____ ______ 10. Consent of Surety received on _____ ______ 11. Operating Department personnel notified Project is in operating phase.

_____ ______ 12. All Spare Parts or Special Tools provided to Owner:

_____ ______ 13. Finished Floor Elevation Certificate provided to Owner:

_____ ______ 14. Other:

If any of the above is not applicable, indicate by N/A. If NO is checked for any of the above, attach explanation.

Acknowledgments:

Signature of Design Professional Type Name and Title

Executed by Contractor on , 20_____.

Signature of Contractor Type Name and Title

Executed by Owner on , 20_____.

EXHIBIT G-2

WARRANTY

In consideration of ten dollars, ($10.00), receipt of which is hereby acknowledged, the undersigned CONTRACTOR does hereby provide, warrant and guarantee all work done and executed under the contract either directly performed by the CONTRACTOR or at the express request of the CONTRACTOR by a SUBCONTRACTOR or CONSULTANT.

Project Name:

Date of Substantial Completion:

Name and Address of CONTRACTOR:

CONTRACTOR warrants and guarantees the work performed pursuant to the contract shall be free of all defects of materials and workmanship for a period of one year from the DATE OF SUBSTANTIAL COMPLETION.

The undersigned party further agrees that it will, at its own expense, replace and/or repair all defective work and materials and all other work damaged by any defective work upon written demand by the COUNTY. It is further understood that further consideration for this warranty and guaranty is the consideration given for the requirement pursuant to the general conditions and specifications under which the contract was let that such warranty and guaranty would be given.

This warranty and guaranty is in addition to any other warranties or guaranties for the work performed under the contract and does not constitute a waiver of any rights provided pursuant to Florida Statutes, Chapter 95, et seq.

CONTRACTOR: WITNESS:

Signature Signature

Name Printed and Title Name Printed