Change Order No. 2
,CHANGE
ORDER
OWNER
ARCHITECT
CONTRACTOR
FIELD
OTHER
AlA DOCUMENT G701
'0
o
o
o
o
PROJECT: Plantation Key Detention Facility
(name, address) Upper Keys Government Center
Plantation Key, Florida
TO CONTRACTOR:
(name, address) Advanced Structures, Inc.
600 Brickell Ave. Suite 601
Miami, Florida 33131
The Contract is changed as follows:
Changes to paving specifications
2
CHANGE ORDER NUMBER:
DATE: 2-15-90
ARCHITECT'S PROJECT NO:
CONTRACT DATE:
CONTRACT FOR:
$10,700.00
APPRfl t:i~:OMf
A NV/LtL ~ENCY.
BY ~___
Attorney's Office
Not valid until signed by the Owner, Architect and Contractor.
The original (Contract Sum) (Guaranteed Maximum Price) was . . . . . . . . . . . . . . . . . . . . . . . . S
Net change by previously authorized Change Orders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . S
The (Contract Sum) (Guaranteed Maximum Price) prior to this Change Order was. . . . . . . . . . S
Tbe (Contract Sum) (Guaranteed Maxi.ll1Um Price) will be (increased) (decreased)
(unchanged) by this Change Order in the amount of . . . . . , , . . . . . . . . . . . . . . . , . . , , . S
The new (Contract Sum) (Guaranteed Maximum Price) including this Change Order will be .. S
The Contract Time will be (increased) (decreased) (unchanged) by
The date of Substantial Completion as of the date of this Change Order therefore is J a nua ry 29, 1990
628,700.00
92,820.00
721,520.00
10,700.00
732,220.00
) days.
NOTE:
This summary does not reflect changes in the Contract Sum, Contract Time or Guaranteed Maximum Price which have been authorized by
Construclion Change Directive.
Gonzalez Architects
ARCHITECT
412 Eaton
Advanced Structures, Inc.
CONTRACTOR
600 Brickell Ave. Suite 601
33040
33131
BY
DATE
't>
AlA DOCUMENT G701 . CHANGE ORDER . 1')11.7 EDITION . AlA"' . if) 19H~ . THE
'\MERICAN INSTITUTE Of ARCHITECTS, 17.~~ NEW YORK AVE., N.W., WASHINGTON. DL 2(~)06
Board of Monroe County Comm.
OWNER
Stock Island
AddK.;'~ #t:.)JOr::.. 33040
By(7t ~
7, 1990
, ~
lerk
SWORN STATEM~T UNDER SECfION 287.133(3)(a).
FLORIDA STATUTES. ON PUBUC ENTIn' CRIMES
TIllS FORM MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBUC OR OTHER OFFICER
AUTHORIZED TO ADMINISTER' OATHS.
1. This sworn statement is submitted with Bid, Proposal or Contract No. tJ /4-
for cJ"",~ ()~~:;L -0, T~) c.,vsi!.1J;o.J ,'" P/~/';o..J ~JFL.
This sworn statement is submitted by 4J 11 /I1JQ..J ~ ~ c..~ .. J::;-,v <=--
[name of endty submitting sworn statement]
whose business address is " 0 0 ttt( i cL1J Avt / Ih ;Itm~f' 1= L '3 3/ ~ I
2.
and
3.
(if applicable) its Federal Employer Identification Number (FEIN) is
(If the entity has no FEIN. include the Social Security Number of the individual signing this sworn
statement: ;2. b I - '3 b ~ Lf 393 . .)
My name is fA-\) J 4. lOll; ,.10 and my relationship to the
[please print nlULe of Individual signing]
entity named above is -1U!/4
I understand that a .public entity crime. as defined in Paragraph 287.133(1)(g). Florida Statutes.
means a violation of any state or. federal law by a person with respect to and directly related to the
transaction of business with any public entity or with an agency or political subdivision of any other
state or with the United States. including, but not limited to. ~ny bid or contract for goods or
services to be provided to any public entity or an agency or political subdivision of any other state
or of the United States and involving antiuust, fraud, theft, bribery, collusion, racketeering.
conspiracy, or material misrepresentation.
4.
s.
I understand that "convicted. or "conviction" as defined in Paragraph 287.133(1)(b), Florida Statutes.
means a finding of guilt or a conviction of a public entity crime, with or Without an adjudication of
guilt, in. any federal or state trial coun of record relating to charges brought by indictment or
information after July 1, 1989. as a result of a jury verdict, nonjwy trial. or enny of a plea of guilty
or nolo contendere.
6.
I underiaand :hat an "affiliate. as defined in Paragraph 287.133(1)(a), Florida Statutes. means:
1. A predecessor or successor of a person convicted of a public entity crime: or
2. An entity under the control of any natural person who is active in the management of the
entity :md who ha~ been convicted of a public entity crime. The term BaffUiate" includes those
officers. directors. executives, partners, shareholders. employees, members, and agents who are active
in the management of an affiliate. The ownership by one person of shares constituting a controlling
interest in another person. or a pooling of equipm~nt or income among persons when not for fair
market value under an arm's length agreement. shall be a prima facie case that one person controls
another person. A person who knowingly enters into a joint venture with a person who has been
convicted of a public entity crime in Florida during the preceding 36 months shall be considered an
affilia tea
7. 1 understand that a .person" as defined in Paragraph 287.133(l)(e), Florida Statutes, means any
natural person or entity organized under the laws of any Slate or of the United States with the legal
power to enter into a binding contract and which bids or applies to bid on COntracts for the provision
of goods or services let by a public entity, or which otherwise transacts or applies to transact business
with a public entity. The term .person" includes those officers, directors, executives, panners,
shareholders. employees, members, and agents who are active in management of an entity.
8. Based on information and belief, the statement which I have marked below is true in relation to the
emit)' submitting this sworn statement. [Please Indicate which stntemen~ applies.)
~ ' .
Neither the entity submitting this sworn statement. nor any officers, directors, executives,
part ers, shareholders, employees, members', or agents who are active in management of the entity,
nor any affiliate of the entity. ha~e been charged with and convicted of a public entity crime
subsequent to July 1, 1989.
The entity submitting this swom statement, or one or more of the officers, directors,
exeauives, panners, shareholders, employees, members, or agents who are active in management of
the entity, or an affiliate of the entity has been charged with and convicted of a public entity crime
subsequent to July 1~ 1989, ~ [please indicate which additional statement applies.]
-
_ There has been a proceeding concerning the conviction before a hearing. officer of
the State of Florida, Division of Administrative Hearings. The final order entered by the
hearing officer did not place the person or affiliate on the convicted vendor lisL [please
aUSch a copy or the final order.]
_ The person or affiliate was placed on the convicted vendor lisL There has been a
subsequent proceeding before a hearing officer of the State of Florida, Division of
Administrative Hearings. The final order entered by the hearing officer determined that it
was in the, public interest to remove the person or affiliate from the convicted vendor lisL
[please attach a copy or the final order.]
~ The person or affiliate has not been placed on the convicted vendor lisL [please
describe any action taken by or pending with the Department or General Services.]
{2; G. ~
[signatUre]
311, )qD
-
~ _: -L..:t
Date:
STATE OF Ftor/dA
COUNTY OF /?? O;? /' tJ e...
PERSONAllY APPEARED BEFORE ME, the undersigned authority,
~~ L - I ()-PP' . n IJ who, after first being swom by me, affixed his/her 'lignature
[name or indil1dual signing] .
mm.spa~~d~a~.on~ ~p:::L.
NOTARY PUBUC;
My commission expires:
'I.JT.\RY PU:3l.1C. STATE OF FLOP~!)j'"
;\, r COMMISSION EXPlflES: JAN. 2.0. 199-'.
dV'''l)e;O THRlJ NO~ARY r'UBt.1C Ur.lozp;,"{r~rrl-::RSI
For::1 PUR 7068 (Rev. 11189)