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CANARY-CONSTRUCTION FILE CITY OF FORT WORTH CITY SECRETARY
PINK-PROJECT MANAGER CHANGE ORDER REQUEST CONTRACT NO.
GOLDENROD-CONTRACTOR
CHANGE ORDER NO. Four DATE: April 28,2016 D.O.E.NO.(N/A) PROJECT NO.00496
PROJECT DESCRIPTION: Rotting Hills Water Treatment Plant,Lake Worth Spillway and Westside Water Treatment Plant CITY SECRETARY CONTRACT NO.
42116
ORIGINAL CONTRACT AMOUNT.......................................................$2.197.095.00
EXTRAS TO DATE........................................................$547.627.66
CREDITS TO DATE.......................................................$0.00
CONTRACTCOST TO DATE.......................................................................................................................................................................................$2.744.722.66
AMOUNTOF PROPOSED CHANGE ORDER.............................................................................................................................................................$00
REVISEDCONTRACT AMOUNT................................................................................................................................................................................$2.744.722.66
ORIGINAL FUNDS AVAILABLE FOR CHANGE ORDERS.......................................................................................................................................$549.273.75
ADDITIONALFUNDING(IF NECESSARY)................................................................................................................................................................$0.00
REMAINING FUNDS AVAILABLE FOR CHANGE ORDER.....................................................................................................................................$1.646.09
IN ACCORDANCE WITH THIS CHANGE ORDER,THE CONTRACTOR SHALL: Change Order No.4 consists of a no-cost change order consisting of the
following items:
Credit—Delete installation of a multi-mode fiber connection between pole an Electrical Building at Lake Worth Spillway: $4,465.00(Credit)
Credit—Delete installation of a new canopy at the end of Lake Worth Spillway $3,641.00(Credit)
Cost—Add a thermal camera,installed and mounted at Lake Worth Spillway,includes camera,installation,and programming $8.106.00(Cost)
TOTAL AMOUNT CHANGE ORDER: No Cost
Staff has reviewed this change order and is in agreement with the modifications to the scope of work and the costs and credits associated with the work.
Documentation providing additional information is attached to and made part of this change order. No additional contract time has been requested by the
Contractor for this proposed change order.
It is understood and agreed that the acceptance of this Change Order by the Contractor constitutes an accord and satisfaction and represents payment in full
(both in time and money)for all costs arising out of,or incidental to,the Change Order.
ORIGINAL CONTRACT TIME ADDITIONAL APPROVED TIME TO DATE APPROVED CONTRACT TIME ADDITIONAL TIME FOR THIS CHANGE
TO DATE ORDER
300 Calendar Das 392 Calendar Das 692 Calendar Das 0 Calendar Days
CONTRACTOR_ DATE-5/jXQ%6 PROJECT MANAGER DATE/1 //j/
MANAGER/CONST.SER. DATE DIRECTOR/MANAGING D DATE
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