HomeMy WebLinkAboutContract 47635-CO2 H CITY SECRETARY
FORT WORT .- C
City of Fort Worth CONTRACT N0.
Change Order Request Breakdown
ProjectNamel 2014 CIP Sidewalk Contract 4 City Sec# 1 47635
Client Project#(s) T/PW
Contractorl ADVANCED PAVING PM TARIQUL ISLAM Inspectorl WILLIAM MASON
Change Order Submittal# 0 Date 4/15/2017
Dept. T/PW Contract Time
Totals CD
Original Contract Amount $553,112.50 $553,112.50 150
Extras to Date $0.00 55
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $553,112.50 $553,112.50 205
Amount of Proposed Change Order $0.00 105
Revised Contract Amount $553,112.50 $553,112.50 310
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) E��
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.007
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $691,390.63
JUSTIFICATION(REASONS) FOR CHANGE ORDER
This Change Order is to request additional time to the contract for the following reasons:60 days for utility delays on Brentwood Stairs and Ray
White,45 days for extra work on Acadame, Shaw Ln.and Ray White.
8� 89l
lop
�oP�N a
aiy J. qXerjCity SBCTetaTy
C �
L �
O
SAS
OFFICIAL RECORD
CITY SECRETARY
FM WORTH,TX
' y PORT�, WORrri City of Fort worth
Change Order Additions
Project Name 2014 CIP Sidewalk Contract 4 City Sec# 47635
Client Project# T/PW
Contractor ADVANCED PAVING PM TARIQUL ISLAM Inspector WILLIAM MASON
Change Order Submittal# 0 Date 4/15/2017
ADDITIONS
Qty Unit Unit Cost Total
TME ONLY 777-----=0001 DAYS
T/PW $0.00
Sub Total Additions
Change Order Additions Page 1 of 1
' o
Foer_ �TH City of Fort Worth
Change Order Deletions
Project Name 2014 CIP Sidewalk Contract 4 City Sec# 47635
Client Project# T/PW
Contractor ADVANCED PAVING PM TARIOUL ISLAM Inspectorl WILLIAM MASON
Change Order Submittal# 0 Date 4/15/2017
DELETIONS
ITEM TESCRIP= DEPT Qty Unit Unit Cost Total
T/PW $0.00
Sub Total Deletions
Change Order Deletions Page 1 of 1
M/SBE Breakdown for this Change Order
M/SBE Sub Type of Service Amount for this CO
Total $0.00
Previous Change Orders
co# DATE AMOUNT
Total $0.00
CFW Change Order Approval St-COApp03 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/02704 - 2014 CIP Sidewalk Contract 4/Contractor/Change Orders/Change Order
Breakdown #2 02704.x1s
Attachments(0)
No Attachments have been added to this form.
https://projectpoint.buzzsaw.com/ bz_web/Forms/FonnPrint.aspx?SiteId=51500&ProcessI... 6/15/2017
CFW Change Order Approval St-COApp03 Page 2 of 3
FORT WORTH. city of Fort Worth
-- ..-- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: St-COSub02
Change Order No.: St-COApp03 Date Started: 2017-06-01
City Sec. No.: Date Due: 2017-06-16
Project Name: 02704 - 2014 CIP Sidewalk Contract 4
Project Numbers: 02704 DOE Numbers:
Project Sidewalk installation at various locations
Description:
Project Manager: Tariqul Islam City Inspector: William Mason
Contractor:
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
105
Total Cost: $ 0.00 Total Requested Days: 105
Approval Status:
https://proj ectpoint.buzzsaw.com/_bz_web/Forms/ForrnPrint.aspx?Siteld=51500&Processl... 6/15/2017
CFW Change Order Approval St-COApp03 Page 3 of 3
Approved: Yes
Comments:
User: Becky Garrett
Date: 2017-06-01 12:05 PM
Approved: Yes
Comments:
User: Tariqul Islam
Date: 2017-06-01 12:14 PM
Approved: Yes
Comments:
User: Riad Nusrallah
Date: 2017-06-06 5:35 PM
Approved: Yes
Comments:
User: Richard Martinez
Date: 2017-06-07 2:31 PM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2017-06-08 2:11 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2017-06-14 4:43 PM
Approved: Yes
Comments:
User: Jay Chapa
Date: 2017-06-15 10:44 AM
Action Required:
https:Hprojectpoint.buzzsaw.com/ bz_web/Forms/ForrnPrint.aspx?Siteld=51500&ProcessI... 6/15/2017
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Tariqul Islam
q-n'V�4447j, ,Awl,
Title
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature