HomeMy WebLinkAboutContract 47349-CO3 CITYSECRETARY FORT WORTH. Cit of Fort Worth CONTRACT NO. q� C_�,
~ � Change Order Request Breakdown
ProjectNamel N.Beach Street from Fossil Creek to NE Loop 820 City Sec# 1 47349
Client Project#(s)l 02238
Change Order Submittal# Date 12/2/2016
Dept. TIPW Water Sewer Contract Time
Totals CD
Original Contract Amount $5,675,296.15 $89,335.52 $82,214.26 $5,846,845.93 541
Extras to Date $82,180.00 $0.00 $82,180.00 7
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date ;.$5,757".,,47615 $89,33552 $82,2126_ $5,929,025.93 548
Amount of Proposed Change Order $3,300.00
Revised Contract Amount :$5,760;776151°: $85,335;52" x$82,2[456 $5,932,325.93 548
Original Funds Available for Change Orders $488,154.00 $6,250.00 $5,750.00 $500,154.00
Remaining Funds Available for this CO 0Q $417,974.00
Additional Funding(if necessary) •
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT ---1.46%
:
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $7;308,557,41
Change order required to add an item to connect an existing 8"storm drainage pipe to the new storm system at RaceTrac
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OFFICIAL RECORD
CITY SECRETARY
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FORTWORTH City of Fort Worth
Change Order Additions
Project Name I N.Beach Street from Fossil Creek to NE Loop 820 City Sec# 47349
Client Project# Fo2238
Change Order Submittal# 0 Date 12/2/2016
ADDITIONS
ITEM DESURIF I]ON DEPT Qty Unit Unit Cost I ota
new onnect existing at RaceTrac
T/PW $3,300.00
Water $0.00
Sewer $0.00
Sub Total Additions $3,300.00
Change Order Additions Page 1 of 1
Fox._ z�H City of Fort worth
Change Order Deletions
Project Name N.Beach Street from Fossil Creek to NE Loop 820 City Sec# 47349
Client Project# 02238
Change Order Submittal# Date 121212016
DELETIONS
ITEM DEbURIP I ION DEPT Qty Unit Unit Cost I ota
T/PW $0.00
Water $0.00
Sewer $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
Previous Change Orders
co# DATE AMQUNT -
$
Total O:OO c'
CFW Change Order Approval St-COApp08 Page 1 of 3
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Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/02238 - N. Beach Street from NE Loop 820 to Fossil Creek/Contractor/Change Orders/Change Order
Breakdown template co3 - 8 in SD @ racetrac (003) (revised 6.15.2017).xlsm
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CFW Change Order Approval St-COApp08 Page 2 of 3
FORTWORTH,) City of Fort Worth
�• Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.:
Change Order No.: St-COApp08 Date Started: 2017-06-16
City Sec. No.: Date Due:12017-08-05
Project Name:IN. Beach Street from NE Loop 820 to Fossil Creek
Project Numbers: 02238 IDOE Numbers:
Project Widen N. Beach Street to a 6-lane divided arterial street with
Description: paving, drainage, sidewalks, water, sewer, traffic signal,
illumination, landscape and irrigation improvements.
Project Manager: Michael Weiss —� City Inspector: Tom Miller
Contractor:
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:�-
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW 1$ 3,300.00F 110___�
F_
Total Cost: 3,300.00 I Total Requested Days:10
Approval Status:
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CFW Change Order Approval St-COApp08 Page 3 of 3
:Approved: Yes
:Comments:
User: Aaron Perez
!Date: 2017-06-19 1:35 PM
I
i
Approved: Yes
,Comments:
,User: Michael Weiss
'Date: 2017-06-19 3:51 PM
jApproved: Yes
Comments:
?User: Martin Phillips
Date: 2017-06-19 4:47 PM
!Approved: Yes
Comments:
!User: Kim Arnold
Date: 2017-06-20 2:40 PM
;Approved: Yes
!Comments:
!User: Doug Wiersig
;Date: 2017-06-26 4:59 PM
jApproved: Yes
!.Comments:
User: Doug Black
;Date: 2017-06-28 5:46 PM
;Approved: Yes
3Comments:
jUser: Jay Chapa
!Date: 2017-06-29 9:49 AM
i
Action Required:
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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.
Michael Weiss,P.E.
Sr.Professional Engineer
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature