HomeMy WebLinkAboutContract 47927-CO1 FORT WORTH® CITY SECRETARY' f
City of Fort Worth CONTRACTNO.SECRETARY, r
Change Order Request Breakdown
Projed I9 Brick Pavement Rehabilitation 2016 At Various Locations City Sec# 47927
Q ClienW,roject#(s 0068
N C6gtktor 0 Green Sca in:g:L:P= PMj Tariqul Islam Inspectorl Michael Flute
I�2 N11 w Change Order Submittal# �1 Date 6/15/2017
Cyr
�a
Contract Time
Dept. TPIW Totals CD
Original Contract Amount $368,458.00 $368,458.00 210
Extras to Date 150
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $368,458.00 $368,458.00 360
Amount of Proposed Change Order $0.01 $0.01 60
Revised Contract Amount $368,458.01 $368,458.01 420
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $0.01 $0.01
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.00%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $460,572.50
RISTIFICATIOk(RPSONSIFQR-CHANGE ORDER
This change order is needed for time extention for added locations on East Evans Ave. at (E.Rosedale Ave to E..Terrell Avre).Also,colored
concrete was required for Commerce Street.
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
FOR_ TWOR H City of Fort worth
Change Order Additions
Project Name I Brick Pavement Rehabilitation 2016 At Various Locations City Sec# 47927
Client Project# 1 1000068
Contracto Green Scaping LP PM Tarlqul Islam Inspectorl Michael Flute
Change Order Submittal# 0 Date 6I15I2017
ADDITIONS
nit Unit CostTotal
me ExtensionDays) ays
1 00 Concrete for Commerece Street TP7W
TP/W $8,649.93
Sub Total Ad itions
Change Order Additions Page 1 of 1
FORT WORTH City of Fort Worth
Change Order Deletions
Project Name I Brick Pavement Rehabilitation 2016 At Various Locations City Sec# 47927
Client Project# 1 1000068
Green Seeping LP PM TariQul Islam Inspector Michael Flute
Change Order Submittal# F——1 � Date 611512017
DELETIONS
ITEM L)I:SG ION DEPT ry Unit Unit Cost Total
Concrete Curb and Gutter
TOM $8,649.92
Sub Total Deletions
Change Order Deletions Page 1 of 1
MISBE Breakdown for this Change Order
MISBE Sub Type of Service Amount for this CO
Total $0.00
Previous Change Orders
Co# DATE AMOUNT
Total $0.00
CFW Change Order Approval St-COApp02 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/100068 - Brick Pavement Rehabilitation 2016/Contractor/Change Orders/Copy of
Copy of Copy of Change Order for 100068 (Time Colored Concrete) 3 0.xls
Attachments(0)
No Attachments have been added to this form.
https://projectpoint.buzzsaw.com/ bz web/Forms/FonnPrint.aspx?Siteld=51500&ProcessI... 8/11/2017
CFW Change Order Approval St-COApp02 Page 2 of 3
FORT WORTHm City of Fort Worth
—� Change Order Request Approval
(Change Order Breakdown Available in Links)
...............................................................
For Change Order Submittal No.:
..............................................................
Change Order No.: St-COApp02 Date Started: 2017-08-01
City Sec. No.: Date Due: 2017-09-20
Project Name: 100068 - Brick Pavement Rehabilitation 2016
Project Numbers: 100068 DOE Numbers:
Project Brick rehabilitation at various locations
Description:
Project Manager: Tariqul Islam City Inspector: Michael Flute
Contractor: C. Green Scaping
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
60
Total Cost: $ 0.00 Total Requested Days: 60
Approval Status:
https://projectpoint.buzzsaw.com/ bz web/Forms/ForniPrint.aspx?SiteId=51500&ProcessI... 8/11/2017
CFW Change Order Approval St-COApp02 Page 3 of 3
Approved: Yes
Comments:
User: Dana Loucks
Date: 2017-08-02 2:48 PM
Approved: Yes
Comments:
User: Tariqul Islam
Date: 2017-08-02 3:44 PM
Approved: Yes
Comments:
User: Richard Martinez
Date: 2017-08-09 3:01 PM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2017-08-09 10:46 PM
Action Required:
wwt C'-)rV1 A+ rwnvi
Attested b�. F O R T
T.fayse , City Secretary 7 _
•TEXAS
NO M&C REQUIRED
OFFICIAL. RECORD
CITY SECRETARY
y PT.WORTH, Tat` ,
https://projectpoint.buzzsaw.com/ bz web/Fonns/FonuPrint.aspx?SiteId=51500&ProcessI... 8/11/2017
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.
16 A
Tariqul Islam
Title
This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX