HomeMy WebLinkAboutContract 49566-CO1 Y
FORT WORTH City of Fort Worth CITY SECRETARY
Change Order Request Breakdown CONTRACT NO.yq5(o�'C
Project Namel Traffic Signal Infrastructure City Sec# 1 49566
Client Project#(s)l CPN 100963
Contractor EAR Telecommunications PMF Ali Mozdbar,P.E. InspectorFLee Soria
Change Order Submittal# 0 Date 10/3/2017
Dept. TPW Contract Time
Totals CD
Original Contract Amount $500,000.00 $500,000.00
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $500,000.00 $500,000.00
Amount of Proposed Change Order $0.00
Revised Contract Amount $500,000.00 $500,000.00
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary)
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.00%
MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $625,000.00
Additional bid items that were not included in the original contract is needed in order to construct proposed improvements. The additional bid
items will not increase the total contract amount.
j
OFFICIAL RECORD
CITY SECRETARY
�� IST.WORTH, TX
FoxT Wors ry City of Fort Worth
^V_ _ Change Order Additions
Project Name Traffic Signal Infrastructure City Sec# 49566
Client Project# CPN 100963
Contractor EAR Telecommunications PM Ali Mozdbar,P.E. Inspectorl Lee Soria
Change Order Submittal# L� Date 10/3/2017
ADDITIONS
—ITEM UESGRIPTION DEPT Qty Unit Unit Cost Total
emove xisting igna a ine an ns a ew
Local Verizon Activation,Digi lou Setup and Test Per Unit PW A
Staging-Baseline Provisioning for FieldfLocal and Remote Test Per Unit T
Installation Per Site/FieldTest Per Site Per Unit PW A $80.06 4G
5 CCTVStaging-BaselineProvisioning/Local est Per Unit 0.0000000 A
6 CCTV Four Presets ouring Provisioning and Test Per Unit W A
7 3GAG Troubleshooting,Diagnosisand Repair/Report PerUnit TPW O.00OGOOOO EA
Troubleshooting,Diagnosis and and Repair/Report Per Unit T
TPW $0.00
Sub Total Additions 0
Change Order Additions Page 2 of 4
FOR I'WOR H City of Fort worth
IV--- Change Order Deletions
Project Name Traffic Signal Infrastructure City Sec# 49566
Client Project# CPN 100963
Contractor EAR Telecommunications PM Ali Mozdbar,P.E. Inspector Lee Soria
Change Order Submittal# t-J Date 10/3/2017
DELETIONS
ITEM DESCRIP VION DEPT Qty Unit Unit Total
TPW $0.00
Sub Total Deletions 0.
Change Order Deletions Page 3 of 4
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 $0.00
CFW Change Order Approval 1 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/100963 -TPW-Traffic Signal Infrastructure/Contractor/Chanoe Orders/Change Order
No 1 Breakdown 100963.x)
Attachments 101
No Attachments have been added to this form.
https://projectpoint.buzzsaw.com/ bz web/Forms/FonnPrint.aspx?SiteId=51500&Proces... 10/13/2017
CFW Change Order Approval 1 Page 2 of 3
FORT WORTH City of Fort Worth
-.,� •..r— Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 1
Change Order No.: 1 Date Started: 2017-10-04
City Sec. No.: Date Due: 2017-10-21
Project Name: Traffic Signal Infrastructure
100963 DOE Numbers:
Project Numbers:
Project Installation of traffic signal infrastructure improvements
Description:
Project/Contract
Compliance Scott Arnold City Inspector: Lee Soria
Manager:
Contractor:
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 0.00 0 0
Total Cost: $ 0.00 Total Requested Days: 0
Approval Status:
https://projectpoint.buzzsaw.com/ bz web/Forms/FonnPrint.aspx?SiteId=51500&Proces... 10/13/2017
0
CFW Change Order Approval 1 Page 3 of 3
Approved: Yes
Comments:
User: Carlos Reyes
Date: 2017-10-06 4:50 PM
Approved: Yes
Comments:
User: Scott Arnold
Date: 2017-10-08 12:55 PM
Approved: Yes
Comments:
User: Ali Mozdbar
Date: 2017-10-09 1:43 PM
Approved: Yes
Comments:
User: Sam Werschky
Date: 2017-10-11 4:18 PM yam'
Approved: Yes
Comments:
User: Doug Wiersig Ronald P. Gonzales,Asst)City Secretary
Date: 2017-10-12 11:33 AM
Approved: Yes F0Rr
Comments:
User: Doug Black
Date: 2017-10-13 11:08 AM
Approved: Yes '�..
Comments: AS
User: Jay Chapa
Date: 2017-10-13 11:52 AM
Action Required: Approval
x, 6, 56..7.89
A� N
OFFICIAL RECORD
$ CITY SECRETARY
FT.WORTH,TX
68 L 95 V �
https://projectpoint.buzzsaw.com/_bz web/Forms/ForrnPrint.aspx?Siteld=51500&Proces... 10/13/2017