HomeMy WebLinkAboutContract 47465-CO2 FORT WORTH® City of Fort Worth CITY SECRETARY ( s_ ,
Change Order Request Breakdown CONTRACT N0._
Project Namel HMAC 20154 Rehab City Sec# 1 47465
Client Project#(s)l 02551 -39408-0200431-5740010--CO2551-C06283—
Contractor JLB Contracting LLC PM Kristian Sugrim Inspectorl Gary Deyon
Change Order Submittal# Date 6/28/2016
Contract Time
Dept. TPW Totals CD
Original Contract Amount $1,607,630.92 $1,607,630.92 220
Extras to Date $175,406.14 $175,406.14 35
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $1,783,037.06 $1,783,037.06 255
Go to ADD&DEL Tabs to Enter CO Backup $0.00 314
Revised Contract Amount $1,783,037.06 $1,783,037.06 569
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 10.91
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $2,009,538.65
JUSTIFICATION(REASONS)FOR CHANGE,ORDER
Additional time is required for the construction of Harrison and Morphy which were released for construction 369 days after the start of the
project.
4� m
CF)
Co
OFFICIAL RECORD
CITY ZEMETARY
FT.WORTH,Tx
FOR_ rH City of Fort worth
Change Order Additions
Project Name HMAC 2015-4 Rehab City Sec# 47465
Client Project# 02551-39408-0200431-5740010--CO2551-C06283--
Contractor JLB Contracting LLC PM Kristian Sugrim InspectorF Gary Deyon
Change Order Submittal# Date 6/28/2016
ADDITIONS
ITEM ULSCRIFITION DEPT Qty Unit Unit Cost Total
TPW $0.00
Sub Total Additions
Change Order Additions Page 1 of 1
FORI_1T'-H City of Fort worth
Change Order Deletions
Project Name I HMAC 2015-4 Rehab City Sec# 47465
Client Project# 1 02551-39408-0200431-5740010—CO2551-C06283—
Contractor JLB Contracting LLC PM Kristian Sugrim Inspector Gary Deyon
Change Order Submittal# 0 Date 6/28/2016
DELETIONS
I I EM DESCRIPTION DEPT Qty Unit Unit Cost Total
TPW $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 $0.00
CFW Change Order Approval St-COApp02 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/02551 - Street Rehabilitation (HMAC 2015-4)/Contractor/Change Orders/HMAC
2015-4- change order 2 breakdown - additional time.xls
Attachments(0)
No Attachments have been added to this form.
https://projeetpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 2/15/2018
CFW Change Order Approval St-COApp02 Page 2 of 3
FORT WORTH. city of Fort Worth
•.- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 2
Change Order No.: St-COApp02 Date Started: 2018-01-30
City Sec. No.: Date Due: 2018-03-21
Project Name: 02551 - Street Rehabilitation (HMAC 2015-4)
Project Numbers: 02551 DOE Numbers:
Project Removal and replacement of nonfunctional driveways,
Description: curb&gutter and sidewalks, followed by the puverization and
stabilization of the existing pavement and a 2" HMAC overlay.
Project Manager: Kristian Sugrim City Inspector: Gary Deyon
Contractor: JLB Contracting, LLC.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 0.00 314
Total Cost: $ 0.00 Total Requested Days: 314
Approval Status:
https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?Siteld=51500&ProcessI... 2/15/2018
CFW Change Order Approval St-COApp02 Page 3 of 3
Approved: Yes
Comments:
User: Sam Davis
Date: 2018-01-30 1:25 PM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2018-01-31 9:08 AM
Approved: Yes
Comments:
User: Lane Zarate
Date: 2018-01-31 6:51 PM
Approved: Yes
Comments:
User: Kim Arnold
Date: 2018-02-05 2:19 PM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2018-02-07 3:20 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2018-02-13 6:00 PM
Approved: Yes
Comments:
User: Jay Chapa
Date: 2018-02-14 11:33 AM
Action Required:
ORT.�o
Attested
Mary ay r, City S
'�Pc, OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
https:Hprojectpoint.buzzsaw.com/ bz_web/Forms/FormPrint.aspx?Siteld=51500&ProcessI... 2/15/2018
Contract Compliance Manager
Re: Change Order No. 2 ($0.00)
Contractor: JLB Contracting, LLC.
Project Name: HMAC 2015-4 Street rehab.
City Secretary No.: 47465
Project No.: CO2551
By signing, I acknowledge that I am the person responsible for the monitoring and
administration of this contract including ensuring all performance and reporting
requir ments.
Name of Employee Project Manager
Title