HomeMy WebLinkAboutContract 47204-CO2 FORT WORTH. City of Fort Worth CITY SECRETARY
Change Order Request Breakdown CONTRACT NO. 472, q 2
Project Namel HMAC 2015-3 Street Rehab City Sec# 1 47204
Client Project#(s)l 02550
Contractorl JLB Construction, Inc PM Kristian Sugrim Inspectorl William Mason
Change Order Submittal# Date 2/2/2018
Dept. TIPW WATER SEWER Contract Time
Totals CD
Original Contract Amount $1,131,234.38 $565,617.19 $565,617.19 $2,262,468.76 210
Extras to Date $282,700.56 $141,462.74 $141,453.88 $565,617.18 315
Credits to Date
Pending Change Orders(in M&C Process) $0.00 $0.00 $0.00
Contract Cost to Date $1,413,934.94 $707,079.93 $707,071.07 $2,828,085.94 525
Go to ADD&DEL Tabs to Enter CO Backup $0.00 $0.00 $0.00 163
Revised Contract Amount $1,413,934.94 $707,079.93 $707,071.07 $2,828,085.94 688
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00 $0.00 $0.00
Additional Funding(if necessary)
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 25.00%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $2,828,085.95
JUSTIFICATION(REASONS) FOR CHANGE ORDER
This Change Order is being submitted to request that additional time be added to the contract for the rehabilitation of NW 18th St.,Overhill Rd.,
Gaston Ave.,Treehaven Rd.and Alcannon St. Except for Alcannon St.,which was delayed by a stormwater sinkhole,all the others were due to
utility completion delays.
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OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
FOR_ T. TWO,TH City of Fort worth
Change Order Additions
Project Name HMAC 2015-3 Street Rehab CitySec# 47204
Client Project# 1 02550
Contractor JLB Construction,Inc PM Kristian Sugrim Inspector William Mason
Change Order Submittal# 0 Date 2/2/2018
ADDITIONS
ty Unit Unitost rota
me contract time only ay
T/PW $0.00
WATER $0.00
SEWER $0.00
Sub Total Additions
Change Order Additions Page 1 of 1
Foa_ TT WORTH City of Fort Worth
Change Order Deletions
Project Name I HMAC 2015-3 Street Rehab CitySec# 47204
Client Project# 02550
Contractor JLB Construction,Inc PM Kristian Sugrim Inspector William Mason
Change Order Submittal# 0 Date 2 2 2018
DELETIONS
ITEM DESCHIPI ION DEPT Qty Unit Ufft Cost Total
T/PW $0.00
WATER $0.00
SEWER $0.00
ub 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 $0.00
CFW Change Order Approval St-COApp03 Page 1 of 4
Routin
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/02550 - Street Rehab HMAC 2015-3/Contractor/Change Orders/2015-3 Change
Order 2 - time onlv.xls
Attachments(Ol
No Attachments have been added to this form.
1
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CFW Change Order Approval St-COApp03 Page 2 of 4
FORTWORTH, City of Fort Worth
�--.� --- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.:
Change Order No.: ;St-COApp03 Date Started::2018-02-07
City Sec. No.: 47204 Date Due: 2018-03-29
Project Name: 02550 - Street Rehab HMAC 2015-3
102550 DOE Numbers:
Project Numbers: ._ --
Project !Removal
_Project !Removal and replacement of nonfunctional driveways, curb &
Description: Igutter and sidewalks; followed by the pulverization and
stabilization of the existing pavement and a 2" HMAC Overlay.
Project Manager: Kristian Sugrim City Inspector: William Mason
Contractor: JLB Contracting, LLC.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 0.00 163
Total Cost: $ 0.00 Total Requested Days:'163
Approval Status:
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CFW Change Order Approval St-COApp03 Page 3 of 4
Approved: Yes
Comments:
User: Matt Monedero
Date: 2018-02-13 8:55 AM
.Approved: Yes
Comments:
User: Sam Davis
Date: 2018-02-13 9:18 AM
;Approved: Yes
Cgmments:
'User: Kristian Sugrim
Date: 2018-02-13 10:16 AM
1
Approved: Yes
Comments:
User: Matt Monedero
Date: 2018-02-13 1:00 PM
Approved: Yes
Comments:
User: Sam Davis
Date: 2018-02-13 1:24 PM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2018-02-13 2:53 PM
Approved: Yes
Comments:
User: Lane Zarate
Date: 2018-02-14 3:20 PM
Approved: Yes
Comments:
User: Kim Arnold
Date: 2018-02-14 9:50 AM
;Approved: Yes
Comments:
User: Doug Wiersig
Date: 2018-02-14 5:00 PM
Approved: YesJ?� hn �`
Comments: U
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CFW Change Order Approval St-COApp03 Page 4 of 4
User: Jay Chapa
Date: 2018-02-14 5:18 PM
Action Required:
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OFRECORD
CITY SECRETARY
FT.WORTH,TX
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Contract Compliance Manager
Re: Change Order No. 2 ($0.00)
Contractor: JLB Contracting, LLC.
Project Name: HMAC 2015-3 Street rehab.
City Secretary No.: 47204
Project No.: CO2550
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.
Name of Employee
Project Manager
Title