HomeMy WebLinkAboutContract 49217-CO1 FORT WORTH. City of Fort worth CITY SECRETARY f I
Change Order Request Breakdof PNTRACT NO.
ProjectNamel Brick Pavement Rehabilitation 2017 at Various Location City Sec# 1 49217
Client Project#(s) 100632
Contractorl C.Green Scaping,L.P. PM Tariqul Islam InspeGtorl Roy Scharfenberg
Change Order Submittal# Date 411212018
Contract Time
Dept. TPW Totals CD
Original Contract Amount $337,685.00 $337,685.00 210
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $337,685.00 $337,685.00 210
Amount of Proposed Change Order $2,202.75 $2,202.75 20
Revised Contract Amount $339,887.75 $339,887.75 230
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $2,202.75 $2,202.75
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.65%
MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $422,106.25
The purpose of this change order is to provide additional funding to cover the overrun of item#20(3214.0101 Brick Pavement Joints)
RECEIVED o
MAY 31 2018
CI1Y OF FORT WORTH N
d' CITY SECRETARY Sia
OFFICIAL.RECORD
CITY ONCRETARY
11117. IQTH,TX
T City of Fort Worth
Change Order Additions
Project Name Brick Pavement Rehabilitation 2017 at Various Location City Sec# 49217
Client Project# 100632
Contractor C.Green Scalping,L.P. PMJ Tariqul Islam Inspector Roy Scharfenberg
Change Order Submittal# 0 Date 4/12 2018
ADDITIONS
ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total
— 7 3214.0101 Brick Pavement Joints T W LF 75 .75
TPW $2,202.75
Sub Total Additions 2,202.75
Change Order Additions Page 1 of 1
FoK_ORrH City of Fort worth
Change Order Deletions
Project Name Brick Pavement Rehabilitation 2017 at Various Location City Sec# 49217
Client Project# 100632
Contractor C.Green Scaping,L.P. PM Tariqul Islam ri Roy Scharfenberg
Change Order Submittal# 1 Date 4/12 2018
DELETIONS
ITEM DESCRIPTION DPT City Unit Unit Cost Total
TPW $0.00
Sub Total Deletions 0.00
Change Order Deletions Page 1 of 2
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 $0.00
CFW Change Order Approval 01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthoov/Infrastructure Proiects/100632 - Brick Pavement Rehabilitation 2017/Contractor/Change Orders/Copy of
100632 Brick Pavement Repair 20017 Change Order Breakdown #1.xlsm Revised 4.12.18 (002).xlsm
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CFW Change Order Approval 01 Page 2 of 3
FORT WORTH. C'ty of Fort Worth
--. .-..- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: CO-Sub01
Change Order No.: 01 Date Started: 2018-04-27
City Sec. No.: 49217 Date Due: 2018-05-18
Project Name: 100632 - Brick Pavement Rehabilitation 2017
DOE Numbers:
Project Numbers:
Project Brick Rehabilitation at various locations
Description:
Project/Contract
Compliance Tariqul Islam City Inspector: Roy Scharfenberg
Manager:
Contractor: C. Green Scaping
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 2,202.75 30100 0200431 5740010 20
100632 006480
Total Cost: $ 2,202.75 Total Requested Days: 20
Approval Status:
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CFW Change Order Approval 01 Page 3 of 3
Approved: Yes
Comments:
User: Dana Loucks
Date: 2018-04-27 9:56 AM
Approved: Yes
Comments:
User: Tariqul Islam
Date: 2018-04-27 10:01 AM
Approved: Yes
Comments:
User: Richard Martinez
Date: 2018-05-10 11:29 AM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2018-05-10 12:47 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2018-05-17 5:26 PM
Approved: Yes • 1 T4
Comments: �.
User: Susan Alanis
Date: 2018-05-21 8:45 AM
M&C: U �`
..........
Action Required:
OFFICIAL RECORn
CITY S�CRLtTARY
"�.UI 1-THO TX
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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.
Tariqul Islam
�rrl� t!�;cJ j Aez- -
Title
This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT.NORTH,TX