HomeMy WebLinkAboutContract 50676-CO1 CITY smRETARY
FORT WORTH City of Fort Worth COw'KACT NO.
Change Order Request Breakdown
Project Namel Concrete Restoration(2018-2) City Sec# 1 50676
Client Project#(s)l 101294
Contractorl Xtreeme Swaing and Sealing PM Islam,Tariqul Inspectorl James Diver
Change Order Submittal# Date 5/14/2018
Dept. TPW Contract Time
Totals CD
Original Contract Amount $335,668.00 $335,668.00 150
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $335,668.00 $335,668.00 150
Amount of Proposed Change Order $12,600.00 $12,600.00 30
Revised Contract Amount $348,268.00 $348,268.00 180
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) 1 $12,600.00 $12,600.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 3.75%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+259/6) $419,585.00
Due to nature of traffic on Bryant Irvin Rd a portable electronic meesage board to be placed for the duration of contract and 2 weeks prior to start construction
OFFICIAL RECORD
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City of Fort worth
Change Order Additions
Project Name Concrete Restoration(2018-2) City Sec# 50676
Client Project# 101294
Contractor Xtreeme Swaing and Sealing PM Islam,Tariqul Inspectorl James Diver
Change Order Submittal Date 5114/2018
ADDITIONS
City Unit nit ost Total
ew orta aectronic essage Boards
TPW $12,600.00
Sub Total Additions L�l , 0
Change Order Additions Page 1 of 1
FORT WOR rH City of Fort Worth
V--- Change Order Deletions
Project Name Concrete Restoration(2018-2) City Sec# 50676
Client Project# 101294
Contractor Xtreeme Swaing and Sealing PM Islam,Taricul Inspector FJames Diver
Change Order Submittal# F1 Date 5/14/2018
DELETIONS
ty Unit UnitCost Total
TPW $0.00
Sub Total Deletions 0.
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 $0.00
CFW Change Order Approval COAppr-01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/101294 - Concrete Restoration 2018-2/Contractor/Change Orders/Copy of Change
Order 1 Breakdown CPN 101294(729)-l.xlsm
Attachments(0)
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CFW Change Order Approval COAppr-01 Page 2 of 3
FORT WORTH. City of Fort Worth
�. Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: COSub-01
Change Order No.: COAppr-01 Date Started: 2018-05-31
City Sec. No.: 50676 Date Due: 2018-06-08
Project Name: Concrete Restoration 2018-2
101294 DOE Numbers:
Project Numbers:
Project Concrete Restoration (Type B) at various locations
Description:
Project/Contract
Compliance Tariqul Islam City Inspector: James Diver
Manager:
Contractor: X Treeme Sawing & Sealing, Inc
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 12,600.00 30100 0200431 5740010 30
101294 003380
Total Cost: $ 12,600.00 Total Requested Days: 30
Approval Status:
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CFW Change Order Approval COAppr-01 Page 3 of 3
Approved: Yes
Comments:
User: Stuart Spradley
Date: 2018-06-04 10:48 AM
Approved: Yes
Comments:
User: Tariqul Islam
Date: 2018-06-04 11:21 AM
Approved: Yes
Comments:
User: Riad Nusrallah
Date: 2018-06-06 11:12 AM M&C:- NA
Approved: Yes 1295: A
Comments:
User: Richard Martinez
Date: 2018-06-08 12:12 PM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2018-06-11 5:02 PM
Ited luy.:
Approved: Yes �
Comments: �1 -
User: Doug Black nald P. Gonzales, t. ity SM0107
Date: 2018-06-15 5:11 PM
FoRr
Approved: Yes 0: O.A
Comments:
User: Susan Alanis U
Date: 2018-06-28 1:15 PM *'. ' ♦r
�XPS
Action Required:
FOIFFFICIALRECORD
RETARY H,TQC
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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.
M��
Tariqul Islam
Title
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature