HomeMy WebLinkAboutContract 48191-CO2 CITY SECRETARY o
FORT WORTH City of Fort Worth CONTRACT N0. `� q �`CJD
Change Order Request Breakdown
Project Name 2016-10 HIR Street Rehabilitation CitySec# 1 48191
Client Project#(s)l 100345
Contractor Cutler Repaving PM Kristian Sugrim Inspectorl William Mason
Change Order Submittal# 0 Date 7/13/2018
Contract Time
Dept. TIPW Totals CD
Original Contract Amount $2,767,877.69 $2,767,877.69 185
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $2,767,877.69 $2,767,877.69 185
Amount of Proposed Change Order $95,060.00 $95,060.00 485
Revised Contract Amount $2,862,937.69 $2,862,937.69 670
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $95,060.00 $95,060.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 3.43%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $3,459,847.11
JUSt—IF 1 E ORDER --� —
This Change Order No.2 is being submitted to request increases for time and funding to the Contract. Due to the inclusion of Trinity Blvd.and
McCart Ave.,the asphalt pavement base repair quantities have overrun the original projected planned quantities.Also,supplementing Trinity
Blvd.and McCart Ave.,to the Contract,for Hemphill Ave. have compounded the delays to the contracted time;therefore 485 days is being
requested.
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OFFICIAL RECORD
CITY SECRETARY
IFT.WORTH,TX
FORT WORTH City of Fort Worth
---- Change Order Additions
Project Name 2016-10 HIR Street Rehabilitation City Sec# 48191
Client Project# 100345
Contractor Cutler Repaving PM[7 Kristian Sugrim lnspector.F William Mason7
Change Order Submittal# �2 Date 7/13/2018
ADDITIONS
Qty unit I unit cost Total
22 Asphalt pavement base repair
T/PW $95,060.00
�I
Sub Total Additions $95,060
Change Order Additions Page 1 of 1
FORT WORTH City of Fort Worth
Ir— Change Order Deletions
Project Name 2016-10 HIR Street Rehabilitation City Sec# 48191
Client Project# 100345
Contractor Cutler Repaving PM Kristian Sugrim Inspector Wlliam Mason
Change Order Submittal# 0 Date 7/13/2018
DELETIONS
Qty Unit Unit Cost I ota
I
T/PW $0.00
Sub Totai Deletions
Change Order Deletions Page 1 of 1
M/SBE Breakdown for this Change Order
M/SBE Sub Type.of.S`eivice Amount for,ath�s CQ'
N/A
Total
Previous Change Orders
DAT:E A'MO`UNT
.
Total
CFW Change Order Approval St-COApp03 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 2
fortworthgov/Infrastructure Projects/100345 - HMAC HIR Street Rehab (2016-10)/Contractor/Change Orders/Change
Order Breakdown # 2 2016-10.xis
fortworthgov/Infrastructure Projects/100345 - HMAC HIR Street Rehab (2016-10)/Contractor/Change Orders/MBE-
APCForm HIR2016-10 CO2.pdf
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CFW Change Order Approval St-COApp03 Page 2 of 3
FORT WORTH. City of Fort Worth
-�.. �•....- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 2
Change Order No.: St-COApp03 Date Started: 2018-07-25
City Sec. No.: 48191 Date Due: 2018-09-13
Project Name: 100345 - HMAC HIR Street Rehab (2016-10)
100345 DOE Numbers:
Project Numbers: -
Project Removal and replacement of nonfunctional curb & gutter and
Description: driveways, followed by a 1" HMAC overlay.
Project Manager: Kristian Sugrim City Inspector: William Mason
Contractor: Cutler Repaving, Inc.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 95,060.00 39412-0200431-5740010-100345-0 485
Total Cost: $ 95,060.00 Total Requested Days: 485
Approval Status:
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F City of Fort Worth
ACCEPTANCE OF PREVIOUS MSE COMMITMENT FORM
(for use with CHANGE ORDERSybr AMENOMENTS greater than$50,000)
To be Completed by City Project Manager "
Change Order(for Construction Contract)
Project Name: City Project Number
100345
HMAC 2016-10 HIR Street Rehabilitation
City-Project Manager
Contractor: Kristian Sugrim
Cutler Repaving, Inc. City's MBE Project Goal: 9 %
Original Amount of Contract: $2,767,877.69 Accepted MBE Commitment: 9 %
Total of Previous Change Orders: $0.00 Date of Last MBE Report:
Amount for this Change Order. $95,060.00 Change Order* 2
Revised Amount of Contract: $2,862,937.69 pate: 7/20/2018
Language to be inserted in the M&C for this Contract
Cutler Repaving, inc. agrees to maintain Its Initial MISE commitment of 9% that it made on the
original contract and extend and maintain that same MBE commitment of 9%to all prior change
orders up to and inclusive of this Change Order No, 2, Therefore Cutler Repaving, Inc. remains in
compliance with the City's BDE Ordinance and attests to Its commitment by its signature on the
Acceptance of Previous MSE Commitment form executed by an authorized representative of its
company.
To be Completed by the Representative of the Contra r
Chanes R.Veskema Presiden#
Printed Signature Title Authorized Signature/Date
Cutter Repaving, Inc. _
Company Name Contact Name(If different)
921 E 27th St
..__ byg,�o (]a�8'[cutiert9DayinQ,COm ,
Address E-mail address
Lawrence,KS 66046-4917 795-843-1524 785-843-3942
City/State/Zip Phone number Fax Number
as of -'/!•10/g
MSE% Paid to Date Date,
City ro ect anager has reviewed the work:associated withs anger ,er,
considers it the same or similar to work in the original Contract, and recommends that the
Contractor have the Option to retrain d confit its existing MBE commitment.
Kristian Sugrim �- _ 7/20/2018
C(ty Project Manager. Clty'Project Mana r Signature Date
OrderAttach Complete Change Documentation and Forward to MIWBE office
. .• Completed .
M/WBE Compliance Staff 1D# MBE Current%Level via Last Report Rec'd
M/WBE Signature pate
Contract Compliance Manager
40,
Re: Change Order No. 2 ($95,060.00)
Contractor: Cutler Repaving �Ty,
4 ,
Project Name: HMAC 2016-10 HIR
City Secretary No.: 48191
Project No.: 100345 w
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
Project No. IOD345 City Secretary No.48191
Project Name: HMAC 2019-10 HIR Change Order#2
Contractor Cutler Repaving
Signature Routing Sheet
Signature: Date A44 Iff
Bob Veskerna
Signature: Date: 0V(` �rl``2c7�8
Kristian Sugrlm,Project Anager
Signature:, AAt A-A I&e Date:_
Lane Zarate,Vograrn Manager
Signature: Z�/' -� Date:
Sr.Capital Projects Officer
fill,i i.Cl !ll. ;rc/I
Signature: 142L �• t`' Date:
(rY
Doug kviersig,Director
Signature: Date: l l?v
113
Doug Black,Sr Assistant City Attorney
Signature:_ � / W, Date:
Susan Alanis,Assistant City Manager 4
Mdr
YJ. IC r,02 ny
S
EOFFICIALRDRYx
4�
FORTWORTH. City of Fort Worth CITY SECRETARY
**111� Change Order Request Breakdown CONTRACT N0. �-
Project Name 2016-10 HIR Street Rehabilitation City Sec# 1 48191
Client Project#(s)l 100345
Contractor Cutler Repaving PM Kristian Sugrim Inspectorl William Mason
Change Order Submittal# Date 7/13/2018
Dept. T/PW Contract Time
Totals CD
Original Contract Amount $2,767,877.69 $2,767,877.69 185
Extras to Date $95,060.00 $95,060.00 485
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $2,862,937.69 $2,862,937.69 670
Amount of Proposed Change Order $95,060.00 $95,060.00
Revised Contract Amount $2,957,997.69 $2,957,997.69 670
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) L $95,060.00 $95,060.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 6.87%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $3,459,847.11
4 STIFICATION(REASONS)FOR CHANGE ORDER—,
This Change Order No.2 is being submitted to request increases for time and funding to the Contract. Due to the inclusion of Trinity Blvd.and
McCart Ave.,the asphalt pavement base repair quantities have overrun the original projected planned quantifies.Also,supplementing Trinity
Blvd.and McCart Ave.,to the Contract,for Hemphill Ave.have compounded the delays to the contracted time;therefore 485 days is being
requested.
RECEIVED
AUG 2 ? 2018
CITY OF FORT WORTH
CITYSECRETARY
FORT WORTH City of Fort Worth
— — Change Order Additions
Project Name 1 2016-10 HIR Street Rehabilitation City Sec# 48191
Client Project# 1 100345
Contractor Cutler Repaving PM Kristian Sugrim Inspector William Mason
Change Order Submittal# F2 Dale 7/13/2018
ADDITIONS
I I EM DES R17777 DEPT City Unit Unit Cost Total
Asphalt pavement base repair
T/PW $95,060.00
Sub Total Additions 5,
Change Order Additions Page 1 of 1
FORT WORTH City Of Fort Worth
T�_— Change Order Deletions
Project Name 2016-10 HIR Street Rehabilitation CitySec# 48191
Client Project# 100345
Contractor Cutler Repaving PM Kristian Sugrim Inspector William Mason
Change Order Submittal# 2 Date 7/13/2018
DELETIONS
ITEM DESCRIPTION DEP I Qty Unit UnitCost Total
T/PW
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
N/A
Total $0.00
Previous Change Orders
Co# DATE AMOUNT
Total $0.00
CFW Change Order Approval St-COApp03 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 2
fortworthgov/Infrastructure Proiects/100345 - HMAC HIR Street Rehab (2016-10)/Contractor/Change Orders/Change
Order Breakdown # 2 2016-10.x1s
fortworthgov/Infrastructure Projects/100345 - HMAC HIR Street Rehab (2016-10)/Contractor/Change Orders/MBE-
APCForm HIR2016-10 CO2.pdf
Attachments(0)
No Attachments have been added to this form.
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CFW Change Order Approval St-COApp03 Page 2 of 3
FORT WORTH. city of Fort Worth
�.-•.� Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 2
Change Order No.: St-COApp03 Date Started: 2018-07-25
City Sec. No.: 48191 Date Due: 2018-09-13
Project Name: 100345 - HMAC HIR Street Rehab (2016-10)
100345 DOE Numbers:
Project Numbers:
Project Removal and replacement of nonfunctional curb & gutter and
Description: driveways, followed by a 1" HMAC overlay.
Project Manager: Kristian Sugrim City Inspector: William Mason
Contractor: Cutler Repaving, Inc.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 95,060.00 39412-0200431-5740010-100345-0 485
vo 61� 90
Total Cost: $ 95,060.00 Total Requested Days: 485
Approval Status:
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F9BTW09J1JCity of Fort Worth
ACCEPTANCE OF PREVIOUS MBE COMMITMENT FORM
(for use with CHANGE ORDERS or AMENDMENTS greater than sso,00o)
To be Completed by City Project Manager
Change Order(for Construction Contract)
Project Name: City Project Number
100345
HMAC 2016-10 HJR Street Rehabilitation
City-Project Manager
Contractor: Kristian Sugdm
Cutler Repaving, Inc. City's MBE Project Goal: 9 %
Original Amount of Contract: $2,767,877.69 Accepted MBE Commitment: 9 %
Total of Previous Change Orders: $0.00 Date of Last MBE Report:
Amount for this Change Order. $95,060.00 Change Order#: 2
Revised Amount of Contract: $2,862,937.69 Date: 7/20/2018
Language to be inserted In the M&C for this Contract
Cutler Repaving, inc. agrees to maintain its initial MBE commitment of 9%that it made on the
original contract and extend and maintain that same MBE commitment of 9%to all prior change
orders up to and inclusive of this Change Order No, 2, Therefore Cutler Repaving, Inc. remains In
compliance with the City's BIDE Ordinance and attests to Its commitment by its signature on the
Acceptance of Previous MBE Commitment form executed by an authorized representative of its
company.
To be Completed by the Representative oft .Contrar
Charles R.1Veskema President u� Aao./$
Printed Signature Title Authorized Signature/Date
Culler Repaving, Inc.
Company Name Contact Name(If different)
921 E 27th St _ byeAkilMa@cutlerrer)aving.com
Address IE-mail address
Lawrence,KS 66046-4917 785-843-1524 785-843-3942
City/State/Zip Phone number Fax Number
as of '7-It•-90/�"
MSE% Paid to Date . Date,
City ro ect anager has reviewed the wor associated wit s ange r er,,
considers it the same or similar to work in the original Contract, and recommends that the
Contractor have the option to retain apd. confirol its existing MBE commitment.
Kristian Sugrim 7/20/2018
City Project Manager. C1ty'P.roject Mans r Signature Date
CompletedA(tach Complete Change Order Docunientation and Fotward to MIWBE office
To be by the MiVVBE Compliance Staff
M/WBE Compliance Staff ID 9 MBE Current%Level via Last Report Recd
M/WBE Signature Date
CFW Change Order Approval St-COApp03 Page 3 of 3
Approved: Yes
Comments:
User: Bob Veskerna
Date: 2018-07-27 4:13 PM
Approved: Yes
Comments:
User: Kristian Sugrim AtteesWd b
Date: 2018-07-30 9:56 AM F�I�T�w`
Approved: Yes Mary J• K y ;
Comments: :=
User: Lane Zarate
Date: 2018-07-30 9:15 PM
�XAS
Approved: Yes
Comments: II��II11 1
User: Ricardo Matute M&C:
Date: 2018-08-09 11:02 AM N f
1295:
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2018-08-10 3:52 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2018-08-17 6:41 PM
Approved: Yes
Comments:
User: Susan Alanis
Date: 2018-08-20 10:10 AM
Action Required:
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Contract Compliance Manager q6�1
cry, 4-�8
Re: Change Order No. 2 ($95,060.00)
Contractor: Cutler Repaving
Project Name: HMAC 2016-10 HIR
City Secretary No.: 48191 ,
Project No.: 100345
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 of Employee
Project Manager
Title
TRANSPORTATION & PUBLIC WORKS
Routing Slip
Date: August 21, 2018
To: Department Initials Date
Allison Tidwell /Mary
Kayser City Sectary Office
Action _File Note & Return
�1 Approval _ For Clearance _ Per Conversation
As Requested _For Correction _ Prepare Reply
_Circulate For Your Information See Me
Comment _, Investigate _ Signature
Coordination _Justify Other
Remarks: CONTRACT FOR CITY PROJECT NO.
2 Copies
Return To: TPWContracts@FortWorthTexas.gov x7233