HomeMy WebLinkAboutContract 51012-AR1 CITY SECRETARY
FORT WORTH City of Fort Worth CONTRACTNO.
Construction Allowance Request Breakdown
Construction CA# 0 Date 12/3/2018 City Sec# 1 51012
Client Project#(s)l 101333
FAC#(s)
Project Name HMAC(2018-4)HIR Street Rehabilitation
Description
Contractorl Cutler Repaving, Inc. City Inspector Jarad Souders
Funding TPW Select Day Type
Allocation Account Totals
Original Contract Amount $1,865,363.60 $1,865,363.60
Extras to Date
Credits to Date
Current Contract Amount $1,865,363.60 $1,865,363.60
Amount of Proposed Allocation $48,750.00 $48,750.00
Original Allowance Available for Allocation $102,443.00 $102,443.00
Allowance Funds Previously Allocated
Remaining Funds Available for this Allocation $102,443.00 $102,443.00
_ JUSTIFICATION SUMMARY
The City requested Surface Milling be performed on International Plaza. The original bid sheet only has an item for Wedge Milling.This
Construction Allowance add the bid item for Surface Millling
It is understood and agreed that the acceptance of this Construction Allowance Request by the contractor constitutes an accord and satisfaction and
represents payment in full for all costs arising out of,or incidental to,the above Construction Allowance Request.Contract Time will be adjusted on the
basis of the time shown on this Construction Allowance Request by a later Change Order,if necessary.
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FORT WORTH® City of Fort Worth
Construction Allowance Request Breakdown
Construction FOA# 1 Date 12/3/2018
Client Project#(s) 101333
FAC#(s)
Project Name HMAC(2018-4)HIR Street Rehabilitation
Description
Contractorl Cutler Repaving, Inc. City Inspector C
ADDITIONS
ITEM MCPIPTIM ep yUnit'
Surface Milling
Change Order Additions Page 1 of 4
Sub'
Change Order Additions Page 2 of 4
City Sec# 51012
Jarad Souders
Unit os o a
Change Order Additions Page 3 of 4
TPW $48,750.00
Total Additions 75 .0
Change Order Additions Page 4 of 4
75
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MIWBE Breakdown for this Construction Allowance Request
MWBE Sub Type of Service Amount for this FOA
N/A
Total $0.00
Previous Construction Allowance Requests
CO# DATE AMOUNT
N/A
Total $0.00
CFW Construction Allowance Request Approval CAAppr-01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Projects/101333 - HMAC 2018-04 HIR Street Rehab/Contractor/Change Orders/Constr Allow
Request Breakdown #1R 2018-4.xlsm
Attachments(0)
No Attachments have been added to this form.
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CFW Construction Allowance Request Approval CAAppr-01 Page 2 of 3
FORT WORTH., City of Fort Worth
Construction Allowance Request Approval
(Construction Allowance Breakdown Available in Links)
For Construction Allowance Submittal No.: 1
Construction Allowance Request Approval No.: CAAppr-01
Date Started: 2018-12-04 Date Due: 2019-01-23
City Sec. No.: 51012
Project Name: 101333 - HMAC 2018-04 HIR Street Rehab
Project Numbers: 101333 DOE Numbers:
Project Removal and replacement of non-functional curb&gutter,
Description: driveways sidewalks and pavement remarkings, followed by a HIR
overlay of 1" HMAC.
Project/Contract
Compliance Kristian Sugrim City Inspector: Jarad Souders
Manager:
Contractor: Cutler Repaving, Inc.
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 48,750.00 30100-0200431-5740010-101333-0
Total Cost: $ 48,750.00 Total Requested Days: 0
Approval Status:
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CFW Construction Allowance Request Approval CAAppr-01 Page 3 of 3
Approved: Yes
Comments:
User: Lane Zarate
Date: 2018-12-05 3:59 PM
Approved: Yes
Comments:
User: Ricardo Matute
Date: 2018-12-10 10:59 AM
Approved: Yes
Comments:
User: Signing for TPW Director Role Approvals
Date: 2018-12-10 1:18 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2018-12-17 6:35 PM OF FO�T
A7 C)
Approved: Yes
Comments:
User: Susan Alanis 94ar� S8 , City Secr4q "
Date: 2018-12-28 2:50 PM
Action Required:
OFFICIAL RECORD
f CITY SECRETARY
FT. WORTH,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.
Kristian Sugrim /Name of of Employee/Signature
Project Manager
Title
❑ This form is N/A as No City Funds are associated with this Contract
Kristian Sugrim /Printed Name Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX