HomeMy WebLinkAboutContract 49776-AR2 CITY SECRETARY
FORTWORTH® City of Fort Worth CONTRACT NO._ 7�.6',. a
""4 rConstruction Allowance Request Breakdown
Construction CA# Date 12/3/2018 City Sec# ggc • q1`� KS
Client Project
FAC#(s)
Project Name 2017-13 HIR Street Rehabilitation
Description
Contractorl Cutler Repaving, Inc. City Inspector Jarad Souders
Funding TPW Select Day Type
Allocation Account Totals
Original Contract Amount $1,735,745.70 $1,735,745.70
Extras to Date
Credits to Date
Current Contract Amount $1,735,745.70 $1,735,745.70
Amount of Proposed Allocation $3,075.00 $3,075.00
Original Allowance Available for Allocation $94,546.00 $94,546.00
Allowance Funds Previously Allocated $20,679.70 $20,679.70
Remaining Funds Available for this Allocation $73,866.30 $73,866.30
JUSTIFICATION KU-MM ARY
The City has requested 24"Solid Pavement Markings for Crosswalks installed on Ridgemar Boulevard. The bid schedule only has an item for
12'"Crosswalks.Yhis Constructioin Allowance adds the 24"Pavement Marking item.
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.
P,yid RECORD
4",'rl SECRETARY
c��or�oR�woa�N �1-, WORTH,TX
FORT WORTH. City of Fort Worth
Construction Allowance Request Breakdown
Construction FOA# 2 Date 12/3/2018
Client Project#(s) 7729
FAC#(s)
Project Name 2017-13 HIR Street Rehabilitation
Description
Contractorl Cutler Repaving, Inc. City Inspector C
ADDITIONS
Dept/FAC y Unit
Solid avemen Markings(Crosswalks)
Change Order Additions Page 1 of 4
Sub'
Change Order Additions Page 2 of 4
City Sec# F 100994
Jarad Souders
Unit os o a
Change Order Additions Page 3 of 4
TPW $3,075.00
Total Additions 3,075. 0
Change Order Additions Page 4 of 4
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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 $0.00
CFW Construction Allowance Request Approval CAAppr-03 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/100994- HMAC 2017-13 HIR Street Rehab/Contractor/Change Orders/Constr Allow
Reauest Breakdown #2 2017-13.xlsm
Attachments(91
No Attachments have been added to this form.
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CFW Construction Allowance Request Approval CAAppr-03 Page 2 of 3
FORT WORTH . City of Fort Worth
Construction Allowance Request Approval
(Construction Allowance Breakdown Available in Links)
For Construction Allowance Submittal No.: [3
Construction Allowance Request Approval No.: ;CAAppr-03
Date Started: ,2018-12-03 Date Due: 2019-01-22
City Sec. No.: 49776
Project Name: HMAC 2017-13 HIR Street Rehab
Project Numbers: 100994 DOE Numbers:
Project3Removal and replacement of nonfunctional curbs and gutters,
Description: sidewalks and driveways, followed by a HIR overlay of 1" HMAC.
Project/Contract
Compliance Kristian Sugrim City Inspector: Jarad Sounders
Manager:
Contractor: Cutler Repaving, Inc.
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW ;$ 3,075.00 ;;30100-0200431-5740010-100994-0
Total Cost: $ 3,075.00 Total Requested Days: 0
Approval Status:
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CFW Construction Allowance Request Approval CAAppr-03 Page 3 of 3
Approved: Yes
Comments:
User: Lane Zarate
Date: 2018-12-03 8:24 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 1:19 PM
Approved: Yes
Comments:
User: Doug Black EDRF
Date: 2018-12-17 6:37 PM 0:• 0� ,
Attested by:, ► . :X
Approved: Yes V'• •'
Comments: _
User: Susan Alanis R ary J. Ser, City Secretary .
Date: 2018-12-28 2:50 PM XP5,
Action Required:
OXFICIAL RECORD
CITY SECRETARY
ET WORTH,TX
https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&Proces... 12/31/2018
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 Su rig m /
Name of Employee/Signature
Project Manager
Title
❑ This form is N/A as No City Funds are associated with this Contract
Kristian Sugrim
Printed Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,Tat