HomeMy WebLinkAboutContract 50673-CO1 CFW Change Order Approval COAppr-01 Page 2 of 3
G.1'Y SECRETARY
FORT WORTH,
City of Fort Worth COY °RAGTNO._5ot,9-73-CC)1
•..--- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 1
Change Order No.: COAppr-01 Date Started: 2019-01-07
City Sec. No.: 50673 Date Due: 2019-02-26
Project Name: Bridge Rehabilitation 2018-1
Project Numbers: 101296 DOE Numbers:
Project Various bridge rehab
Description:
Project/Contract
Compliance Shammi Rahman City Inspector: Tommy Mckinnon
Manager:
Contractor: Gibson
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 $ 18,458.80 43
Total Cost: $ 18,458.80 Total Requested Days: 43
Approval Status:
RECEIVED O
FFICIAL RECORD
JAN 18 2019 CRETARY
CITY Y FORT WORTH TX
CIN SECRETARY
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CFW Change Order Approval COAppr-01 Page 3 of 3
Approved: Yes
Comments:
User: Joe Montgomery
Date: 2019-01-09 8:41 AM
Approved: Yes
Comments:
User: Shammi Rahman
Date: 2019-01-09 8:44 AM
Approved: Yes
Comments:
User: Riad Nusrallah
Date: 2019-01-11 12:25 PM
Approved: Yes
Comments:
User: Lauren Prieur
Date: 2019-01-14 2:57 PM
Approved: Yes
Comments:
User: Signing for TPW Director Role Approvals
Date: 2019-01-14 9:50 AM
Approved: Yes
Comments:
User: Doug Black
Date: 2019-01-16 3:55 PM
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A by:
Approved: Yes U
Comments:
User: Susanj W—d P GonWes,Aws 1
Date: 2019-01-181-18 10:57 AM ty
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Action Required:
r
CIAL RECORD
SECRETARY
WORTH,TX
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CFW Change Order Approval COAppr-01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Projects/101296 - Bridge Rehabilitation 2018-1/Contractor/Change Orders/Change Order
#1.xlsm
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FORT WORTH® City of Fort Worth
Change Order Request Breakdown
ProjectNamel Bridge rehabilation at Nine Locations City Sec# 1 50673
Client Project#(s)l 101296
Gontractorl Gibson PM I Shammi Rahman Inspector Tommy Mckinnon
Change Order Submittal# 0 Date 12(7/2018
Dept. TPW Contract Time
Totals CD
Original Contract Amount $415,371.00 $415,371.00 120
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process) $0.00
Contract Cost to Date $415,371.00 $415,371.00 120
Amount of Proposed Change Order $18,458.80 $18,458.80 43
Revised Contract Amount $433,829.80 $433,829.80 163
Original Funds Available for Change Orders $0.00 $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $18,458.80 $18,458.80
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 4.44%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $519,213.75
Due to a change in design for the Meadow Brook bridge requires the addition of 48 linear feet of armor joint.Also,more sidewalk work was added to the project than
originally estimated.The estimated sidewalk quantity was revised to 307 square feet to accomodate field conditions.The Western Center bridge requires striping but it was
not initially included in the contract.The city's trafffic department will complete the striping in Western Blvd.The addtional work requires a total of$18,458.80 and 43
additional calendar days to complete the contract.
City of Fort worth
Change Order Additions
Project Name Bridge rehabilation at Nine Locations City Sec# 50673
Client Project# 101296
Contractor Gibson PM Shammi Rahman Inspector[Tommy Mckinnon
Change Order Submittal# Date 12 7/2018
ADDITIONS
Unit UnitCost Total
Flowable ac
5 CL C Conc(Abut) TPW 2.00000000 Y
7 Bridge sidewalk TPW 151.94000000 SF 20.0
Armorjoint TPW 00—LF ----515-00
Striping TPW 1.00000000 EA 570
TPW $18,458.80
Sub Total Additions 18,45 .8
Change Order Additions Page 1 of 1
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.
Shammi Rahman
Project Manager
Title
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
6L,)*FF CIAL RECORD
'SECRETARY
1NORTH,TX