HomeMy WebLinkAboutContract 49218-CO1 KECE[VED
OR 3 0 2019 CITY SECRETARY
CITYOFFORTW, CONTRACT NO.
tITYSE'CRETA T WORTHS City of Fort Worth
Change Order Request
Project Name 100773 H2O17-10 CDBG City Sec# 1 49218
Client Project#(s)l City Project No.100773
Prof HMAC 2017-10(CDBG)Street Rehabilitation
Description
Contractorl Peachtree Construction Change Order# I�J Date 3/29/2019
City Project Mgr.1 Kristian Sugrim City Inspector Fshawn Fargo
TPW-Storm contfact Time
Dept. Water Totals D
Original Contract Amount S 176.��550 $1,17$:955.50 200
Extras to Date
Credits to Date 126
Pending Change Orders(in M&C Process)
Contract Cost to Date 1, 7$,9 5,54 5t,176.955.50 320
Amount of Propas2d Change Order $CM
Reviscaf,�,n8rS,4mgL.rr ,) $1,t7fi,955.54 320
Original Funds Available for Change Orders
Remaining Funds Available for this CO $Q00
Additional Funding(if necessary)
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0,00%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $1,471,194,38
,}ll *CAI!PR{R> !SOWS)FDR CHANGE IR M
A new bid pay item,pavement wedge milling,is required since pavement pulverization is not applicable;due to water utility impacts on
Gcrdc r Avenue.Also,120 days of additional time is associated with utility assessments and relocations of gas services.
F FopT
Atte by: o
-
Mary, =2
J. K , Ci retary
It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents
payment in full(both time and money)for all costs arising out of,or incidental to,the above Change Order. The Project/Program Manager signing
below acknowledges that he/she is the person responsible for the monitoring and administration of this contract,including ensuring all performance
and reporting requirements.
Peachtree Construction
t ate.
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FT WORTH,TX
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MMBE Breakdown for this Change Order
MW6C t,-Ab Type of Service Amount for this CO
N/A
Total Q
Previous Change Orders
Co# IA'C AMUIT
None
Total
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 rgLim
Name of Employee/Signature
Project Manager
Title
❑ This form is N/A as No City Funds are associated with this Contract
Kristian Su rim
Printed Name Signat
OFFICIAL RECORD
CM SECRETARY
T 1NORTH,TX