HomeMy WebLinkAboutContract 51361-CO1 CITY SECRETARY
CONTRACT NO. �5 13 b I-GU I
FQRTWORTH. City of Fort Worth
Change Order Request
Project Namel Fort Worth Concrete Restoration 2019-2 At Various Locations City Sec# 1 51361
Client Project#(s)l 101603
PM*i Fort Worth Concrete Restoration 2019-2 At Various Locations
Description
Contractor Urban Infraconstruction LLC Change Order# �9� Date 5/3/2019
City Project Mgr.J Shammi Rahman City Inspector Brian Mcgill
Dept. TPWStorm Contract Time
Water Totals MDl
Original Contract Amount $605,790.00 $605,790.00 150
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $605.790.00 $605,790.00 150
Go to ADD&DEL Tabs to Enter CO Backup $0.00 21
Revised Contract Amount $605,790.00 $605,790.00 171
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0,00
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%) S757,237.50
The original locations on the Concrete Restoration contract are complete and additional funds remain.A fund balance of$75,000 will be
allocated to make necessary concrete repairs to Lake Country Drive(western lakes dr to golf club dr)on approximately 582 square yards of
pavement.The supplementary work will require the addition of twenty-one(21)calendar days to the contract.
Wald P. Gonzales, s City seavtar<y
•rEXAs
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.
Urban Infraconstruction LLC Anup Tamrakar
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M&C Number M&C Date Approved RECORD
Mai SECRETARY
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M/WBE Breakdown for this Change Order
MWBE Sub Type of Service Amount for this CO
N/A
Total $0.00
Previous Change Orders
CO# DATE AMOUNT
None
Total $0.00
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
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX