HomeMy WebLinkAboutContract 36695-CO1 (2) CITY SECRET
FoRTWORTH. City of Fort Worth CONTRACT NO, 95—
Change Order Request
Project N Sidewalk Contract Renewal#2—DOE ti5t34 City Sec# I 3105M
Client Project#(sJ GG01-539l5M 040M
Project Dewrlpftf 9 Replac nwM
Co Macval and Associates Change Order# Date 4/24/2011
City Project mgr.1 Rind Ntrsrallatr City Inspector Luisa Allbright
Contract Time
Dept TPW Water Sewer WO
Original Contract Amount W3,4'1.M $113,411.39
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date 13,411.39 $113,411.39
IGo to AW&0SL Tabs to 11riter 0arkup PITOWN,
RVmed Contract Anxwnt
Original Funds Available for Change Orders 5800.00 $8,000,00
Remaining Funds Available for this CO WODD,00 $8,000,00
Additional Funding(if necessary) ,1 3_�0 $2,089.50
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT iIG
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%1
This change order is to request addwtat funds to pay im ovemns on ft taro line items hstod.
F��a OFFICIAL RECORD
A'p�� �°�o�D����� CITY SECRETARY
p�0 o�
FT. WORTH, TX
It
TO Attested by:
ft
;&60V
§l
c, Marty Hendrix, Secre y
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.
Macval and Associates imA —a-
i
-a�_l rs✓�- _5 / �� �
-3Ptj tj 3 ZoI
,. .
011
1`
M&C Number M&C Date Approved
1 P03:53 IN _ y
Xl `HISOM Id
AHVIM33S A110
MOM IVIOIJJ0
� g
IR
co
CD
0
N
N O C
O
c -
N N
U c o
c
L
cm
.c
� L
Q
ca
fn
J
d
O a-1
O
a) O
yUy
cC n
L C �
U _ m
C i5 a
O
c
h O
013 Z EL CL
4-1
D �
00
U.
o °
tio
Z�0)
t
V o
0
N
(C
NW
C a)( � (C
O U
W O c
O Q W
Lo N N
Y m w = o
m 9 m Z m
'o v m mLi
3
CD
a>
O> d c
O
3 Z p^a c
U c V O� O
a)
o U U n
d a
fir U 'o U
a
Xl `HiSOM Old
ANVi3H33S A110
CIHO33H iviollj0
SS
c
co
co
N
N � C
� � O
c y
I m N
U 0 a_ ca � o
c �
L
cn
� L
a
o
o
O U
L6 d
L U) G1
U c o0
C U JLJa
t O
O O
3o W o
om w
U. o
4- 0
m
Z�m
t
V o
0
N
ft
fC
N04
CD Z
a CC� E ld
O
N O U
co CD ca
C CDd QLO
f6
ti
lL1 —co
fd
7
>CD Z
v m v
05 c� in m
x
F m � o o rn
G m (D CL
Z p^ c
3 d c N O
OFC o 4) U d
Lo a U o U
MMBE Breakdown for this Change Order
MWBE Sub Type of Service Amount far this CO
Total 0_00
Previous Change Orders
CO# DATE AMOUNT
Total $0.01
OFFICIAL RECORD
CITY SECRETARY
FT,WORTH, TX
PROJECT SUMMARY SHEET
(Change Order Attachment)
PROJECT NAME: Sidewalk Contract-Group 5, 2nd Renewal
BuySpeed No: PO-11-00063980
Contract No: CS36695412
City Project Number. NIA
D.O.E. No: 6584
Attachment to Change Order No: 1
Today's Date: 4128111
TOTAL
Original Contract Amount $ 113,411.39
Extras to Date: $ -
Credits to Date: $ -
Contract Amount to Date: $ 113,411.39
Amount of Proposed Change Order. $ 10,089.50
Revised Contract Amount $ 123,500.89
Contingency Funds Avail. for Admin. Change Orders: $ 8,000.00
Remaining Funds Available for Change Orders: $ 8,000.00
Additional Funding (if necessary): $ (2,089.50)
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
Prepared By: Christy Ezemack T/PW Construction Services
PROJECT SUMMARY SHEET
(Change Order Attachment)
PROJECT NAME: Sidewalk Renewal#2- DOE 6684 Contract/CS36695-R2
D.O.E. No.: 6684
Attachment to Change Order No.: 1
Today's Date: 513111
TOTAL
Original Contract Amount: $ 113,411.39
Extras to Date: $ -
Credits to Date: $ -
Contract Amount to Date: $ 113,411.39
Amount of Proposed Change Order: $ 10,089.50
Revised Contract Amount: $ 123,500.89
Contingency Funds Avail. for Admin. Change Orders: $ 8,000.00
Remaining Funds Available for Change Orders: $ 8,000.00
Additional Funding (if necessary): $ 2,089.50
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX