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Home My WebLink AboutContract 45921-CO1 (2) ' City of Fort Worth CITY SECIRMARY Change Order Request CONTRACT NO. �G' Change Order No. Date TPW Project No. Funding(FAC) 1 (One) 1/22/2015 P 195-531060- 023195023002 Facility and Project Description City Secretary Contract No. CONCRETE PADS AT 3 DROP OFF STATIONS 45921 ORIGINAL CONTRACT AMOUNT................................................................ $ 154,700.00 EXTRAS TO DATE..................................................................... $ 0 CREDITS TO DATE.............................................................. $ 0 CONTRACT COST TO DATE.................................................................................................. $ 154,700.00 AMOUNT OF PROPOSED CHANGE ORDER............................................................................ $ 17,234.19 REVISED CONTRACT AMOUNT................................................... .OFFfCIAL R COKI) ......... $ 171,934.19 ORIGINAL FUNDS AVAILABLE FOR CHANGE ORDERS.................. ..CiTY•SECRETARY""""•. $ 37,800.00 REMAINING FUNDS AVAILABLE FOR CHANGE ORDERS....................FT.•WORTNj.TX••• ...-... $ 20,565.81 ADDITIONAL FUNDING (IF NECESSARY)................................................................................ 0 IN ACCORDANCE WITH THIS CHANGE ORDER, THE CONTRACTOR SHALL: Additional site work required, cut and fill as due to site conditions as per the attached PCR. $ 17,234.19 ------------------------------------------------------------------------------------------------------------------------------ Total Add $ 17,234.19 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 Contractor's Name NISSI DEVELOPMENT GROUP INC. Original Contract Time Additional Approved Time To Date Approved Contract Time To Date Additional Time For This Change Order 45 cd , 10 0 cd 0 Contractor-. Date Constr ion Man er vale Chief,Ar itectural Services Division Date Dire, ,Transportation and Public works Date I Project Architect/ Date Assistant�Ky Manager// Date Assista t City Attorney Date Council Action(If Required) Date ❑ Approved ❑ Disapproved ❑ Other Distribution: Mon File AWSWd' °° . Construction Manager o $ Project Manager %O Contractor $ °� o° mmy J. Ka 4 Mmvtmr `� �$��► 0000O00 RECEIVED FEB B 4 7015 NO M&C REQUIRED xA8 es ift., ivision Change Order Form(3/20/12) re Nlssl Development Group inc. Change Order Date: January 14,2015 Invoice CO 1-CP To:City of fort Worth Drop off Concrete Pads ATTN: Alan Bagamery Project Name Job Payment Terms due Date Drop off Pads Old Hemphill Site Additional Work Due upon receipt PVDleer WGR X DESCRIPTION 14 ei al; Labor UNE TOTAL Work from 1 Excavator Rental 6,884.48 $6,884.48 11/24-12/19 2 Roller Rental 1,440.71 $1,440.71 3 Diesel 350.00 $350.00 4 Labor:160 Man-Hours @$22/hr 3,520.00 $3,520.00 Work Estimate 1 Excavator Rental 2,504.00 $2,504.00 from 1/26-1/30 2 Roller Rental 625.00 $625.00 3 Diesel 150.00 $150.00 4 Labor:80 Man-Hours @$22/hr 1,760.00 $1,760.00 Accepted by: Title: Date: TOTAL: $17,234.19 Explanation/Breakdown of Equipment Rentals for Invoice #CO I-CP 1) Excavator Rental: We pay$7099.48 for work from 1 1/24-12/19 including the waiting time. (See attached invoice from United Rentals) Subtract$215 because City shouldn't pay for transportation of equipment. This comes out to be $6884.48. 2) Roller Rental: We pay $1440.71 for work from 1 1/24-12/19 including the waiting time. (See attached invoice from United Rentals) 3) Diesel: Diesel purchased for work. See attached receipts. 4) Work Estimate from 1/26-1/30: Applied one week rental costs in this. 0United Rentals 4 WEEK BILLING BRANCH 537 INVOICE SORT BAST LOOP 820 - # 124052602-001 FORT WORTH TX 76116119-7028 7028 817-483-6411 817-483-0723 FAX Customer # 1296766 Invoice Date Dat out 43 NISSI JOB # 2 Billed Through e 1116 S HUGHES AVE UR Job Loc FORT WORTH TX 7 610 5-18 2 0 UR Job # : 12 Customer Job ID: P.O. # BRIAN WANG h Office: 847-981-4772 Cell: 972-998-3532 Ordered By : BRIAN HWANG oPritten By CYCLE BILL Salesperson CHELSEA WELCH NISSI GROUP Invoice Amount $7,099.48 11498 LUNA RD STE 104 DALLAS TX 7 5 2 3 4-9 4 1 2 Terms: Due Upon Receipt Payment options: Contact our credit office 212-333-6600 Rxt, e REMIT TO: UNITED RENTALS(NORTH AMERICA),INC. PO BOX 840514 DALLAS TX 75284-0514 RENTAL ITEMS: Qty Equipment Description Minimum Day Week 4 Week Amount 1 10086812 EXCAVATOR 43000-49999# 898.00 898.00 2504.00 5797.00 5,797.00 Make: JOHN DEERE Model: 210GLC Serial: 1FF210GXKCE520504 Meter out: 1099.70 Meter in: .00 Rental Subtotal: 5,797.00 SALES/MISCELLANEOUS ITEMS: Qty Item Price Unit of Measure Extended Amt. 1 TRANSPORTATION OF EQUIPMENT [MOVE/MCI] 215.000 EACH 215.00 11/07/14 move unit from 800 timberview court south to 1116 s hughes ave 1 TX UNIT PROPERTY TAX [DRSURTX/MCI] 13.709 EACH 13.71 1 TEXAS DIESEL TAX [TXDSL/MCI] 128.540 EACH 128.54 1 ENVIRONMENTAL CHARGE [ENV/MCI] 75.000 EACH 75.00 1 DELIVERY CHARGE 170.000 EACH 170.00 1 PICKUP CHARGE 170.000 EACH 170.00 Sales/Misc Subtotal: 772.25 Agreement Subtotal: 6,569.25 Tax: 530.23 Total: 7,099.48 COMMENTS/NOTES: CONTACT: BRIAN HWANG CELL#: 972-998-3532 THIS 4 WEEK BILLING INVOICE IS ISSUED SUBJECT TO THE TERMS AND CONDITIONS OF THE RENTAL AGREEMENT,WHICH ARE INCORPORATED HEREIN BY REFERENCE. A COPY OF THE RENTAL AGREEMENT IS AVAILABLE UPON REQUEST. You Can Now Access Invoice History srd Update Purchase Orders Online Page: 1 To Sign Up,contact U9Contro1Support&r.com 0United Rentals 4 WEEK BILLING BRANCH 537 INVOICE SORT BAST LOOP eta s7 # 124203914-002 FORT WORTS TB 7b119-7028 028 817-483-6411 817-483-0723 PAX Customer # 1296766 Invoice Date 41 NISSI JOB # 2 Bi11eduThrough 1116 S HUGHES AVE mt Job Loc FORT WORTH TX 7 610 5-182 0 Cu Job # : 12 .4 Customer Job ID: P.O. # : 1296760 h Office: 847-981-4772 Cell: 972-998-3532 Ordered By : ,UAN RODRIGUEZ Written By DAVID TYLER Salesperson KEVIN STARK N I S S I GROUP Invoice Amount $1,440.71 11498 LUNA RD STE 104 DALLAS TX 7 5 2 3 4-9 4 1 2 Terms: Due Upon Receipt Payment options: Contact our credit office 212-333-6600 Ext B REMIT TO: UNITED RENTALS(NORTH AMERICA),INC. PO BOX 840514 DALLAS TX 75284-0514 RENTAL ITEMS: Qty Equipment Description Minimum Day Week 4 Week Amount 1 89833BRA ROLLER 1.5 TON DOUBLE DRUM SMOOTH 193.00 193.00 625.00 1311.00 1,311.00 Make: WACKER Model: RD12A Serial: 20060709 Meter out: 249.30 Meter in: .00 Rental Subtotal: 1,311.00 SALES/MISCELLANEOUS ITEMS: Qty Item Price Unit of Measure Extended Amt. 1 TX UNIT PROPERTY TAX (DRSURTX/MCI] 3.100 EACH 3.10 1 ENVIRONMENTAL CHARGE [ENV/MCI] 17.040 EACH 17.04 Sales/Misc Subtotal: 20.14 Agreement Subtotal: 1,331.14 Tax: 109.57 Total: 1,440.71 COMMENTS/NOTES: CONTACT: BRIAN HWANG CELL#: 972-998-3532 AM THIS 4 WEEK BILLING INVOICE IS ISSUED SUBJECT TO THE TERMS AND CONDITIONS OF THE RENTAL AGREEMENT,WHICH ARE INCORPORATED HEREIN BY REFERENCE. A COPY OF THE RENTAL AGREEMENT IS AVAILABLE UPON REQUEST. You Can Now Access Invoke Niatoq and Ubrgh Purchase Orden Online Page: 1 To Sign Up,contact URConbo1SupponVurcom 'OJ I Q O Q O p C iO r�66 CDO 6 m y-1 N ¢ O O !R � Off? 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