HomeMy WebLinkAboutContract 43492-CO2 (3). �'��p� � a �' �,
� FORT WOR'I'lI City of Fort Worth C1TV SECRETARI�
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Change Order Request �o��� w�° ----
Project Name HMAC Surface Overlay (2012-16) At Various Locations City Sec # 43492
Client Project #(s) City Project No: 01926 DOE 6861
HMAC Surface Overlay At Various Locations Throughout The City
Contractor JLB Construction L.L.C. Change Order #� Date 5121/2013
City Project Mgr. Kristian Sugrim (817)392-8902 City Inspector Mike Glover
Dept. I TPW I Water I Sewer I I Contract Time
Totals (CDI
Original Contract Amount $966,118.25 $966,118.25 120
Extras to Date $97,274.06 $97,274.06 101
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $1,063,392.31 $1,063,392.31 221
Amount of Proposed Change Order $0.00 $0.00 $0.00 35
Revised Contract Amount $1,063,392.31 $1,063,392.31 256
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 10.07%
MAX ALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25%) $1,207,647.81
JUSTIFICATION (REASONS) FOR CHANGE ORDER
This change ortler is for adtlitional 35 calendar days due to tlelay by Water Department for water line installation on Park hill from Shirley to
Colonial Pkwy.
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�IiY SECR�TARY
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It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents
payment in full (both time and money) for all costs arising out of, or incidental to, the above Change Order.
Contractor's Company Name Contractor Name) Contract S�gnature Date
JLB Construction L.L.C. , � .� �' r}. � ' � � `� - �;,,- - � a..,
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M&C Number
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Council Action (if required ��
M&C Date Approvetl � �
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' RECEIVED JU(� 1$ 201��'�
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�\ FORT wORTH. City of Fort Worth
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Change Order Request
Project Name HMAC Surface Overlay (2012-16) At Various Locations City Sec # 43492
i� Client Project #(s) City Project No: 01926 DOE 6861
Project HMAC Surface Overlay At Various Locations Throughout The City
Description
Contractor JLB Construction L.L.C. Change Order #� Date 5/21/2013
City Project Mgr. Kristian Sugrim (817)392-8902 City Inspector Mike Glover
Contract Time
Dept. TPW Water Sewer Totals CD
Original Contract Amount $966,118.25 $966,118.25 120
Extras to Date $97,274.06 $97,274.06 101
Cretlits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $1,063,392.31 $1,063,392.31
Amount of Proposed Change Order $0.00 $0.00 $0.00
Revised Contract Amount $1,063,392.31 $1,063,392.31
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 10.07%
MAXALLOWABLECONTRACTAMOUNT(ORIGINALCONTRACTCOST+25%) $1,207,647.81
221
35
256
It is untlerstood and agreed that the acceptance of this Change Order by the contractor constitutes an accord antl satisfaction and represents
payment in full (both time antl money) for all costs arising out of, or incidental to, the above Change Order.
Contractor's Company Name Contractor (Name) Contract Signature Date
JLB Construction L.L.C.
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Inspectorllnspection Supervis�r , ,, ; D�te Project ManagerlProgram Manager Date
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Assistant Director (Dept ' Date' � Director, Contracting Department (Dept) Date
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Assistant�City.�Attorney � Date Assis�ant City Manager ` Date
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"�� yFORT WORTH. City of Fort Worth �
Change Order Request ` ' r �� � � ' ` t �
Project Name HMAC Surface Overlay (2012-16) At Various Locations City Sec # 43492
Client Project #(s) City Project No: 01926 DOE 6861
Project HMAC Surface Overlay At Various Locations Throughout The City
Description
Contractor JLB Construction L.L.C. Change Order# �2 Date 5/21/2013
City Project Mgr. Kristian Sugrim (817)392-8902 City Inspector Mike Glover
Dept. � TPW � Water � Sewer
Original ContractAmount $966,118.25
Extras to Date $97,274.06
Cretlits to Date
Pentling Change Orders (in M&C Process)
Contract Cost to Date $1,063,392.31
Amount of Proposed Change Order $0.00 $0.00 $0.(
Revisetl Contract Amount $1,063,392.31
Original Funds Available for Change Orders
Remaining Funds Available for this CO $0.00
Additional Funding (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONEJ AS % OF ORIGINAL CONTRACT
MAX ALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST + 25%)
Contract Time
Totals CD
966,118.25 120
$97,274.06 101
31
00
10.07%
$1,207,647.81
221
35
256
It is understood antl agreed that the acceptance of this Change Ortler by the contractor constitutes an accortl 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 Company Name Contractor (Name Contract Si nature Date
JLB Construction L.L.C. C,, ; z.,�
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Inspector/Inspection Supervisor ` , Date Project Manager/Program Manager Date
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Assistant Director (Dept) i 1 �� Date � Director, Contracting Department (Dept) Date `���
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Assistant City Atto ney Date Assistant City Manager Date �
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Council Action (if required , `j
M&C Number M&C Date Approved � `" ��'
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� FORT WORTH City of Fort Worth
Change Order Request
Project Name HMAC Surface Overlay (2012-16) At Various Locations City Sec # 43492
Client Project #(s) City Project No: 01926 DOE 6861
Project HMAC Surface Overlay At Various Locations Throughout The City
Description
Contractor JLB Construction L.L.C. Change Order #�2 Date 5/21/2013
City Project Mgr. Kristian Sugrim (817)392-8902 City Inspector Mike Glover
Contract Time
Dept. TPW Water Sewer Totals CD
Original Contract Amount $966,118.25 $966,118.25 120
Extras to Date $97,274.06 $97,274.06 101
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $1,063,392.31 $1,063,392.31 221
Amount of Proposed Change Order $0.00 $0.00 $0.00 35
Revised ContractAmount $1,063,392.31 $1,063,392.31 256
Original Funtls Available for Change Orders $0.00
Remaining Funtls Available for this CO $0.00
Additional Funding (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 10.07%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $1,207,647.81
It is understootl and agreetl that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents
payment in fuil (both time antl money) for all costs arising out of, or incitlental to, the above Change Order.
Contractor's Company Name Contractor (Name) Contract Signature Date
JLB Construction L.L.C. ' ,.
Inspector/Inspection Supervisor Date Project ManagedProgram Manager Date
Assistant Director (Dept) ' Date Director, Contracting Department Dept) Date
Assistant City Attorney Date Assistant City Manager Date
Council Action (if requiretl
M&C Number M&C Date Approved �
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MiWBE Breakdown for this Change Order
MWBE Sub ' Type of Service Amount for this CO '
Total ( ; $0.00
Previous Chanae Orders
Co# ( DATE � AMOUNT
Total � $0.00
PROJECT SUIVIMi4RY SH ET
(Change Order Attachment)
PROJECT NAME:
BuySpeed No:
Contract No:
D.O.E. No:
Attachment to Change Order No:
Today's Date:
Original Contract Amount:
Extras to Date:
Credits to Date:
HMAC Surface Overlay 2012-16
CS43492
6$61
2
6/12/13
Contract Amount to Date:
Amount of Proposed Change Order:
Revised Contract Amount:
Contingency Funds Avail. for Admin. Change Orders
Remaining Funds Available for Change Orders:
Additional Funding (if necessary):
.
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35 Calendar days
,,
,,
1,Q63,392.31
1,063,392.31
(97,274.06)
Prepared By: Karen Striker - T/PW Business Support