HomeMy WebLinkAboutContract 57089-CO1 CSC No. 57089-001
FOR_ _T WORTH,., City of Fort Worth
Change Order Request
Project Name CC Moss and ML Phillips SRTS Improvements City Sec# 1 57089
Client Project#(s) City Project Number 102411-TxDOT CSJ 0902-90-084
Project Description SRTS project improvements including construction of new and reconstruction of existing sidewalks,curb ramps,driveways,curb and gutter,small retaining
walls,signs,crosswalks and pavement markings within an approximate quarter mile of both the C.C.Moss and M.L.Phillips Elementary School Campuses.
Contractor Northstar Construction,LLC Change Order# 1 Date
City Project Mgr. Brendan McInnes,PE City Inspector F Matt Cain
Contract Time
Dept. TPW Totals (CD)
Original Contract Amount $1,449,726.40 $1,449,726.40 270
Extras to Date $0.00 0
Credits to Date $0.00 0
Pending Change Orders(in M&C Process) $0.00 0
Contract Cost to Date $1,449,726.40 $1,449,726.40 270
Amount of Proposed Change Order $58,721.00 $58,721.00 0
Revised Contract Amount $1,508,447.40 $1,508,447.40 270
Original Funds Available for Change Orders $144,972.64 $144,972.64
Remaining Funds Available for this CO $144,972.64 $144,972.64
Additional Funding(if necessary)
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 4.05%
MAXALLOWABLE CONTRACTAMOUNT(ORIGINAL CONTRACT COST+25%) $1,812,158.00
JUSTIFICATION(REASONS)FOR CHANGE ORDER
This change order is necessary in order to make revisions to the contract to compensate the contractor for removing 6-12"trees in ROW,adjusting irrigation and water service
(paid by invoice with markups per TxDOT Spec 9L),and placing new meter boxes in location where the existing ones could not be salvaged.Contractor has submitted prices for
the added work,and it was reviewed and determined to be fair and reasonable for the scope.
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.
Contractor's Company Name Contractor(Name) Contract Signature Date
�ila�aLA Pf011/Z/6I1 Aug2,2022
Northstar Construction,LLC Mike Hiemlich n,,,,. IT, g
Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date
"4�l%^� Aug 21,2022 Aug 22,2022
���>� .,ar,-�.,
Program Manager Date Senior Ca ital Project Officer Date
Aug 31,2022 4�/ Aug 31,2022
Assist Date Director, ment(Dept) Date
Sep 1,2022 Sep 2,2022
Assistant City Attorney Date Assistant City Manager Date
Sep 2,2022 &Ww- Sep 5,2022
Council Action(if required)
M&C Number M&C Date Approved
ATTEST: 7GZ�LfLBEE S. gdG4FOI;paT
Jan nette S.Gooda[I(Se 6,202209:26 CDT) .p
P O°°OppO oo°00�"
Jannette Goodall,City Secretary pp�o %O��d OFFICIAL RECORD
p/6 o
vg 0 CITY SECRETARY
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FORT WORTH City of Fort Worth
V-- Change Order Additions
Project Name CC Moss and ML Phillips SRTS Improvements City Sec# 57089
Client Project# City Project Number 102411-TxDOT CSJ 0902-90-084
Contractor Norlhstar Construction,LLC PM Brendan McInnes,PE Inspector7 Matt Cain
Change Order Submittal# 0 Date
ADDITIONS
ITEM DESCRIPTION Oty Unit Unit Cost Total
47 7049.6195 WATER METER BOX TRW 20.00000000 EA 651.05 13,021.00
48 9608.6001 Unique Change Order Item 41 Utility Adjustments(UOM:DOL) TPW 50,000.00000000 SY $1.05 50 00.0D
49 9100.6003 Prep ROW Jree)(Y to 12"D A) TRW 2.00000000 CY $6DO.05 1,200.00
TPW $64,221.05
Sub Total Additions 64,221.OD
Change Order Additions Page 2 of 4
FORT WORTH City of Fort Worth
IV- Change Order Deletions
Project Name CC Moss and ML Phillips SRTS Improvements City Sec 4 57089
Client Project 4 City Project Number 102411-TxDOT CSJ 0902-9D-084
Contracto Northstar Construction,LLC PM Brendan McInnes,PE Inspector Matt Cain
Change Order Submittal 0 Date O
DELETIONS
ITEM DESCRIPTION DEPT City Unit Unit Cost Total
13 04791 Adjusting Manholes(Water Valve Box) TPW 20.00000000 CY 275.00 5,500.00
TPW $5,500.00
II
Sub I otal Deetions 5,5 00.00
Change Order Deletions Page 3 of 4
MISBE for this Change Order
MISBE Sub Type of Service Amount for this CO
Total $0.00
Previous Change Orders
co# DATE AMOUNT
Total $0.00
INSTRUCTIONS FOR PREPARING THE CHANGE ORDER (Local Agency)
The following information is provided to assist you in preparing the Change Order(CO).
1 Insert the Contractor's name as it appears in the contract.
2 Insert the work limits for the Change Order.
3 Indicate if a change is major or minor.
4 Give a narrative of the revised work being authorized in the change order.
If the CO affects pedestrian elements,state in the narrative that a copy of this CO must be sent to the Field Coordination
Section of the Design Division.
Address time by one of the following methods:
1)Add the time extension number and time in the box provided.
2)State in the narrative that no time is added by this CO.
3)State in the narrative that time will be addressed later in the project when the time impact of the change order is
better known.
Methods 1 and 2 are preferred.Method 3 should not be a normal practice. If time can not be agreed on with the
contractor upon execution of a CO,method 3 is acceptable. In this case,time associated with this CO will be non-
participating until the time justification is provided.
5 Attach any new/revised plan sheet(s).
6 For TxDOT use only. The TxDOT representative must designate if this change order is participating by providing a value
for the days and amount participating. If the change order is non-participating,enter a zero"0"in the fields.
7 Direct the contractor to sign in the contractor's signature block.
8 Affix the seal of the authorized local representative in the space located at the left corner of the bottom of the CO Form.
Adhere to Change Order Approval Policy of local agency.
TXDOT Form 2146-L INSTR (Rev.10/11) Page 1 of 1
Form
ion46i CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: 001
Page i of 1
I.CONTRACTOR: Northstar Construction,LLC CCSJ: 0902-90-084
2.Change Order Work Limits:Sta. ENTIRE PROJECT to Ste. ENTIRE PROJECT STP 2022(069)TP
Project.
3.Type of Change(on federal-aid non-exempt projects): Minor (Major/Minor) Highway: VA
4.Describe the change and the reason for the change order.When necessary,include County: TARRANT
exceptions to this agreement
District: FART WORTH
This change order is necessary In order to make revisions to the contract to
compensate the contractor for removing 6-12"trees In ROW,adjusting Irrigation
and water service(paid by invoice with markups per TxDOT Spec 91.),and placing Contract
new meter boxes in location where the existing ones could not be salvaged. Number.
Contractor has submitted prices for the added work,and it was reviewed and
determined to be fair and reasonable for the scope.
5.New or revised plan sheet(s)are attached and numbered: N/A
Each signatory hereby warrants that each has the authority to execute this Change Order.
By signing this change order,the contractor agrees to valve anyand all The following information must be provided
claims for additional compensation due to arty and all other expenses;
additional changes for time,overhead and profit;or loss of compensation Time Ext# 0 Days added on this C 0: 0
as a result of this change Further,the contractor agrees that this agreement
is made In accordance with item 4 and the Contract receptions should be
noted In the response for rs above. Amt.added by this change order. $58.721.00
For TxDQT use only:
THE CONTRACTOR Date Aug 12,2022 Days participating:
By+�l�w,:lr.xonl�:acm1 Art tnt articipatlng:
Typed/Printed Name Michael A.Heimlich vv- ✓L Z 7 Z3
Sig re Date
Typed/Printed Title President �1 S s�- A,-e, -L
NameMtle
RECOMMENDED FOR EXECUTION:
Mate g 21. 0222P03C01] Aug 21, 2022 l6u'{:4'binlanm5r[POI+>ut3l,muts:rt<nti---Aug 31, 2022
Name/Title Inspector Date Namefritle Interim Sr.CPO Date
®APPROVED rl REQUEST APPROVAL
"UL, Aug 30, 2022 7> P Sep 1, 2022
Name/Tltle project Manager Date Name/ntle interim Assistant Director Date
®APPROVED REQUEST APPROVAL
offilri Diit+cNiSec2.2�12 t5:�2CDt� Sep 2, 2022 �P— Sep 2, 2022
Name/Title Sr. Assistant City Attorney Date Name/Title Interim Director-TPVV Date
®APPROVED F1 REQUEST APPROVAL
skb.°2022 09,296�DT, Sep 6, 2022 y,;,,;,mlo,,,wois 5.20�=08:43EDT)
11) Sep 5, 2022
Nam&Title City Secretary Date NameMtie Assitant City Manager September 5 2022 Date
®APPROVED
Engineer's Seal
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102411 -CNCO-Construction Change Order
No. 1 — CC Moss and ML Phillips SRTS
Improvements
Final Audit Report 2022-08-29
Created: 2022-08-10
By: Andrea Munoz(Andrea.Munoz@fortworthtexas.gov)
Status: Canceled/Declined
Transaction ID: CBJCHBCAABAA3DLvv7t26jvWQoFKMEYsdzubGMB6J7yM
"102411-CNCO-Construction Change Order No. 1 — CC Moss a
nd ML Phillips SRTS Improvements" History
Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov)
2022-08-10-2:29:51 PM GMT-IP address:204.10.91.100
Document emailed to Sara.Cox@fortworthtexas.gov for filling
2022-08-10-3:45:21 PM GMT
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Signer Sara.Cox@fortworthtexas.gov entered name at signing as Sara Cox
2022-08-11 -4:52:30 PM GMT-IP address: 204.10.91.100
Form filled by Sara Cox(Sara.Cox@fortworthtexas.gov)
Form filling Date:2022-08-11 -4:52:31 PM GMT-Time Source:server-IP address:204.10.91.100
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Signer mike@northstar93.com entered name at signing as Michael A. Heimlich
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Signature Date: 2022-08-12-5:49:37 PM GMT-Time Source:server-IP address:75.140.227.86
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Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) added mcain@multatech.com as an alternate for
matt.cain@fortworthtexas.gov
2022-08-19-10:13:30 PM GMT-IP address:204.10.91.100
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4�o Signer brendan.mcinnes@fortworthtexas.gov entered name at signing as Brendan McInnes
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Signature Date: 2022-08-22-12:33:00 PM GMT-Time Source:server-IP address:70.241.106.163
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Doug,per Vania's request,is it okay to replace the TxDOT
change order (57089-001) on the CSCO website with this
change order?
FORT WORTH,
This version combines the TxDOT and CFW change orders
into one file. Thanks,Andrea
Routing and Transmittal Slip
Transportation & Public Works
Department
DOCUMENT TITLE: Construction Change Order No. 1-CC Moss and ML Phillips
SRTS Improvements
M&C: 21-0972 CPN: 102411 CSO: 57089 DOC#: 1
Date:
To: Name Department Initials Date Out
1. Bus. Support Partner-Sara Cox TPW-initial .-212 Aug 11, 2022
2. Michael A. Heimlich-Contractor Contractor MAH
40,t Aug 12, 2022
3. Matt Cain-Inspector TPW- sign Mc aLAug 21, 2022
4. Brendan McInnes-Project Manger TPW-initial BR Aug 22, 2022
5. Chad Allen-Contract Compliance Mngr TPW- sign CA Aug 30, 2022
6. Lissette Acevedo-Program Manager TPW- sign A Aug 31, 2022
7. Martin Phillips-Acting AD TPW- sign MAP Sep 1, 2022
8. Lauren Prieur-Acting Director TPW- sign «, Sep 2, 2022
9.
10. Doug Black-City Attorney Legal- sign a Sep 2, 2022
11. William Johnson ACM CMO - sign w�.Lil
Sep 5, 2022
12. Jannette Goodall- CSO CSO- sign 4 Sep 6, 2022
13. TPW Contracts TPW
DOCUMENTS FOR CITY MANAGER'S SIGNATURE: All documents received from any
and all City Departments requesting City Manager's signature for approval MUST BE ROUTED
TO THE APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip,
David will review and take the next steps.
NEEDS TO BE NOTARIZED: []YES ®No
RUSH: []YES ®No SAME DAY: []YES ®No NEXT DAY: []YES ®No
ROUTING TO CSO: ®YES ❑No
Action Required: ❑ Attach Signature,Initial and Notary Tabs
❑ As Requested
❑ For Your Information
® Signature/Routing and or Recording
❑ Comment
❑ File
Return To: TPWContract5(LDfortworthtexa5.000v, for pick up when completed;list"Please call Brendan Cv
ext#2817 for questions. Thank you."
102411 -CNCO-Construction Change Order
No. 1 — CC Moss and ML Phillips SRTS
Improvements
Interim Agreement Report 2022-09-16
Created: 2022-08-29
By: Andrea Munoz(Andrea.Munoz@fortworthtexas.gov)
Status: Out for Filling
Transaction ID: CBJCHBCAABAAOOBhKSwAhOgtzbEXMWUbXdRtgi2PtvuN
Agreement History
Agreement history is the list of the events that have impacted the status of the agreement prior to the final signature.A final audit report will
be generated when the agreement is complete.
"102411-CNCO-Construction Change Order No. 1 — CC Moss a
nd ML Phillips SRTS Improvements" History
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102411 -CSCO-Construction Change Order
No. 1 — CC Moss and ML Phillips SRTS
Improvements
Final Audit Report 2022-09-28
Created: 2022-09-27
By: Andrea Munoz(Andrea.Munoz@fortworthtexas.gov)
Status: Canceled/Declined
Transaction ID: CBJCHBCAABAAwh1tDIOJ3CUSssvGIJ8CJK0-B6G210tu
"102411 -CSCO-Construction Change Order No. 1 — CC Moss a
nd ML Phillips SRTS Improvements" History
Document created by Andrea Munoz (Andrea.M u noz@fortworthtexas.gov)
2022-09-27-9:49:29 PM GMT-IP address:209.194.29.100
Document emailed to Douglas.Black@fortworthtexas.gov for filling
2022-09-27-9:53:12 PM GMT
Email viewed by Douglas.Black@fortworthtexas.gov
2022-09-28-3:12:20 PM GMT-IP address:209.194.29.100
Document declined by Douglas.Black@fortworthtexas.gov
Decline reason:i don't know how to check the box"approved".you don't need it if you have my initials.
2022-09-28-3:14:13 PM GMT-IP address:209.194.29.100
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