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HomeMy WebLinkAboutContract 55385-CO2CSC No. 55385-CO2 FORT WORTH,., City of Fort Worth Change Order Request Project Name Westport Parkway - Altavista to Keller Haslet City Sec # I 55385 Client Project #(s) I 101019 Project Description I New 4-lane arterial roadway including shared use paths, lighting and storm drainage between roundabouts at Keller Haslet Rd and Altavista Blvd Contractor) Jackson Construction, Ltd. ChangeOrder#2 Date) 11/22/2023 City Project Mgr. l Bereket Birhane City Inspector Kevin Jackson Dept. Water 1060043 Sewer 10700430 TPW 10200431 Totals Contract Time (CD) Original Contract Amount $377,881.00 $9,875.00 $2,990,879.75 $3,378,635.75 240 Extras to Date $0.00 $0.00 $51,602.05 $51,602.05 Credits to Date $0.00 $0.00 $0.00 Pending Change Orders (in M&C Process) $0.00 $0.00 $0.00 Contract Cost to Date $377,881.00 $9,875.00 $3,042,481.80 $3,430,237.80 240 MAmount of Proposed Change Order $0.00 $0.00 $16,397.49 $16,397.49 84 Revised Contract Amount $377,881.00 $9,875.00 $3,058,879.29 $3,446,635.29 324 Original Funds Available for Change Orders $18,894.00 $988.00 $464,317.00 $484,199.00 Remaining Funds Available for this CO $18,894.00 $988.00 $412,714.95 $432,596.95 Additional Funding (if necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 2.01 % MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $4,223,294.69 JUSTIFICATION (REASONS) FOR CHANGE ORDER This change order includes the following Items of work: A- Additional excavation and backfill needed to expose and adjust water valve discovered during construction (Item 111-96). Requesting 15 days. B- Additional portable changeable message board used during temporary closure of Ponderosa Ranch Road and Keller Haslet Road (Item 111-97). C- Reimbursement for connection fee paid to Tri-County Electric for street light electrical service (Item 111-98). D- Re -mobilize to adjust fencing location on Jameson property (Item 111-99). Requesting 10 days. E - Object markers installed on new street light poles (Item 111-100). Requesting 5 days. E - Additional contract time due to tree protection and cattle removal (9 days), cement shortage (24 days), 66" storm drain pipe delivery (12 days), water department coordination for extra valve (10 days), water valve adjustment (5 days), extra fence installation (10 days), extra sign procurement and installation (5 days), adjusting last chargeable construction day from 5/17/23 to 5/12/23 (5 days), deducting days charged between 4/7/23 water valve final and 4/11/23 (4 days). 84 days total. Staff and consultant team evaluated proposed unit prices using recent City, TxDOT and other unit price sources and found them to be reasonable 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. Jackson Construction, Ltd. Troy Jackson Nov 29, 2023 Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date Nov 29, 2023 s K� - r Nov 29, 2023 Program Manager Date . 6it Officer Date Dec 1, 2023 Dec 1, 2023 Assistant Director (Dept) Date Director, Contracting Department (Dept) Date w Dec 4, 2023 Dec 4, 2023 mey Date Dec 4, 2023 Assistant City Manager Date Dec 5, 2023 M&C Number N/A I M&C Date Approved N/A ATTEST: Jannette Goodall, City Secretary OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX mar LW-0 " City of Fort Worth Change Order Additions Project Name I Westport Parkway- Altavista to Keller Haslet ' City Sec# 55385 1 Client Project# •101"'0 • • • • • • _____ • • • •I _________ • • —_—_ ConVactor • Jackson Construction, Ltd. • • • PM B e ie kt B i h an �� T Inspector Kevin Jackson CJ I • Change Order Submittal# —1 Date 11/22/2023 ADDITIONS ITEM DESCRIPTION DEPT Qjy Unit UnilCost Total 111-96 ITcKoosel backfill & recompact water valve trench per COFTW directive TPW / 0200431 j �0000000 EA $8,480.61 $8\\480.61 111-97 Special Signage per COFTW (PCMB for Residential Notification) TPW / 0200431 1.00000000 EA $914.25 $J14.25 111-98 Independent Utility Construction (Tri-County Electric) - reimbursement TPW / 0200431 1.00000000 EA $4,017.63 $4 017.63 111-99 Re -mobilization (fencing reQuested by COFTWI TPW/ 0200431 1.00000006 EA $1,200.00 $600.00 111-100 Object Mali<ersfor Light Poles TPW 0200431 3.00000006 EA, $595.00 $1,785.00 Water%060043 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 $0.001 Sewer/ 0700430 $0.001 I TPW10200431 $16,397.491 Sub Total Additions 1 $16,397.491 Change Order Additions Page 2 of 4 FORTTnRTH City of Fort Worth J Change Order Deletions Project Name I Westport Parkway -Altavista to Keller Haslet City Sec # 55385 Client Project# 1 101019 1 Contractor Jackson Construction, Ltd. I PMI Bereket Birhane I Inspectorl Kevin Jackson Change Order Submittal # 0 Date 1 11/22/2023 1 DELETIONS I I LM ULb(;HIP I ION ULP I uty Unit Unit cost I otal Water /060043 $0.00 Sewer/0700430 $0.00 TPW 10200431 $0.00 Sub Total Deletions $0.00 Change Order Deletions Page 3 of 4 * Jackson Construction, Ltd. Change Order Request Item Description Project: City: County: Project #: Quantity UM Bid Price Westport Parkway Fort Worth Tarrant 101019 Amount Add Expose, backfill & recompact trench per COFTW directive 1.000 EA $ 8,480.61 $ 8,480.61 Add Special Signage Per COFTW (Residential Notification) 1.000 EA $ 914.25 $ 914.25 Add Independent Utility Construction (Tri-County Electric) 1.000 EA $ 4,017.63 $ 4,017,63 Add Re -mobilization (fencing requested by COFTIM 1.000 EA $ 1,200.00 $ 1,200.00 Add OM -Marker Installed on Existing Light Post 3.000 EA $ 595.00 $ 1,785.00 Total $ 16,397.49 Page 1 of 1 7/14/2023 10:01 AM J&CKSON CONSTRUCTION LTD. Force Account Daily Time and Material County Tarrant Project Westport Parkway __- City _- Fort Worth Location _. Westport Parkway Now Location Description of Work: EKpose, bacAli the excavated french aftriocating the exIsUng water valve per the COFTW dlfocffve, EQUIPMENT Labor Description Hrs Rate Amount _-.___Hours Rate Amount Reg. O.T. Reg. O.T. Caterpillar 322 Trackhoe i . - _ 6.001 $ .121.41-, $_ _ _ 728.46 (1) Foreman 10.00' _ $ 45.00 I S - , _ $ _. 450.00 Caterpillar 938 Loader_ -_ ., _ __ ; _ _6.0--- 80.20 , $ -_ 481`20 (1) Trackhoe Operator •_. _. - _ •..._ _- . _ 6.00 $ 24.00 ;_$ _ _ ... _$ 14- 00 Pickup __. I 10A01349.12-i $ 491.20 (1)LoaderOperator 6.00: $ 22.00 ` $ _. $ 132.00 - - _-__!_$ _ _ ._ . (3) Concrete Finisher _ _ 30.00 J $_ 26.00_ -$ $ 780.00 $ (5) Concrete Fm;sher Helper 60.00 $ 21.00 ! $ i i.$.. ... $- $ ... Sub -Total! S 1,700.86 Sub -Total $ 2,556.00 15%I S 255.13 55% $ 1,405,80 Total Equipment: $ 1,955.99 15%' $ 383.40 Total Labor. $ 4,345.20 Material Subcontract Description Quantity UOM Rate Amount Quantity; UOM Rate Amount Cfisi C Concrete 3.50 i CYT $ _._ 38.00 ;-•$ _. 133.00 Breakout Sawcut (Minimum Charge) _ _. 1.00 Ea $_ .. 500.000 $ 500.00 Reinforcing Steel _ _ i $ Trailer Trucking (Minimum Charge) 4.00 Hr $ 150.000 $ 600.00 Straight. Tie Bars w- _ 1 4 $ Silicone Sealer (Minimum Charge) _ 1.00 Ea $_ 750 000 $ 750.00 - _. Drill Bit Two Part Epoxy _ UPCHARGE FOR $._ $.._ P_aving Chairs _ _ REDI-MIX CONCRTE 1$ - - - $ 2 x 12 Form Lumber $ $ - . _ --- --_-- MINIMUM CHARGES _.$ THAT WILL BE $ Sub-Toial', $ 133,06 INCCURED Sub -Total!, $ 1,850.00 15%> $ 19.95 5% $ 92.50 Total Material:; $ 152.95 Total Subcontract: $ 1,942.50 Approved: Steve 3-Caherstroh JACKSON CONSTRUCTION LTD. Dale 05/25123 Dale JACKSON CONSTRUCTION JOB 4 3274 Summary Labor $ 4,345.20 Equipment $ 1,955.99 Material $ 152.95 Subcontract $ 1,942.56 Bond 1% $ 63.97 Total This Sheet $ 8,490.61 6/212023 10:25 AM 101019 Westport Parkway Change Order #2 — Fence and Object Markers on Jameson Property �u r.�j.,� � , �, �. ;ti { ,.� ,,� 1•dk«err ,�; e� +'¢,� � . 3 a� � _ v���-µ� / � ' i��� � FLr 7. t y ♦„T� _. 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'\� INGA WESTPORT PARKWAY Y \ INSIALL TYPE B PULL HI)X srElo xo WITH APRON X O Nj EaclnOL N=7039766.60 E=7039664.70 IICAUTIONII eHi OVERHEAD reonownr Gwwe ELECTRIC +pworroM ` a ci N rn , I �{ OVERHEAD / I , TRANSMISSION t- I M� o zs- ' � o - a + T-20 % ' 0 1 4STA 7-65.40, 35.75' FIT W ESQ P WESTPORT PARKWAY ' t .INSTALL LIGHT POLE AND / / IICAUTIONH OVERHEAD TRANSMISSION o , LOST SPURS , PARK - STA 75 35 75' LT = -_ PORT WESTPORT PARKWAY INSIALL TYPE U PULL b X, WITH APRONLX/ X X X _- REVISIONS Ixa A DLacmPTMx wATE r` II A N 12 A Y ly 0 MEN mom HALFF® 000 TBPE FRM NO.F-312 4000 FOSSIL CREEIt BLVB FORTL 1TD THtT<22 AS 76137-2797 FAX (517)232-9784 DOCUMENT wAS AIpTHORIZTRIO AE Of fl, BY JACOBT HAYS B 12751 O h1i"• tigfR�� sEgLEo OOLIILMENT"THOFIT PROPER NOTIFICATION TO THE %�:.................. .:�% RESPOSE IBLE ENTINEERI SSAN JACOB T. XAYS UNDER Z %••••••••121558••••••'••% EREINEERINNOG PRAY OF EACT . ,�T�'45�'+n'CENSE�V••�_� OFFICES OF 1, 11LEATTHTHIEIF TE U INC.I40000FOSS GTX REEK137 TBLVD'S W AUGUST20, 2D2D FIRMTRwPE H' � a CONSTRUCTION NOTES NOTE, RETTAIRII:GOWALLIS LAND STRE101CBRESEUNLESS OT XISE NOTED 'BTILITES. E.) NOTE: CONTRACTOR SIWLL LOCATE. VERIFY WORKING CONDITION AND PROTECT ALL SPRINKLER SYSTEMS. REIAOVE QJUST. REINSTALL AND/OR REPLACE EW TO OR BETTER THAN EXISTINO CONDITION AT NO EXTRA PAY. THE CONTRACTOR SHALL CONTACT THE FOLLOWING AT LEAST 48 HOURS PRIOR TO EXCAVATING AT EACH LOCAT%HN ATBT 1- 0-BT 41" FORT WORTH WATER 0 81: FELD OPERATIONS OF7)392-8296 FORT WORTH T&Pw TI "I".ATMOS ENERGY 01111215-4366 ONCOR OAS & ELECTRIC 18171215-R214 T%U ENERGY 1-800-233-2133 E=2340706.7$ / i INS, ALLn LIGH In PULC ANU SBC TELEPHONE 18171JJB-6819 / ! �`• FOUNDATION' Q LLAROTIHEROF CLRES 1-8—DO-TM363 E-234oB44.33� + HORIZONTAL & VERTICAL CONTROL —ta - T-1( �, .�, RIO R9 _________1IT. _________ NOTES: '' F- \� T-07 �RI1I v T-DB Q 1. PRIOR TO ANY WORK, IT SHALL Z V � �,,99 BE THE RESPONSIBILITY OF THE W Il_00 12, 0 — _oy3+OV 14+00 — _ — 151 0 — — —16 CONTRACTOR TO LOCATE AND A_ppq 2 — U% VERIFY ON -SITE ALL UNDERGROUND CITY PROJECT WI0y019 � ' OR OVERHEAD UTILITIES THAT MAY AWPSCO Na BS, BE. BP -- Single Signs Cyf CONFLICT WITH CONSTRUCTION. of T-19 T-1 A n T-77 n ----- / _ — 2. CONDUIT DEPTH SHALL T A EL --- -- ---R23 9 9 Back-i g-Bgck = — MINIMUM OF 36' BELOW TOP OF ,Dolt Signs _ J FINISHED GRADE. CITY OF FORT WORTH, TEXAS­11} =1Ix4reo.oT --� --/, - 3.STUB OUT AT EACH END SHALL TRANSPORTATION AND PUBLIC WORKS Q LM—EUSINGANyw�an moaner, flat �� - = BE A MINIMUM OF 36' AND CAPPED 0 on`1aEE.xpIL J slal ,,,, ocK w°B°ef' �slDn P—I U WITH LIKE MATERIALS. CAPITAL DELIVERY DIVISION ­IDclac O �siiL'ci)x AClxc 14.6, 35.T5' PIT SIpI Poet rNueploek RT E,CMMN PARKWAY cf LIGHT POLE AND / Q LEGEND FOR ILLUMINATION THEWESTPORT PARKWAY evnirEEr } aaOVE oo-w, aon°war°aADe3ATION -766.60 LIGHT POLE CF— /� � 89.86 ^ x rKKN q Po, FROM KELLER HASLET ROAD STA 10-63.97. 35.75' FIT ELECTRICAL CONDUIT — — — - TO AL TA VISTA ROAD 519N PWaeIS,�Wy .Io. a I, LLR � pNax Waener, ELECTRICAL PULL BOX � F �xA 2 WESTPORT PARKWAY L aMEEroa „Fq,,,,,.. L. p1p1 SECTIDNAUZER ScIN 807 ILLUMINATION PLAN O 5716-1eiNC 90IwRI:e4 saDore�neuo W; to ,Ut, C1Ofo Bp1 Sipi P BEGINNING TO STA 16+00 F sxEEn IrINDI �lon WRwner,' r ,am �1ac never, ine Nylon .ssnek plat �� PEDESTAL SERVICE PS N / Ie h IOirc for seller. Mer, SiO, BOIt DESIGNED: HALFF SCALE: GATE: SHEET'MN W E—AlON OF —)`DRAWN: HALFF I 1'=40' I OB/2020 167 OF 114 rew°wA.°reaPE I nn I:\32000s\32942\001\CADD\Sheets\32942-ILLUM-01.Ogn 8/20/2020 2:39:55 PM Oh26U7 101019-CNCO-Westport Parkway CO #2 Final Audit Report 2023-12-05 Created: 2023-11-29 By: Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAA1pKQIWo4bYpmLBCzyAglIGrDfm-A314t "101019-CNCO-Westport Parkway CO #2" History Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) 2023-11-29 - 1:26:48 AM GMT- IP address: 204.10.90.100 Document emailed to ann.estes@fortworthtexas.gov for filling 2023-11-29 - 2:11:30 PM GMT Document emailed to bereket.birhane@fortworthtexas.gov for signature 2023-11-29 - 2:11:30 PM GMT Document emailed to troyj@jacksontex.net for signature 2023-11-29 - 2:11:31 PM GMT Document emailed to kevin.jackson@fortworthtexas.gov for signature 2023-11-29 - 2:11:31 PM GMT Email sent to troyj@jacksontex.net bounced and could not be delivered 2023-11-29 - 2:11:40 PM GMT Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) added alternate signer Troy Jackson (troyj @jacksontx. net). The original signer troyj@jacksontex.net can still sign. 2023-11-29 - 2:13:09 PM GMT- IP address: 204.10.90.100 Document emailed to Troy Jackson (troyj@jacksontx.net) for signature 2023-11-29 - 2:13:10 PM GMT Email sent to troyj@jacksontex.net bounced and could not be delivered 2023-11-29 - 2:13:14 PM GMT Email viewed by kevin.jackson@fortworthtexas.gov 2023-11-29 - 2:13:28 PM GMT- IP address: 204.10.90.100 Email viewed by ann.estes@fortworthtexas.gov 2023-11-29 - 2:14:14 PM GMT- IP address: 204.10.90.100 FORTWORTH, I PO"' e'by Adobe Acrobat Sign E= Signer kevin.jackson@fortworthtexas.gov entered name at signing as Kevin Jackson 2023-11-29 - 2:14:40 PM GMT- IP address: 204.10.90.100 C'r} Document e-signed by Kevin Jackson (kevin.jackson@fortworthtexas.gov) Signature Date: 2023-11-29 - 2:14:42 PM GMT - Time Source: server- IP address: 204.10.90.100 CV Signer ann.estes@fortworthtexas.gov entered name at signing as Ann Estes 2023-11-29 - 2:23:17 PM GMT- IP address: 204.10.90.100 f= Form filled by Ann Estes (ann.estes@fortworthtexas.gov) Form filling Date: 2023-11-29 - 2:23:19 PM GMT - Time Source: server- IP address: 204.10.90.100 's Email viewed by Troy Jackson (troyj@jacksontx.net) 2023-11-29 - 2:53:52 PM GMT- IP address: 174.244.18.132 3 Email viewed by bereket.birhane@fortworthtexas.gov 2023-11-29 - 7:30:45 PM GMT- IP address: 104.47.64.254 E= Signer bereket.birhane@fortworthtexas.gov entered name at signing as BB 2023-11-29 - 7:31:46 PM GMT- IP address: 204.10.90.100 E= Document e-signed by BB (bereket.birhane@fortworthtexas.gov) Signature Date: 2023-11-29 - 7:31:48 PM GMT - Time Source: server- IP address: 204.10.90.100 f= Document e-signed by Troy Jackson (troyj@jacksontx.net) Signature Date: 2023-11-29 - 7:57:01 PM GMT - Time Source: server- IP address: 75.140.225.246 Document emailed to Raul.LopezRoura@fortworthtexas.gov for signature 2023-11-29 - 7:57:02 PM GMT Email sent to Troy Jackson (troyj@jacksontx.net) bounced and could not be delivered 2023-11-29 - 7:57:20 PM GMT C'r� Signer Raul.LopezRoura@fortworthtexas.gov entered name at signing as Raul E Lopez 2023-12-01 - 4:30:29 PM GMT- IP address: 204.10.90.100 Document e-signed by Raul E Lopez (Raul.LopezRoura@fortworthtexas.gov) Signature Date: 2023-12-01 - 4:30:31 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Lissette.Acevedo@fortworthtexas.gov for signature 2023-12-01 - 4:30:34 PM GMT ~; Email viewed by Lissette.Acevedo@fortworthtexas.gov 2023-12-01 - 5:32:39 PM GMT- IP address: 204.10.90.100 f= Signer Lissette.Acevedo@fortworthtexas.gov entered name at signing as Lissette Acevedo, P.E 2023-12-01 - 5:33:04 PM GMT- IP address: 204.10.90.100 FORTWORTH, I PO"' e'by Adobe Acrobat Sign E= Document e-signed by Lissette Acevedo, P.E (Lissette.Acevedo@fortworthtexas.gov) Signature Date: 2023-12-01 - 5:33:06 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to patricia.wadsack@fortworthtexas.gov for signature 2023-12-01 - 5:33:09 PM GMT f= Signer patricia.wadsack@fortworthtexas.gov entered name at signing as Patricia L. Wadsack 2023-12-04 - 4:57:55 PM GMT- IP address: 204.10.90.100 f= Document e-signed by Patricia L. Wadsack(patricia.wadsack@fortworthtexas.gov) Signature Date: 2023-12-04 - 4:57:57 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Lauren.Prieur@fortworthtexas.gov for signature 2023-12-04 - 4:58:00 PM GMT '.i Email viewed by Lauren.Prieur@fortworthtexas.gov 2023-12-04 - 4:58:23 PM GMT- IP address: 204.10.90.100 E= Signer Lauren.Prieur@fortworthtexas.gov entered name at signing as Lauren Prieur 2023-12-04 - 5:00:00 PM GMT- IP address: 204.10.90.100 E= Document e-signed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) Signature Date: 2023-12-04 - 5:00:02 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Priscilla.Ramirez@fortworthtexas.gov for approval 2023-12-04 - 5:00:05 PM GMT Email viewed by Priscilla.Ramirez@fortworthtexas.gov 2023-12-04 - 5:02:17 PM GMT- IP address: 204.10.90.100 C.'(} Signer Priscilla.Ramirez@fortworthtexas.gov entered name at signing as Priscilla Ramirez 2023-12-04 - 5:02:34 PM GMT- IP address: 204.10.90.100 Ea Document approved by Priscilla Ramirez (Priscilla.Ramirez@fortworthtexas.gov) Approval Date: 2023-12-04 - 5:02:36 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Douglas.Black@fortworthtexas.gov for signature 2023-12-04 - 5:02:40 PM GMT Email viewed by Douglas.Black@fortworthtexas.gov 2023-12-04 - 7:46:27 PM GMT- IP address: 204.10.90.100 f= Signer Douglas.Black@fortworthtexas.gov entered name at signing as DBlack 2023-12-04 - 7:48:54 PM GMT- IP address: 204.10.90.100 f= Document e-signed by DBlack (Douglas.Black@fortworthtexas.gov) Signature Date: 2023-12-04 - 7:48:56 PM GMT - Time Source: server- IP address: 204.10.90.100 FORTWORTH, I PO"' e'by Adobe Acrobat Sign Document emailed to William.Johnson@fortworthtexas.gov for signature 2023-12-04 - 7:49:00 PM GMT Email viewed by William.Johnson@fortworthtexas.gov 2023-12-05 - 4:06:49 PM GMT- IP address: 204.10.90.100 <: Signer William.Johnson@fortworthtexas.gov entered name at signing as William Johnson 2023-12-05 - 4:07:13 PM GMT- IP address: 204.10.90.100 Document e-signed by William Johnson (William.Johnson@fortworthtexas.gov) Signature Date: 2023-12-05 - 4:07:15 PM GMT - Time Source: server- IP address: 204.10.90.100 Document approval automatically delegated to Katherine.Cenicola@fortworthtexas.gov by Ronald.Gonzales@fortworthtexas.gov 2023-12-05 - 4:07:19 PM GMT Document emailed to Katherine.Cenicola@fortworthtexas.gov for approval 2023-12-05 - 4:07:19 PM GMT Document emailed to Ronald.Gonzales@fortworthtexas.gov for approval 2023-12-05 - 4:07:19 PM GMT Signer Ronald.Gonzales@fortworthtexas.gov entered name at signing as Ronald P. Gonzales 2023-12-05 - 4:12:41 PM GMT- IP address: 204.10.90.100 f= Document approved by Ronald P. Gonzales (Ronald.Gonzales@fortworthtexas.gov) Approval Date: 2023-12-05 - 4:12:43 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to jannette.goodall@fortworthtexas.gov for signature 2023-12-05 - 4:12:46 PM GMT f'S Email viewed by Katherine.Cenicola@fortworthtexas.gov 2023-12-05 - 4:13:10 PM GMT- IP address: 104.47.64.254 6"Email viewed by jannette.goodall@fortworthtexas.gov 2023-12-05 - 4:13:51 PM GMT- IP address: 204.10.90.100 E= Signer jannette.goodall@fortworthtexas.gov entered name at signing as Jannette S. Goodall 2023-12-05 - 4:14:09 PM GMT- IP address: 204.10.90.100 E= Document e-signed by Jannette S. Goodall Qannette.goodall@fortworthtexas.gov) Signature Date: 2023-12-05 - 4:14:11 PM GMT - Time Source: server- IP address: 204.10.90.100 Form filling automatically delegated to Elisa.Winterrowd@fortworthtexas.gov by Allison Tidwell (allison.tidwell@fortworthtexas.gov) 2023-12-05 - 4:14:14 PM GMT FORTWORTH, I PO"' e'by Adobe Acrobat Sign Document emailed to Elisa.Winterrowd@fortworthtexas.gov for filling 2023-12-05 - 4:14:15 PM GMT Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for filling 2023-12-05 - 4:14:15 PM GMT f= Form filled by Allison Tidwell (allison.tidwell@fortworthtexas.gov) Form filling Date: 2023-12-05 - 5:46:39 PM GMT - Time Source: server- IP address: 204.10.90.100 Agreement completed. 2023-12-05 - 5:46:39 PM GMT FORTWORTH, I PO"' e'by Adobe Acrobat Sign FORT WORTH. Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: Westport Parkway CO #2 M&C: N/A CPN: 101019 Date: 11/22/2023 To: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10 11 12 Name Ann Estes Bereket Birhane Troy Jackson troviajacksontx.net Kevin Jackson Raul Lopez Lissette Acevedo Patricia Wadsack Lauren Prieur Doug Black William Johnson Jannette Goodall TPW Contracts CSO: 55385 DOC#: N/A Department Initials TPW - Review A TPW - Signatures Jackson Constr - Signature r41 TLJ TPW - Signature 71!Z TPW - Signature /e.�z TPW — Signature CN TPW — Signature pLW 1-W TPW — Signatures Legal — Signature �wdwb CMO — Signature ku W CSO - Signature ,SGTSG Date Out Nov 29, 2023 Nov 29, 2023 Nov 29, 2023 Nov 29, 2023 Dec 1, 2023 Dec 1, 2023 Dec 4, 2023 Dec 4, 2023 Dec 4, 2023 Dec 5, 2023 Dec 5, 2023 CC: Program Manager, Sr. CPO, TPW BSPAP Recon Team, TPW Records Room, TPW Contracts 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: Please notify TPWContracts(a/fortworthtexas.gov for pickup when complete. Call ext. 7233 or ext. 8363 with questions. Thank you!