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CANARY FILE CONSTRUCTIONSERVICES CHANGE ORDER REQUEST CONTRACT
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GOLDENROD
PINK-PROJECT MANAGER CONTRACT NO.
-CONTRACTOR
CHANGE ORDER NO. DATE D.O.E.NO PROJECT NO.
I-REVISED 3/24/06 N/A C201-20 4 72 00173 80
PROJECT DESCRIPTION CITY SECRETARY CONTRACT NO.
Traffic Signal Installation at BeacbBellmap/Yucca(TPW-TS-2005-00018) 32189
ORIGINAL CONTRACT AMOUNT........................E 257,200.00
EXTRAS TO DATE..............................E -0-
CREDITS
0-CREDITS TO DATE..................................E -0-
CONTRACT
0-
CONTRACTCOST TO DATE.........:...............................................................................................................................$ 257,200.00
AMOUNT OF PROPOSED CHANGE ORDER....................................................................................................................................$ 550.00
REVISED CONTRACT AMOUNT............................................................................................................................................................$ 257,750.00
ORIGINAL FUNDS AVAILABLE FOR CHANGE ORDERS.................................................................................................$
REMAINING FUNDS AVAILABLE FOR CHANGE ORDERS..............................................................................................$
ADDITIONAL FUNDING(IF NECESSARY).........................................................................................................................$
IN ACCORDANCE WITH THIS CHANGE ORDER, THE CONTRACTOR SHALL:
Item Description ouantity Unit Cost Total
Add:
55. Install 60'Mast Arm 1 EA $550.00 $550.00
Attested By:
Net Change $550.00
Marty kdr'
City Secretary NO M&C REQUIRE
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:
Durable Specialties,Inc.
ORIGINAL CONTRACT TDHE ADDITIONAL APPROVED TEWE TO DATE APPROVED CONTRACT TRATE TO DATE ADDITIONAL TIME FOR THIS CHANGE ORDER
120 Working Days 0 working days
CONTRACT DAyt PROJECT MANAGER DATE
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MANAGE C D /' AIItE IN DEPT' DATE
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DIRE CONTRACTING DEPT DATE 7CA EY DATEASSISTANT CrrY MANAGE IIAI ,, TION((IF REQUIRED) DATE
n TH OVEA 9 DISAPPROVED 9
04-25-06 P03 :55 IN
DATE 3/24/06
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT
CHANGE ORDER JUSTIFICATION RECORD
PROJECT NAME: Traffic Signal Installation at Beach/Belknap/Yucca(TPW-TS-2005-00018)
CHANGE ORDER: 1 DOE NO. N/A PROJECT NO C201-20 4 72 00173 80
INSPECTOR: Ken Brock PHONE NO: 817-392-8775
PROJECT MANAGER: Marisa Conlin PHONE NO: 817-392-8779
REASON(S)FOR CHANGE:
Item 55—Additional pay item required for field change at Staffs request. Staff determined that the original mast arm
that was installed was too short and asked Durable to install Item 55.
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INSPECTOR � PROJECT MANAGER
DIRECTOR PT. MANAGERF E
DIR.OF CONTRACTING DEPT. '
MKS