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Change Order Number: 1
CWOTS No: 1159T12
Applicant: City of Fort Worth
THIS CHANGE ORDER IS EXECUTED IN DUPLICATE AS FOLLOWS:
® First Original (SWBT dba AT&T) ❑ Second Original (Applicant)
Contract Change Order No: 1 Date: July 10, 2013
1. The following is an amendment to the terms and conditions of CWOTS No. 1159T12
Item No. 1: Additional charges needed due to contractor costs higher than anticipated for manhole/
handhole and associated work.
For any additional items
Item No. 2:
TOTAL EXTRA: $13,480.00
2. The estimated cost in the CWOTS issued in this matter is adjusted to the following amount:
TOTAL ESTIMATED COST: $391,796.35
Review of CWOTS Estimated Cost
A. Original CWOTS Estimated Cost $378,316.35 OFFICIAL RECORD
CITY SECRETARY
B. Net Sum of Previously Authorized Change Orders
C. Present CWOTS Cost $378,316.35 FT.WORTH,TX
D. This Change Order $ 13,480.00
E. New CWOTS Estimated Cost $391,796.35
This Change Order entered into as of the day and year indicated below, by signature, amends and modifies
the original CWOTS agreement between Southwestern Bell Telephone Company, and Applicant. By signature
below, Applicant agrees to make payment to Southwestern Bell Telephone Company in the amount of this
Change Order within thirty (30) days of the date of signature below.
Southwestern Bell Tele hone Company City of Fort Worth
By: By: f.
Title: Manager— Engineering & Design Title: .
BUY
Printed Name: Karen Rose 4 � w � Printed Name:
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Date: 7/10/13 � 00 Date: /
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Attested C
WkSTOFORM AND LEGALITY:
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CITY ATTORNEY