HomeMy WebLinkAboutContract 48734-CO1 FORT WORTH® City of Fort Worth
Change Order Request BreakdownCITY SECRETARY
G0hProject Name Concrete Paving Joint Sealant 2017 CT 1 S
Client Project#(s)l 100628
Contractorl Scott Tucker Construction Co. PM Tariqul Islam Inspector
Change Order Submittal# Date 8/14/2017
Dept. TPW Contract Time
Totals CD
Original Contract Amount $594,650.00 $594,650.00 90
Extras to Date
Credits to Date
Pending Change Orders("n M&C Pr ^)
Contract Cost to Date $594,650.00 $594,650.00 90
Amount of Proposed Change Order $11,900.00 $11,900.00 10
Revised Contract Amount $606,550.00 $606,550.00 100
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $11,900.00 $11,900.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 2.00%
MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $743,312.50
This Change Order is to relect actual field quantites of pay items and to add 2,615 LF of 2"wide joint sealnt for Belknap/Weatherford St.10 additional calendar days has
been added to complete extra work.
OFFICIAL RECORD ,�2 3 4 5 6
CITY SECRETARY
FT.WORTH,TX , RECEIVE P
OCT 4217117 ` .�
City of Fort Worth
Change Order Additions
Project Name Concrete Paving Joint Sealant 2017 City Sec# 48734
Client Pmject# 100628
Contractor Scott Tucker Construction Co. PM TaMul Islam I Inspector
Change Order Submittal# 0 Date 8/14/2017
ADDITIONS
—ITEM L)L6GRIPTIUN DEPT Uty unit Unit os ota
Clean and Sillcon sea existing pavement joint(1/2"to wide)
TPW $259,370-0-0
Sub Total Additions 5 ,
Change Order Additions Page 1 of 1
i
FoeT_ WORTH City of Fort Worth
ir" Change Order Deletions
Project Name I Concrete Paving Joint Sealant 2017 City Sec# 48734
Client Project# I 100628
CoMracto Scott Tucker Construction Co. PMJ Tadqul Islam Inspector
Change Order Submittal# 0 Date 8114!2017
DELETIONS
Qty Unit UnitCost Total
Clean and Silicon seal existing pavement joint up to 2 vn e
TPW $247,450.00
Sub otal Deletions $2477,45-6M.
Change Order Deletions Page 1 of 1
M/SBE Breakdown for this Change Order
M/SBE Sub Type of Service Amount for this CO
Total $0.00
Previous Change Orders
CO# DATE AMOUNT
Total $0.00
CFW.Change Order Approval St-COApp01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/100628 - Concrete Joint Seal 2017/Contractor/Change Orders/Change Orders
Breakdown Joint Seal 2017.xism
Attachments(0)
No Attachments have been added to this form.
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CFW,Change Order Approval St-COApp01 Page 2 of 3
FORT WORTH,,, City of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: St-COSub01
Change Order No.: St-COApp01 Date Started: 2017-08-18
City Sec. No.: Date Due: 2017-09-01
Project Name: 100628 - Concrete Joint Seal 2017
100628 DOE Numbers:
Project Numbers:
Project Concrete paving joint sealnt at various locations
Description:
Project Manager: Tariqul Islam City Inspector:
Contractor: Scott Tucker Construction Company LLC
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 11,900.00 10
Total Cost: $ 11,900.00 Total Requested Days: 10
Approval Status:
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CFW.Change Order Approval St-COApp01 Page 3 of 3
Approved: Yes
Comments:
User: Jack Jackson
Date: 2017-08-18 4:27 PM
Approved: Yes
Comments:
User: Tariqul Islam
Date: 2017-08-21 11:26 AM
Approved: Yes
Comments:
User: Riad Nusrallah
Date: 2017-08-22 4:47 PM
Approved: Yes
Comments:
User: Richard Martinez
Date: 2017-08-25 4:19 PM G RT
Attast by.
Approved: Yes F_ Z
Comments:
User: Doug Wiersig ty s6cm *'
Date: 2017-08-28 10:30 AM
TEA
Approved: Yes
Comments:
User: Doug Black
Date: 2017-09-07 12:09 PM
Approved: Yes
Comments:
User: Jay Chapa
Date: 2017-09-07 12:11 PM
NO M&C REQUIRED
Action Required:
OFFICIAL RECORD
CITY SECRETARY
1, WOItT11,"1 x
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Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Wv�zd=
TariqulI am
Title GJ
❑- This form is N/A as No City Funds are associated with this Contract
Printed Name Signature