HomeMy WebLinkAboutContract 49216-CO1 FORT WORTH City of Fort Worth CITY SECRETARY
CONTRACT N0.
Change Order Request Breakdown
Project Namel Concrete Restoration(2017-3)At Heritage Trace Parkway —� City Sec:#
C nt Project#(s)l 100835
V `air orl C.Green Scaping,L.P. PM Tariqul Islam Inspector Jimmy Raines
Change Order Submittal# 0 Date 10/30/2017
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G� Dept. TPW Totals ContracDtTime
Original Contract Amount $683,055.00 $683.055.00 120
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $683,055.00 S;83 055 C`0 120
Amount of Proposed Change Order $38,393.40 538,393.40
Revised Contract Amount $721,448A0 S'2' 448 40 120,
Original Funds Available for Change Orders SC 00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $38,393.40 1 1 1 1 $38,39340
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 5.62%
MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%, $853,818.75
The purpose of this change order is to add flexbase to help with the areas of concrete placement that have failed subgrades.
OFFICIAL RECORD
CITE`SocRamy
FT. WORTH,TX
City of Fort worth
Change Order Additions
Project Name Concrete Restoration(2017-3)At Heritage Trace Parkway City Sec# 49216
Client Project# 100835
Contracto C.Green Scaping,L.P. PM Tariqul Islam Inspector Jimmy Raines
Change Order Submittal# 0 Date 10/3012017
ADDITIONS
Unit Unit Costo a
22 Furnish and I nstall ype A,Me 2 Flexbase o is
TPw $38,393.40
5557-6—ta—ITR ibons
Change Order Additions Page 1 of 1
FO T WORTH City of Fort Worth
Change Order Deletions
Project Name I Concrete Restoration(2017-3)At Heritage Trace Parkway City Sec# 49216
Client Project# 1 100835
Co C.Green Soaping,L.P. PMIJ Tariqul Islam Inspector Jimmy Raines
Change Order Submittal# 0 Date 10/3012017
DELETIONS
_�r",, < ,i ty Unit Unit Cw I Ma
TPW $0.00
I o+.al Deletions
Change Order Deletions Page 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 $0.00
CFW Change Order Approval St-COApp01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/100835 - Concrete Restoration 2017-3/Contractor/Change Orders/Coov of
100835CO1ConcreteRestorationAtHeritageTraceParkwayChange Order Breakdown.xlsm
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CFW Change Order Approval St-COApp01 Page 2 of 3
FORT WORTH , city of Fort Worth
--� .--- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: St-COSub01
Change Order No.: St-COApp01 Date Started: 2017-11-14
City Sec. No.: 49216 Date Due: 2017-11-30
Project Name: 100835 - Concrete Restoration 2017-3
100835 DOE Numbers:
Project Numbers:
Project Instal stamped concrete in Heritage Trace Pkwy
Description:
Project Manager: Tariqul Islam City Inspector: Jimmy Raines
Contractor: C. Green Scaping, L.P.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 38,393.40 30100 0200431 5740010
100835 003380 9999
Total Cost: $ 38,393.40 Total Requested Days: 0
Approval Status:
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CFW Change Order Approval St-COApp01 Page 3 of 3
Approved: Yes
Comments:
User: Dana Loucks
Date: 2017-11-30 12:00 PM
Approved: Yes
Comments:
User: Tariqul Islam
Date: 2017-11-30 3:12 PM
Approved: Yes
Comments:
User: Riad Nusrallah
Date: 2017-12-06 11:45 AM
Approved: Yes
Comments:
User: Richard Martinez
Date: 2017-12-07 2:42 PM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2017-12-12 6:45 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2017-12-18 11:15 AMTby,"
Approved: Yes
Comments: j(AS
User: Jay ChapaWald P. Gonzales,Ag t. Ity
Date: 2017-12-18 11:44 AM
Action Required:
M&C: A
1295:
OFFICIAL RECORD
CITY SECRETARY
T. WORTH,TX
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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.
Tariqul Islam
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e
Title
This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX