HomeMy WebLinkAboutContract 47874-CO1 (3) FORT WORTH® City of Fort Worth CITY SECRETARY
Change Order Request Breakdown CONTRACT NO. 41R_7L�— i' I
Project Name 2014 CIP YEAR 2 CONTRACT 4 STREET REHAB City Sec# 1 47874
Client Project#(s)l CPN 100181
Contractorl Advance Paving PM Kristian Surgrim Inspector Roy Scharfenberg
Change Order Submittal# 0 Date 5/31/2017
Contract Time
Dept. T/PW Totals CQ
Original Contract Amount $3,771,301.80 $3,771,301.80 310
Extras to Date $0.00
Credits to Date 50.00
Pending Change Orders(in M&C Process)
Contract Cost to Date $3,771,301.80 $3,771,301.80 310
Amount of Proposed Change Order $98,341,27 $98,341.27 20
Revised Contract Amount $3,869,643.07 $3;869,643.07 330
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $98,341.27 $98,341.27
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 2.61
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $4,714,127.25
JUSTIFICATION(REASONS)FOR CHANGE ORDER
The requests on this change order are to allocate additional funding for the lowering of the street lighting conduits on Harrison Ave.and South
Henderson St.,as well as for the sidewalk installation and tree removal on Buck Ave.and Mistletoe Ave.Therefore,an additional 20 days are
being added to the contract to compensate for these added activities.
P
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
FORT WORTH City of Fort worth
*I--- Change Order Additions
Project Name 1 2014 CIP YEAR 2 CONTRACT 4 STREET REHAB City Sec# 47874
Client Project# QTPN 100181
Contractorl Advance Paving PM Kristian Surgrim Inspector Ray Scharfenberg
Change Order Submittal# Date 5I31I2017
ADDITIONS
rnUnl-
38
amson ve reet Lighting Conduit Lowering
7 Concrete,Sidewalk(MistleToe&Buck AveSidewalk) TIPW 4,916.86000000 F
Remove !ewalk TIPW 6. F $T?.' i� 711
3South Henderson Street Lighting Foundation Lowering IPW 0L 4,71 .1
TIPW $98,341.27
Sub Total Add-itons
Change Order Additions Page 1 of 1
FORTWORTH City of Fort Worth
— v-1— Change Order Deletions
Project Name 1 2014 CIP YEAR 2 CONTRACT 4 STREET REHAB City Sec# 47874
Client Project# I CPN 100181
Contraclorl Advance Paving PM Kristian Sufgrim Inspector Roy Scharfenberg
Change Order Submittal# Date 5/3112017
DELETIONS
ITEM DESCRIPTION DEPT Qty Unit Unit Cost Total
T/PW $0.00
Sub Total Delebons
Change Order Deletions Page 1 of 1
MISBE Breakdown for this Change Order
MISBE Sub Type of Service Amount for this CO
Total $0.00
Previous Change Orders
CO# DATE AMOUNT
Total $0.00
CFW Change Order Approval St-COApp02 Page 1 of 4
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 2
Fortworthgov/Infrastructure Proiects/100181 - 2014 CIP Year 2 - Contract 4/Contractor/Change Orders/Change Order
Breakdown #1 Rev2 (002).xls
Fortworthgov/Infrastructure Proiects/100181 - 2014 CIP Year 2 - Contract 4/Contractor/Change Orders/MBE-
APCF 100181.odf
Attachments(01
No Attachments have been added to this fonn.
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CFW Change Order Approval St-COApp02 Page 2 of 4
FORTWORTH'. city of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.:
Change Order No.:rSt-WAPp02 Date Started: 2017-06-30
City Sec. No.: Date Due: 2017-08-19
Project Name: 1100181 - 2014 CIP Year 2 - Contract 4 Street Rehabilitation
Project Numbers: DOE Numbers:
Project Removal and replacement of non-functional curb & gutter,
Description: driveways and sidewalk; pulverization and stabilization of the
existing pavement, followed by a 3" HMAC overlay.
Project Manager: Kristian Sugrim City Inspector: lRoy Scharfenberg
Contractor: JAdvanced Paving Acquisition, Ltd.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
_ _ $ 93,341.27
Total Cost:l$ 98, 43 143 1 27 Total Requested Days:
Approval Status:
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CFW Change Order Approval St-COApp02 Page 3 of 4
Approved: Yes
Comments:
User: Matt for Brandy Crane Monedero
Date: 2017-07-03 9:57 AM
Approved: Yes
Comments:
User: Becky Garrett
Date: 2017-07-05 2:16 PM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2017-07-05 4:37 PM
Approved: Yes
Comments:
User: Najib Fares
Date: 2017-07-05 5:01 PM
Approved: Yes
Comments:
User: Najib Fares
Date: 2017-07-06 9:23 AM
Approved: Yes
Comments:
User: Kim Arnold
Date: 2017-07-10 2:38 PM
Approved: Yes
Comments:
User: Doug Wiersig
. 4
Date: 2017-07-12 2:50 PM FORT
Attested
Approved: Yes _
Comments: * ,
User: Doug Black
Date: 2017-07-12 3:04 PM J. K" �. it _ecre
T�y,PS
Approved: Yes m&C.__.L�
Comments: 'YI V
User: Jay Chapa
Date: 2017-07-12 5:11 PM 1'5..�.�____
OFFICIAL RIGQRD.
C11TV so
FT.WORTH, Tl(
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CFW Change Order Approval St-COApp02 Page 4 of 4
Action Required:
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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.
Kristian Sugrim / ka
`
Name of Employee/Signature
Project Manager
Title
This form is N/A as No City Funds are associated with this Contract
Kristian Su rim
Printed Name Signat re
OFFICIAL RECORD
CITY SECRETARY
FT.WORTN,TX