HomeMy WebLinkAboutContract 47874-CO2 FORTWORTH® city of Fort wCITY SECRETARY.
orth
Change Order Request Breakdown CONTRACT N0. -
ProjectNarnel 2016 C1P YEAR 2 CONTRACT 4 STREET REHAB City Sec# 1 47874
Client Project#(s)l CPN 100181
Contractorl Advance Paving PM Kristian Surgrim Inspectorl Roy Scharfenberg
Change Order Submittal# 0 Date 8/25/2017
Dept. TIM Totals
Time
Totals CD
Original Contract Amount $3,771,301.80 $3,771,301.80 310
Extras to Date $98,341.27 $98,341.27 20
Credits to Date
Pending Change Orders(in M&C Process;
Contract Cost to Date $3,869,643.07 $3,869,643.07 330
Amount of Proposed Change Order $76,301.12 $76,301.12 20
Revised Contract Amount $3,945,94419 $3,945,944.19 350
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $76,301.12 $76,301.12
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT
MAXALLOWABLECONTRACTAMOUNT(OR/GINALCONTRACTCOST+25%) N'$4;714;12-25_-=°
Change order#2 is to facilitate the transfer of additional funds for the inclusion of streetlighting and sidewalks on Henderson St.and Harrison Ave.,into the contract.
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OFFICIAL,RECORD
CITY SECRETARY
. WORTH,TX
City of Fort worth
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rroiect Name 2016 CIP YEAR 2 CONTRACT 4 STREET REHAB t:ny pec;;
ClientPmject# CPN100181
Contractor Advance Paving PIVIJ Kristian Surgrim Inspector Roy Schadenberg
Change Omer Submittal# = uate
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TIPW $76,301.12
Sub Total Additions 76,301.12
Change Order Additions Page 1 of 1
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emJea name 1 2016 CIP YEAR 2 CONTRACT 4 STREET REHAB um bec rf
ClientPmjed# I CPN100181
contrado Advance Paving PM Kristian Surgrim Inspecto Roy SdW nberg
Change Order Submittal# uare
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TIPW $0.00
Sub Total Deletions
Change Order Deletions Page 1 of 1
m/bbt tireaKaown for this unange Uraer
AMOM Tor Inis
Total $0.00
Previous unange Uraers
Total $0.00
CFW Change Order Approval St-COApp03 Page 1 of 3
Links 1
Fortworthgov/Infrastructure Projects/100181 - 2014 CIP Year 2- Contract 4/Contractor/Change Orders/Change Order#2-
Fund Transfer-100181 8-25-2017.xism
Attachments(01
No Attachments have been added to this form.
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CFW Change Order Approval St-COApp03 Page 2 of 3
FORT WORTH, City of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.:
Change Order No.: St-COApp03 �� Date Started: 10/11/2017 ;�
City Sec. No.: Date Due: 11/30/2017 I�
Project Name:1100181 - 2014 CIP Year 2 - Contract 4 Street Rehabilitation
100181 IDOE Numbers:
Project Numbers:
Project ;Removal and replacement of nonfunctional curb&gutter, driveways, and
Description::;sidewalks; followed by a 2" HMAC Overlay.
City Project Mgr.: Kristian Sugrim City Inspector: Roy Scharfenberg !
Contractor: Advanced Paving
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number:�— M&C Date:
COST AND DAYS SUMMARY:
Department: Cost($) Fund Account Center: Requested Days:
11'PW^-�_— --� [P6,302.12 1134014 0200431 5740010 1001E!120
i.
Total.;1..76,3.02.12 Total Requested Days:120
Approval Status:
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CFW Change Order Approval St-COApp03 Page 3 of 3
Approved: Yes
Comments:
User: Matt Monedero
Date: 2017-10-11 4:25 PM
Approved: Yes
Comments:
.User: Becky Garrett
Date: 2017-10-11 5:16 PM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2017-10-12 8:18 AM
Approved: Yes
Comments:
User: Najib Fares
Date: 2017-10-12 8:57 AM
Approved: Yes
Comments:
User: Kim Arnold
Date: 2017-10-26 5:33 PM
ORT ! ,
Approved: Yes
Comments:
f—.
User: Doug Wiersig -
Date: 2017-11-01 2:42 PM 8 SCG
t.
. •1"EXPca �.
Approved: Yes
Comments:
User: Jay Chapa
mc: NA
Date: 2017-11-014:37 PM
1295:
Action Required:
E
CIAL RECORD
SECRETARYWORTH,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.
Kristian Sugrim /
Name of Employee/Signature
Protect Manager
Title
This form is N/A as No J,, Funds are associated with this Contract
Kristian,Scrim �� �
Printed Name Signatt re
OFFICIAL RECORD
CITY EECI IITARY
FT.WORM TX