HomeMy WebLinkAboutContract 47874-CO3FOR
Cit of Fort Worth CITY SECRETARY � -7q �.
CCI
Change Order Request Breakdown mTRACTNO.
_�_
ProjectNamel 2016 CIP YEAR 2 CONTRACT 4 STREET REHAB I City Sec # 47874
Client PrcJect#(s)l CPN100181
Contractorl Advance Paving PM Kristian Surgrim Inspector Roy Scharfenberg
Change Order Submittal # Date 10/6/2017
Dept.
Original Contract Amount
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
Amount of Proposed Change Order
Revised Contract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
T/PW
Totals
Contract Time
CD
$3,771,301.80
$3,771,301.80
310
$174,642.39
$174,642.39
20
$3,945,944,19 1
$3,945,944.19
330
66,988.00
$766,988.00
130
712,93219
$4,712,932.19
460
$U.UU
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 24,97%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $4,714,127.25
This change order is to request additional funding for the installation of new sidewalks and the repair of existing sidewalk at various locations, in order to allow for safe travels
for foot pedestrians in and around schools, businesses, parks and churches. This change order will also provide funding for the installation of ADA compliant wheelchair
ramps in the areas where sidewalks are being installed. Also included in this change order is funding for the rehabilitation of deteriorated existing storm drain inlets tops.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
City of Fort Worth
Change Order Additions
Project Name 2016 CIP YEAR 2 CONTRACT 4 STREET REHAB City Sec # 47874
Client Project # CPN 100181
Contractor Advance Paving PM Kristian Surgrim Inspector Roy Scharfenberg
Change Order Submittal # 0 Date 10/6/2017
ADDITIONS
ITEM
DESCRIPTION
DEPT
Oty
Unit
total
Remove Sidewalk
7
4" Concrete,Sidewalk
T/PW
70,0 0. 00
F
0
Remove ADA Ramps
T/PW
40.00000000
EA
R1485
11
Install ADA Ramp
T/PW
4 . 0 00000
EA34
Block D
T/PW
10,000.00000000
SY35
Concrete Retaining Wall W/Sidewalk,Face
TIPW
1, 00
SF
38 -New
Rehab Existing Inlet Tops and Face
T/PW
7.00000000
EA
$3,174.00
Change Order Additions Page 1 of 1
T/PW $766,988.00
Sub Total Additions $166,98 .00
Foa�:H City of Fort Worth
Change Order Deletions
Project Name 2016 CIP YEAR 2 CONTRACT 4 STREET REHAB City Sec # 47874
Client Project# CPN 100181
Contractor Advance Paving PM Kristian Surgrim Inspector Roy Scharfenberg
Change Order Submittal # 0 Date 10/6/2017
DELETIONS
ty Unit Unit Cost Total
T/PW $0.00
ub Total Deletions $0.001
Change Order Deletions Page 1 of 1
MISBE Breakdown for this Chanqe Order
MISBE Sub I Tvge of Service I Amount for this CO
Total 1 $0.00
Previous Change Orders
co# DATE AMOUNT
Total $0.00
CFW Change Order Approval St-COApp04 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 2
fortworthaov/Infrastructure Proiects/100181 - 2014 CIP Year 2 - Contract 4/Contractor/Chance Orders/Chance Order
Breakdown #3 - 100181 10-06-2017.xism
fortworthaov/Infrastructure Proiects/100181 - 2014 CIP Year 2 - Contract 4/Contractor/Chance Orders/100181 M&C-
CO.Ddf
I No Attachments have been added to this form. I
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CFW Change Order Approval St-COApp04 Page 2 of 3
RT WORTH, C'ty of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: C3
Change Order No.: St-COApp04�Date Started: 2017-12-13
City Sec. No.: 147874 Date Due: 2018-02-01
Project Name: 100181 - 2014 CIP Year 2 - Contract 4 Street Rehabilitation
Project Numbers:
100181 IDOE Numbers:
Project
Description:
Removal and replacement of nonfunctional curb & gutter,
driveways and sidewalks; pulverization and stabilization of
the existing pavement, followed by a 3" HMAC overlay.
Project Manager: JKristian Sugrim �� City Inspector: lRoy Scharfenberg
Contractor: Advanced Paving
COUNCIL ACTION (If Required):
M&C Log Name: 202014 CIP Yr 2 - Contract 4 Street Rehabilitation CO#2 & 3
M&C Number: C-28503 M&C Date: 2017-12-12
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 766,988.00j 34014-0200431-5740010-100181-0; 1130
Total Cost: L_766,988. Total Requested Days: 130
Approval Status:
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Contract Compliance Manager
Re: Change Order No. 3 ($766988.00)
Contractor: Advanced Paving
Project Name: 2014 CIP Year 2 — Contract 4
City Secretary No.: 47874
Project No.: 1004181
By signing, I
administration
requirements.
acknowledge that I am the person responsible for the monitoring and
of this contract including ensuring all performance and reporting
Kristian Sugrim
Name of Employee
Project Manager
Title
1/1
8
CFW Change Order Approval St-COApp04 Page 3 of 3
Approved: Yes
Comments:
User: Matt Monedero
;Date: 2018-01-02 10:57 AM
,Approved: Yes
=Comments:
,User: Becky Garrett
Date: 2018-01-02 11:38 AM
,Approved: Yes
;Comments:
`User: Kristian Sugrim
;Date: 2018-01-02 1:00 PM
;Approved: Yes
Comments:
User: Najib Fares
Date: 2018-01-04 2:19 PM
,Approved: Yes
'Comments:
User: Kim Arnold
Date: 2018-01-18 3:54 PM
Approved: Yes
'Comments:
,User: Doug Wiersig
Date: 2018-01-19 12:06 AM FORS.
-\.0� p
'Approved: Yes Aby� ' •: �
U
Comments: _
;User: )ay Chapa '
Date: 2018-01-19 3:51 PM Nj J. a ,City Secretary
Action Required:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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