HomeMy WebLinkAboutContract 47923-CO1 �C
CITY SECREIIARY
ORTWORTH. City of Fort Worth CONTRACT NO. C� 3"
Change Order Request Breakdown
Project Namel Mark IV Pir-Way and Cantrell Sansom Road City Sec# 1 47923
Client Project#(s)i 02261
Change Order Submittal# 0 Date 2/24/2017
Dept Contract Time TIPW Water Sewer Totals CD
Original Contract Amount $2,745,119.98 $2,745,119.98 250
Extras to Date
Credits to Date
Pending Change Orders(in MSC Process)
Contract Cost to Date $2,745,119,98 $2,745,119.98 250
Amount of Proposed Change Order $70,967.53 $0.00 $0.00 $70,967.53 0
Revised Contract Amount $2,816,087.51 $2,816,087.51 250
Original Funds Available for Change Orders $76,000.00 $76,000.00
Remaining Funds Available for this CO $76,000.00 $76,000.00
Additional Funding(if necessary)
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 2.59%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $3,431,399.98
(First addition)The City of Fort Worth has decided to utilize the portable message signs for the duration of the project in lieu of the original 48
total weeks that was originally contracted.(Second Addition)With underground utility installation stretching across more than one phase,
temporary ditch repair(over the storm drain)was needed to stay on the construction and traffic phasing plan.Currently there is no pay item for
temporary ditch repair.
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OFFICIAL RECORD
CITY SECRETARY
FT.WORTHo TX
oRrWo rH City of Fort Worth
Change Order Additions
Project NNameI Mark IV P and Cantrell Sansom Road City Sec# 47923
Client Project# [-2261
Change Order Submittal# Iu Date 2/24Y1017
ADDMONS
ITEM DESCRIPTION DEPT Qty Unit nTotal
31 3471.000 Portable Message Sign TIPW = Weeks SOUTUD -79
New I emporary DIch Repair
TIPW $70,967.53
Water $0.00
Sewer $0.00
buU Total Additions
Change Order Additions Page 2 of 4
rwoR H City of Fort Worth
Change Order Deletions
Project Name I Mark N Patway and Cantrell Sansom Road City Sec# 47923
Client Project# F 02261
Change Order Submittal# Date 2124/2017
DELETIONS
ITEM DESCRIPTION DEPT Qpy Unit Unit os
T1PW $0.00
Water $0.00
Sewer $0.00
o s
Change Order Deletions Page 3 of
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 $0.00
CFW Change Order Approval St-COApp01 Page 2 of 3
FORT NORTH® city of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.:
Change Order No.: St-COApp01 I Date Started: 2017-03-09
City Sec. No.:147923 1 Date Due: 2017-04-28
Project Name:FMark IV and Cantrell Sansom
Project Numbers: 02261 —71 DOE Numbers:
DOE No.
Project construction of addtional 2 lanes on Cantrell Samson at Mark
Description: IV and roundabout at the interrsection of Mark IV and Cantrell
Samson Rd. including drainage improvements, sidewalks, street
lights and markings.
Project Manager:Jussette Acevedo --� City Inspector: ey( #4_ C)6g �
Contractor:1xz Contrawn9
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
L rR $ 70,967.53 1134014 0200431 5740010 CO2261 d[0
Total Cost: $ 70,967.53 Total Requested Days: 0
Approval Status:
https://projectpoint.buzzsaw.com/ bz web/Forms/Form.Print.aspx?SiteId=51500&ProcessI... 5/23/2017
CFW Change Order Approval St-COApp01 Page 3 of 3
Approved: Yes
Comments:
User: Tara Fishback
Date: 2017-03-10 10:30 AM
Approved: Yes
Comments:
User: Aaron Perez
Date: 2017-03-10 1:11 PM
Approved: Yes #
Comments:
User: Lissette Acevedo
'Date: 2017-03-10 1:22 PM
Approved: No
Comments:
User: Todd Estes
Date: 2017-03-10 3:19 PM
Approved: Yes
Comments:
User: Kim Arnold
Date: 2017-03-13 9:53 AM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2017-03-13 2:26 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2017-04-05 2:56 PM
Action Require aproved
https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 5/23/2017
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.
XI�st e, Ac.-v-e-do
Name of Employee
'fir•�ra�es5 i e�yta/ �y1Gi�
Title
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature