HomeMy WebLinkAboutContract 47060-CO4 FORT WORTH. City of Fort Worth CITY SECRETARY
Change Order Request Breakdown CONTRACTNO.
Project Name Street Rehabilitation(HMAC 2015-2) City Sec# 47060
Client Project#(s)l 02520
Contractorl Peachtree Construction PM Kristian Surgrim Inspector Roy Scharfenberg
Change Order Submittal# ® Date 7/3/2018
Dept. TPW Water Fund Sewer Fund Contract Time
Totals CD
Original Contract Amount $822,472.14 $411,236.00 $411,236.00 $1,644,944.14 190
Extras to Date $269,934.45 $122,334.60 $1,244.60 $393,513.65 194
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $1,092,406.59 $533,570.60 $412,480.60 $2,038,457.79 384
Amount of Proposed Change Order $9,476.73 $0.00 $0.00 $9,476.73 150
Revised Contract Amount $1,101,883.32 $533,570.60 $412,480:60 $2,047,934.52 534
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00 $0.00 $0.00
Additional Funding(if necessary) $9,476.73 $9,476.73
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 24.50%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $2,056,180.18
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This change order request is being submitted to provide revisions and clarification on Change Orders#1,#2,and#3..Change Order(#4)is to
identify items that are to be constructed previously funded in Change Orders#2 and#3 with the exception of the last item for the amount of
$9,476.73 which was not previously funded.
RFS 44
1
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�Q9Y CITY SECRETARY
FT.WORTH,TX
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Change Order Additions
Project Name Street Rehabilitation(HMAC 2015-2) City Sec# 47060
Client Project# 02520
Contractor Peachtree Construction PMJ Kristian Surgrim Inspector Roy Schadenberg
Change Order Submittal# ® Date 7/3/2018
ADDITIONS
ITEM DESCRIPTION UEF I Qty Unit Unit Cost Total
6 HMAC BaseRepair- a mont 31 000OU01117
1 Oakmont Stone Work ,150.00
HMAC Base Repair-Isbell 0 55.00
Raised Pavement Markers $5.00
Extra MOB-Striping Crew Toom000550.00
Extra MOB-Concrete Crew 00000 5 0.00
Cold Mix Used on City Hall Streets 1.000000001 LS $1,468.26
Bamcades and Traffic Handling for City Hall Streets Toom00011, 7.01
Towing- ity Hall Streets 1. 000000 1 4.54
urface Milling-City Hall Streets 15, 5 .5 00
Second Towing City Hall Street 1.00000000 17.54
HMAC Typ'D'PG 64-22 Overlay-City Hall Streets 8,599.39750000 "1 .25
0302 'Asphalt Pavement Type D 7Ff76. 1510 .89 7
HMAC Base Repair-Oakmont TPW _____76T956M00 CY $355.00
TPW $9,476.73
Water Fund $0.00
Sewer Fund $0.00
Sub Total Additions9, 7 .7
Change Order Additions Page 1 of 1
FORT City of Fort Worth
Change Order Deletions
Project Name Street Rehabilitation(HMAC 2015-2) City Sec# 47060
Client Project# 1 02520
Contractor Peachtree Construction PM Kristian Surgrim Inspector Roy Scharfenberg
Change Order Submittal# ® Date 7/3/2018
DELETIONS
ITEM DFSCHIPIION DEPT Qty Unit Unit Cost Total
TPW $0.00
Water Fund $0.00
Sewer Fund $0.00
Sub Total Deletions
Change Order Deletions Page 1 of 1
MISBE Breakdown for this Change Order
MISBE Sub Type of Service Amount for this CO
NA
Total $0.00
Previous Change Orders
CO# DATE AMOUNT
Total $0.00
CFW Change Order Approval St-COApp06 Page I of 4
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Projects/02520 - Street Rehabilitation (HMAC 2015-2)/Contractor/Change Orders/Change
Order 4 2015-2 02025.x1s
Attachments(0)
No Attachments have been added to this form.
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CFW Change Order Approval St-COApp06 Page 2 of 4
FORT WORTH. city of Fort Worth
.--- Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 4
Change Order No.: St-COApp06 Date Started: 2018-08-06
City Sec. No.: 47060 Date Due: 2018-09-25
Project Name: 02520 - HMAC 2015 - 2 Street Rehabilitation
02520 DOE Numbers:
Project Numbers:
DOE No.
Project Remove and replace nonfunctional curb & gutter, driveways and
Description: sidewalks, followed by the pulverization and stabilization of
the existing pavement and a 3" HMAC overlay.
Project Manager: Kristian Sugrim City Inspector: Roy Scharfenberg
Contractor: Peachtree Construction, Ltd.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 9,476.73 39408-0200431-5740010-CO2520-C 150
Total Cost: $ 9,476.73 Total Requested Days: 150
Approval Status:
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CFW Change Order Approval St-COApp06 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 / L�
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 Signatu
CFW Change Order Approval St-COApp06 Page 3 of 4
Approved: Yes
Comments:
User: Brendan Taylor
Date: 2018-08-07 7:27 AM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2018-08-07 9:50 AM
Attest, bey:
Approved: Yes
Comments:
! . /43 A,,-
User: Brendan Taylor Mlcy • Kay C Sec 0R1,
Date: 2018-08-10 11:35 AM
Approved: Yes
U
Comments:
User: Kristian Sugrim
Date: 2018-08-10 11:56 AM �.
Approved: Yes M&C:
Comments: —
User: Lane Zarate 1295: 1
Date: 2018-08-14 10:16 PM
Approved: Yes
Comments:
User: Ricardo Matute
Date: 2018-08-17 9:42 AM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2018-08-17 11:39 AM
Approved: Yes
Comments:
User: Doug Black
Date: 2018-08-17 8:58 PM
Approved: Yes
Comments:
User: Susan Alanis OFFICIAL RECORD
Date: 2018-08-20 10:09 AM
CITY SECRETARY
FT.WORTH,TX
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