HomeMy WebLinkAboutContract 50572-CO1 CITY SECRETARY 5C�-�2 _CO
FORTWORTH. City of Fort Worth CONTRACTNO.
Change Order Request Breakdown
Project Namel Concrete Restoration 2018-1 City Sec# 1 50572
Client Project#(s)l 101293
Contractor Westhill PM Juan Pablo De La Cruz Inspectorl Tommy McKinnon
Change Order Submittal# Date 6I20I2018
Dept. TPW Contract Time
Totals CD
Original Contract Amount $711,497.00 $711,497.00 165
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $711,497.00 $711,497.00 165
Amount of Proposed Change Order $20,000.00 $20,000.00 10
Revised Contract Amount $731,497.00 $731,497.00 175
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $20,000.00 $20,000.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 2,81%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $889,371.25
mI
Houston St,with street limits from 25th St and 26th St existing ramps are not ADA compliance.A change order is required to remove and replace with ADA compliance
ramps at the intersection of Houston St and 25th St and intersection of Houston St and 26th St.
Ji
RECEIVED
AOG 2 12019 OFFICIAL RECORD
C COnTH
IYSECRETA8V CITY SECRETARY
FT.WARTFI,TX
City of Fort worth
Change Order Additions
Project Name Concrete Restoration 2018-1 City Sec# 50572
Client Project# 101293
Contractor Westhill PMF Juan Pablo De La Cruz Inspector Tommy McKinnon
Change Order Submittal# Date 6/20/2018
ADDITIONS
ty Unit UnitCost Total
26 Remove and Replace ADA Ramp
TPW $20,000.00
Sub Total Additions $20,000.00
Change Order Additions Page 2 of 4
FORT WORTH City of Fort Worth
Change Order Deletions
Project Name Concrete Restoration 2018-1 City Sec# 50572
Client Project# 101293
Contractor Westhill PM Juan Pablo De La Cruz Inspector Tommy McKinnon
Change Order Submittal# 0 Date 6/20/2018
DELETIONS
Qty Unt Unit Cost 1 ota
TPW $0.00
ub Total Deletions 0
Change Order Deletions Page 3 of 4
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 $0.00
CFW Change Order Approval COAppr-01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/101293 - Concrete Restoration 2018-1/Contractor/Change Orders/2018-1 Change
Order 1.xlsm
Attachments(0)
No Attachments have been added to this form.
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CFW Change Order Approval COAppr-01 Page 2 of 3
FORT WORTH. City of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: CoSub01
Change Order No.: COAppr-01 Date Started: 2018-07-31
City Sec. No.: 50572 Date Due: 2018-08-03
Project Name: Concrete Restoration 2018-1
101293 DOE Numbers:
Project Numbers:
Project Remove concrete and replace with 7" concrete pavement HES
Description: Remove concrete and replace with 10" concrete pavement HES
Project/Contract
Compliance Juan Pablo De La Cruz City Inspector: Tommy Mckinnon
Manager:
Contractor: Westhill Construction, Inc.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: M&C Date:
COST AND DAYS SUMMARY:
Requested
Department: Cost($) Fund Account Center: Days:
TPW $ 20,000.00 30100-0200431-5740010 10
101293-003380-9999
Total Cost: $ 20,000.00 Total Requested Days: 10
Approval Status:
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CFW Change Order Approval COAppr-01 Page 3 of 3
Approved: Yes
Comments:
User: Katie Newby
Date: 2018-08-03 9:59 AM
Approved: Yes Attested b
Comments:
User: Juan Pablo De La Cruz
Date: 2018-08-03 5:08 PM
Mary ayse i rLL.
• f.•-
Approved: Yes
Comments: ~ `
User: Riad Nusrallah
Date: 2018-08-03 5:28 PM
Approved: Yes M& C:—&
Comments:
User: Lauren Prieur
Date: 2018-08-04 3:05 PM 1295; N A
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2018-08-06 10:18 AM
Approved: Yes
Comments:
User: Doug Black
Date: 2018-08-06 10:02 PM
Approved: Yes
Comments:
User: Susan Alanis
Date: 2018-08-15 8:26 PM
Action Required: Please Review, Approve and Submitt.
OFFICIAL RECORD
CITY SECRETARY
FT.!NORTH,TX
https://proj ectpoint.buzzsaw.com/_bz_web/Forms/FormPrint.aspx?Siteld=51500&Processl... 8/20/2018
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.
Juan Pablo De La Cruz
Project Manager
Title
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
t
L RECORDCRETARYRTH,TX