HomeMy WebLinkAboutContract 51035-CO1 CFW Change Order Approval COAppr-01 Page 2 of 3
CITY SECRETARY
Cit of Fort Worth coNTRACTNo.
ChangeOrder
FORT WORTH. y Ch Orde r Req es u t A pp royal
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: COSub01
Change Order No.: COAppr-01 Date Started: 2018-11-13
City Sec. No.: 51035 Date Due: 2019-01-02
Project Name: HMAC 2018-5 Street Rehab
Project Numbers: 101386 DOE Numbers:
Project Street rehabilitation by the Pulverize and Overlay for various
Description: street segments. Replacing curb & driveway
sections,pulverizing the existing road material, stabilizing
and re-compacting the material, and installing a new 2"
asphalt surface course.
Project/Contract
Compliance Maged Zaki City Inspector: Jesse Guptin
Manager:
Contractor: Advanced Paving
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 $ 14 710.33 30100-0200431-5740010-101386-0 20
TPW $ 14,000.00 130100-0200431-5330201-101234-0
5 6 7 ,6,9 Q Total Cost: $ 28,710.33 Total Requested Days: 20
4� A�oVal us:
`e � °ys��Q `4' OFFICIAL RECORD
CITY SECRETARY
L 9
-- FT. WORTH,TX
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CFW Change Order Approval COAppr-01 Page 3 of 3
Approved: Yes
Comments:
User: Becky Garrett
Date: 2018-11-14 12:44 PM
Approved: Yes
Comments:
User: Maged Zaki
Date: 2018-11-14 5:07 PM
Approved: Yes
Comments:
User: Lane Zarate
Date: 2018-11-15 7:08 PM
Approved: Yes
Comments:
User: Ricardo Matute
Date: 2018-11-16 3:00 PM
Approved: Yes
Comments:
User: Signing for TPW Director Role Approvals
Date: 2018-11-16 3:38 PM
Attestby: — • ;�
Approved: Yes 0:
Comments:
User: Doug BlackA/j J, j{ s City SeCI'et$Ty 'k
Date: 2018-11-16 11:03 PM
�XAS
Approved: Yes
Comments:
User: Susan Alanis
Date: 2018-11-19 8:17 AM
Action Required: Please review and approve
035
Io cC',t:
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX
https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&Proces... 11/26/2018
FORT WORTH. City of Fort Worth
Change Order Request Breakdown
Project Namel HMAC 2018-5 Street Rehabilitation City Sec# 1 51035
Client Project#(s)l CPN#101386
Contractor Advance Paving PM Maged Zaki I Inspectorl Jesse Guptin
Change Order Submittal# 0 Date 11/9/2018
Contract Time
Dept. TIPW Totals CD
Original Contract Amount $945,691.15 $945,691.15 180
Extras to Date $0.00
Credits to Date $0.00
Pending Change Orders(in M&C Process)
Contract Cost to Date $945,691.15 $945,691.15 180
Amount of Proposed Change Order $28,710.33 $28,710.33 20
Revised Contract Amount $974,401.48 $974,401.48 200
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $28,710,33 $28,710.33
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 3.04%
MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $1,182,113.94
CHANGE ORDER
This change is requested to add extra bid items for lowering the street light wiring on BERKELEY PL to prevent damage during street
reclamation.These wires were found on depth 4"from the street surface.
FOR_ rWORTH City of Fort worth
Change Order Additions
Project Name I HMAC 2018-5 Street Rehabilitation City Sec# 51035
Client Project# I CPN#101386
Contractor Advance Paving PM Maged Zaki I Inspector JesseGuptin
Change Order Submittal# 0 Date F 11/9/2018
ADDITIONS
ITEM UE6CRIPTION DEPT City Unit Unit Cost I ota
7SCH 80 PVC Trench
40 2"S H 80 PVC Bore T/PW 350. 0 0 000 LF 2.
# XHHW PW ,622.0 000 LF 1.9
42 Type B Ground Box(@ Oncor Pole) T/PW 3. 00000 EA 77M
43 Reconnect Conductor T/PW 12.00000000 EA 137.50
T/PW $28,710.33
Sub Total Additions
Change Order Additions Page 2 of 4
FORT WORTH City of Fort Worth
—1"T'-- Change Order Deletions
Project Name HMAC 2018-5 Street Rehabilitation CitySec# 51035
Client Project# CPN#101386
Contractor Advance Paving PM Maged Zaki inspector'
Jesse Guptin
Change Order Submittal# 0 Date 11/9/2018
DELETIONS
ITEM DESCRIPTION UEPT Qty Unit Unit Cost Total
T/PW $0.00
Sub Total Deletions
Change Order Deletions Page 3 of 4
M/SBE Breakdown for this Change Order
M/SBE Sub Type of Service Amount for this CO
Total $0.00
Previous Change Orders
Co# DATE AMOUNT
Total $0.00
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.
Maged Zaki
Project Manager
OFFICIAL RECORD
CITY SECRETARY
FT WORTH,TX
CFW Change Order Approval COAppr-01 Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthgov/Infrastructure Proiects/101386 - HMAC 2018-5 Street Rehab/Contractor/Change Orders/Change Order
Breakdown #1 Revl- 2018-5.xls
Attachments 101
No Attachments have been added to this form.
IECEIVED
2019
o►NorFogrw
Cr1'SE'Ch4Y
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