HomeMy WebLinkAboutContract 49776-CO1 CITY SECRETARY, F
FORT WORTH. City of Fort Worth CONTRACT NO.. `T9,T&-CZ
Change Order Request Breakdown
Project Name HMAG 2017-13 HIR Street Rehab City Sec# 1 49776
Client Project#(s)i 100994
Contractorl Cutler Repaving PM Kristian Sugrim Inspector! Jarad Souders
Change Order Submittal# Date 10/12/2018
Dept. T/PW Contract Time
Totals CD
Original Contract Amount $1,735,745.70 $1,735,745.70 180
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $1,735,745.70 $1,735,745.70 180
Amount of Proposed Change Order $85,000.00 $85,000.00 130
Revised Contract Amount 1,820,745.70 $1,820,745.70 310
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) $85,000.00 $85,000.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 4.90%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $2,169,682.13
This Change Order will provide for overrun on plan quantities on asphalt pavement base repairs.Also,additional pay items,Unclassified Excavation and Flexbase,are
necessary to complete the repairs on Green Oaks Road within the limits of Alta Mere Dr.and Calmont Ave.Staff concurs with the request of an additional 130 calendar days.
RECEIVED
DEC 312018 OFFICIAL RECORD
CIV Or FORT WORTH CITY SECRETARY
CIZYSECRETARY FT. WORTH,TX
City of Fort worth
Change Order Additions
Project Name I HMAC 2017-13 HIR Street Rehab City Sec# 49776
Client Project# 100994
Contractor Cutler Repaving PM Kristian Sugrim InspectorF, Jafad Souders
Change Order Submittal# C� Date 10/12/2018
ADDITIONS
ty Unit UnitCost Total
22 Asphalt Pavement Base Repair
New Unclassified Street Excavation T/PW 70.00000 Y 50.00
New F exbase T/PW 1,540.00 000 Y $30.06
T/PW $85,000.00
ub Iota(Additions M,000.00
Change Order Additions Page 1 of 1
FoeTwoRm City of Fort worth
v--- Change Change Order Deletions
Project Name HMAC2017-13 HIR Street Rehab CitySec# 49776
Client Project# 100994
Contractor Cutler Repaving PM Kristian Sugrim Inspector Jarad Souders
Change Order Submittal# 0 Date 10/12 2018
DELETIONS
ITEM DESCRIPT10N DEV I ty Unit Unit Cost Total
T/PW $0.00
bub Total Deletions 0.00
Change Order Deletions Page 1 of 1
MISBE 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
F` rgif City of Fort worth
ACCEPTANCE OF PREVIOUS MBE COMMITMENT FORM
(for use with CHANGE ORDERS or AMENDMENTS greater than$60,000)
To be Completed by City Project Manager
Change Order(for Construction Contract)
Project Name: City Project Number
HMAC 2017-13 HIR Street Rehabilitation 100994
City Project Manager
Contractor: Kristian Sugrim
Cutler Repaving,Inc. City's MBE Project Goal: 10 %
Original Amount of Contract $1,735,745.70 Accepted MBE Commitment: 10 %
Total of Previous Change Orders: $0,00 Date of Last MBE Report:
Amount for this Change Order: $85,000.00 Change Order#: 1
Revised Amount of Contract $1,820,746.70 Date: 11/21/2018
Language to be inserted in the MBC for this Contract
Cutler Repaving, Inc. agrees to maintain its initial MBE commitment of 10%that it made on the
original contract and extend and maintain that same MBE commitment of 10%to this first change
order. Therefore Cutler Repaving, inc. remains in compliance with the City's BDE Ordinance and
attests to its commitment by its signature on the Acceptance of Previous MBE Commitment form
executed by an authorized representative of its company.
To be Completed by the Representative of theC actor
Charles R.Veskema President ^-& It,�r lix A
Printed Signature Titie Authorized Signature/Date
Cutler Repaving, Inc,
Company Name Contact Name(if different)
921 E 27th St hVeSkAMa@rutlarrepayina.com _
Address E-mail address
Lawrence,KS 66046-4917 785-843-1524 785-843.3942
City/State/Zlp Phone number Fax Number
as of -IAW,
MBE%Paid to Date Date
ry Project Manager has reviewed the work associated with is CSange Order,
considers it the same or similar to work in the original Contract, and recommends that the
Contractor have the option to retain a d confl=itsisting MBE commitment.
Kristian Sugrim 11/21/2018
City Project Manager City Project Mana r Signature Date
Attach Complete Change Order Documentation and Fotward to MIWBE office
To be CompletedCompliance
M/WBE Compliance Staff ID# MBE Current%Level via Last Report Recd
-
BE Signature ate
CFW Change Order Approval COAppr-Ol Page 1 of 3
Routing
Assigned To: Due Date:
Assigned By: Due Time:
Links 2
fortworthgov/Infrastructure Projects/100994 - HMAC 2017-13 HIR Street Rehab/Contractor/Change Orders/Change Order
Breakdown # 1 2017-13.xlsm
fortworthgov/Infrastructure Projects/100994 - HMAC 2017-13 HIR Street Rehab/Contractor/Change Orders/2017-13
HIR APC C01.pdf
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.: `1
Change Order No.:'C pA0 pr-01 ; Date Started: 12018-12-14
City Sec. No.: 49776 Date Due. ?2019-02 02
-
Project Name:.H MAC2017-13 HIR Street Rehab
100994 DOE Numbers:
Project Numbers:
Project ;Removal and replacement of nonfunctional curbs & gutters,
Description: 'driveways and sidewalks, followed by a HIR overlay of 1" HMAC.
Project/Contract
Compliance _.
Manager: Kristian Sugrim City Inspector: ,)arad Sounders
Contractor: !Cutler Repaving, 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 ( $ 85,000.00 J 30100-0200431-5740010-100994-0 1,130
_-- .... .....�___
J
Total Cost: $ 85,000.00 Total Requested Days: 130
Approval Status:
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CFW Change Order Approval COAppr-01 Page 3 of 3
'Approved: Yes
Comments:
User: Bob Veskerna
Date: 2018-12-14 10:47 AM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2018-12-14 3:41 PM
Approved: Yes
Comments: Extension is due to seasonal tempearature restrictions for HIR construction
User: Lane Zarate
Date: 2018-12-17 6:42 PM
Approved: Yes
Comments:
User: Ricardo Matute
Date: 2018-12-20 9:50 AM
Approved: Yes
Comments:
User: Signing for TPW Director Role Approvals
Date: 2018-12-20 10:16 AM
Approved: Yes
Comments:
User: Doug Black®.............
Date: 2018-12-214:34 PM -�
AtWWCi• :�
Approved: Yes
Comments:
pry SBCrC
User: Susan Alanis M7 J. �s )r, C
Date: 2018-12-28 2:49 PMF_. --`
Action Required:
M
htt„c nnm/ h7 wPh/Fnrm-,/FnrmPrint-a-nOSiteld=51500&Proces... 12/31/2018
Contract Compliance Manager
Re: Change Order No. 1 ($85,000.00)
Contractor: Cutler Repaving, Inc.
Project Name: HMAC 2017-13 HIR Street Rehabilitation
City Secretary No.: 49776
Project No.: 100994
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.
Name of Employee
Project Manager
Title
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX