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HomeMy WebLinkAboutContract 44743-CO39 CITY SECRETARY CONTRACT NO.44743-CO39 TEXAS DEPARTMENT OF TRANSPORTATION CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: 39 Third Party Funding Notification Sheet This form is used when the subject change order involves funding by a source other than TxDOT/U.S.DOT,and involves third parties who are providing funding under an Advance Funding Agreement or Donation Agreement. 1. Outside funding provided by: CCSJ: 0902-48-539 City of Fort Worth (Outside Entity's Legal Name) Project. BR 2006(132) 2. Type of outside funding agreement for this change: Highway. CS P1 Existing nn Amended Flew County: Tarrant [Chick one] District: 02-Fort Worth 3. Indicate the type and amount of funding: Contract El Fixed Price(Lump Sum) (Estimated Amount ) Number: 08133013 Actual Cost J (a) Contract Items(Bid Items): $1,450.00 Use as needed: I hereby acknowledge notification of the modifications (b) E&C": (a)x = $0.00 covered by this Change Order. enter% (c) Indirect Cost**: (a+b)x = $0.00 enter% Date 12/14/16 TOTAL $1,450.00 �--- By CITY OF FORT WORTH APPOVAL RECOMMENDED: Typed/Printed Name Jay Chapa ' I I L"r Typed/Printed Title Assistant City Manager Douglas W1 Wiersig,P.E. Director,Transpotation/Public W ,ks Department *The percentage(%)for E&C(Engineering and Contingencies)charges varies from project to project depending on the contract amount of the project.Projects with higher contract amount will have the lower rate of E&C charge. For a specific project,E&C rate(%)can be derived from the cost of"Engineering and Contingencies"in the"Estimated Cost"of the project. " Use the statewide district rate as established by Finance Division each year. This line 3(c)is for Service Project only, unless otherwise specified in the Advance Funding Agreement. See Stand Alone Manual Notice 98-2 for instructions. Funding for this Change Order has been arranged: TxDOT Representative Date Typed/Printed Name: TXDOT Form 2146-AFA(Rev.07113)Page 1 of 1 AX PROVED AS TO FORM AND LEGALITY . ,, Doug as W. Black Assistant City Attorney E< / « § » \ / � - - J 8 \ / _0 to \ / & } \ LL / \ / § ❑❑�❑ & \ = R LD < ® 3 CD 4§ \ A \ / \ / \ =; \ @ E \ §\ <} < E a)kj o ± \/ ƒ §\ \ z LL 0 LL Sl❑❑❑❑ \ w O ` / z \ \ / �\ / \ o § E \ cm ui ; z § /\\ ® ° ) p E e = \ \ � \ § § \_ o @ / g \ \ / \ / w \ n -ju a § @ % t e z a_ E _0 _ @ g § < 2 f 2 / 2 z § L zIII § \ / / m o z / e = § § z } IL z 0 § \ § ) d k R z « « § 2 § k 2 $ ® o � w m w w « o % § § 2 2 R $ $ o § w / 6 \ o ba cn } } ITC-3) � o ` 0 � \ \ \ § / a) / o \ / k / ) / \ f / < U) 7 o e S k =_ f @c E 2 \ ® 2e z S \ _ ? 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R $ iL 2 CL R S g c) # = c &/ / / / / z z « a uj LU 13 LU \ 0 // C5 cn ) { &f B ) / § » / 2 k § b cu r § D § / § o z m / \ § k� LLJ ( § / \ j § § M k \7 0 0 0 LL § 5 \ \ LU LU LU ui \ } k k \ co/ \ \ CU 0 2 \ a : § \ \ ( o § 2G � \ % ¥ \ \ § S w 2 z z z § \\\ $ ( ¢ § / [ u S ui a « \ o ƒ / / / k k ~ O o 0 Z 0 O 0 _0 v_ m a� R LO a O L o w � z O F- z O 0 O U o C'J � Q 2 � F, W K O LU O z a x U W Fes- O w C7 0 d > o + W C7 � O � M O 0' m z W W F- U_ o D z R o d' a o O C; w v C7 z x F- U Z p � p N N O W rn I- M � O W p � W O (9 w z cD z Oz F = a_ U ❑ w ❑ L) Z) 0 N O > w z w G Z) w a rn o N Z M 00 U LO ON co co w 04 CM ❑ O O 0 O O N H W ro Q W O o U rn N D ~ m z W m LLI F- U z J rn W W Z z O F- 0 V OU m U Z o 1* 4- 0 a m a� co a rn M O O O m V z d' 64 W O w a z x U C 7 O E Q co O d a� t6 U Y L O 0) M LO co 'd' J N Q CD U CD O J N W E L ❑ M cm F O 0 U w a 0 le z O o M 0 LL r FORTWORTH MEMORANDUM TO THE RECORD TO: CONTRACT FILE NO. 44743 DATE: January 3, 2019 FROM: Vania Soto, Administrative Assistant City Secretary's Office SUBJECT: REQUEST TO FILE MULTIPLE CHANGE ORDERS TO CITY SECRETARY CONTRACT NO. 44743 BACKGROUND On January 2, 2019,the City Secretary's Office received Change Order Nos. 38, 43 and 45-51 to City Secretary Contract No. 44743. During routine research before filing, it was discovered that previous change orders had never been filed with the City Secretary's Office. The Administrative Assistant requested originals of these documents from Transportation and Public Works for attesting and recording, but was informed that Change Order No. 1, 7, 29 and 33 did not have any documentation and were not received at the City Secretary's Office. Change Order No. 2, 3, 11, 21, 25, 30, 31, 37, 40 and 44 were not required by TXDOT to be signed by the City. All other Change Orders not mentioned have signatures and do not require a memo to record. Therefore, it was requested by Transportation/Public Works that a copy of the change orders or this memo be made the original in order to facilitate the processing of subsequent Change Orders. Correspondence related to the location of the original and the request for filing has been included in the contract file. AUTHORIZATION FOR CONTRACT NUMBER Per the direction of Mary Kayser, City Secretary, the City Secretary's Office has been requested to issue a contract number,and place in the City of Fort Worth's official contract files the Change Orders that were missing. This request has been approve City Secretary's Office