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Contract 50857-CO1
FORT wORTH® City of Fort Worth CINSECRETARY REACC� -(,(� Change Order Request Project Namel Concrete Paving Joint Sealant 2019 City Sec# 1 50857 Client Project#(s)l 101287 Project Clean and Silicon Existing Concrete Pavement Joint Description Contractorl Macias Specialty Contracting Change Order# 0 Date 2/18/2019 City Project Mgr.1 Juan Pablo De La Cruz City Inspector Matt Cain Dept. TPW-Storm Contract Time Water Totals D Original Contract Amount $349,080.00 $349,080.00 120 Extras to Date Credits to Date Pending Change Orders(in M&C Process) Contract Cost to Date $349,080.00 $349,080.00 120 Go to ADD&DEL Tabs to Enter CO Backup $0.00 24 Revised Contract Amount $349,080.00 $349,080.00 144 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 Additional Funding(if necessary) CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.00% MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $436,350.0)q AWIR '11C11111(R�FORCHANOE ORDER A change order is required to add additional contract days for Macias Specialty Contracting LLC.The contractor encountered 25 rain days during the contract period.However,only 24 additional days were required to complete the work.Therefore,we are only requesting the 24 additional days,as required.Throughout the project duration,the contractor has made a good faith effort to complete the work on time,with sufficient equipment,material,and labor. AtlesW by - Q �•.0 i} R/�on2�oe�N M G� OF ORc(PF' � retary Sec % It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full(both time and money)for all costs arising out of,or incidental to,the above Change Order. The Project/Program Manager signing below acknowledges that he/she is the person responsible for the monitoring and administration of this contract,including ensuring all performance and reporting requirements. Contractors CmpW Name Macias Specialty Contracting o•fi L Jnspector/nsdecttqn Date Ass' M&C Number M&C Date Approved ti 0 00 CD 0 rn 0 N_ O 1k N U O C CO O U � c r c U m a`> 72 O N a> O 0 Q1 U (UCL L U U -S� pp N 2, cc a U d 0 Ln +_ o C 'a z Q ~ a LL ` L y- O c O Q o A d +-0 of UM t m U 0- CT) O ZS a) N U O U a� m - W a� _m N U C CO o w U cu U Q1 �!:, J c U c6 O cc — U (d CO d Q _O O C U) � N cu cu U _ U 00 cu C c C N N (UU U o U O E o m a"i Q m 3 U U U U CO O E o c p U O _ d G4 U 'o U d CD 0 0 0 0 0 co m o � =o E Q o co � o H � N O N 61 Cup f0 d N O Q Q1 0 cu txoC f0 L U O U') co CD Lorn 0 N_ � O � N U O C U) a N U is c c ca U is > CD O N CD O O CM CDU (D d aI a O U N L 0 N c O w 0 t: J L O d w LL V- O c O O 0 a� � c ago C CD U ca � v t U `a a o � N U C O 01 � U c is CD _0) 0 U) — N � C O CO p LU U U CD C a J c O + U (D N f6 U CD d _0 d O CD c U) (d a) a_ d_ 00 ca C N O Uca ca C CD T p m 3 ZO U C U 0 N O N O a � U � �o U d C) 0 0 0 ell 691 � o E p o � � o CO N O N a) tao ld d C O a, a, a, a, OD C ra t U M/WBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO N/A Total $0.00 Previous Change Orders CO# DATE AMOUNT None 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. Juan Pablo De La Cruz-/ Name of Employee/Signature Project Manager Title This form is N/A as No City Funds are associated with this Contract Printed Name Signature A RECORD RETARY RTH, TQC i Concrete Joint Sealing 2018 Day Number: 1 Chargeable Day?: Yes Date: 7I30I2018 Day of the Week: Monday Weather Conditions: Rain H=91 L=73 _ CONTRACTOR Forman 1 Operator 4 Pipe Layer _.. PERSONNEL Laborers 6 Truck Driver . EQUIPMENT= Backhoe Loader Haul Truck }Misc_E ui menta lCompressor, sawcutters Progress: (Designation: Cooks Ln. From: 1-30 To: Brentwood Stair l Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: j .Designation. From: To: General Remarks: Marked Ciooks Ln.from 1-30 to Ederville Rd_ Contractor is rained out- _____ ._ (Use Aft+Enter for Line Breaks) i i I i_ i Concrete Joint Sealing 2018 Day Number: 12 Chargeable Day?: Yes Date: 8110!2018 Day of the Week: Friday Weather Conditions: Rain H=85 L=73 CONTRACTOR Forman 1 Operator 4 Pipe Layer PERSONNEL: Laborers 4 Truck Driver (EQUIPMENT: Backhoe Loader0 Haul TruckO ' Misc_ Equipment: ICompressor, sawcutters Progress: ;Designation: Cooks Ln. From: 1-30 To: Brentwood Stair [Designation: From: Tn: Designation: From: To: �Designation: From: To: Designation: From: To: DesignatiGn: Fram: To: i. General Remarks: TCP in place. Rained out (Use Aft+Enter for Line i Breaks) Concrete Joint Sealing 2018 -- -- Day Number_ Chargeable Qay? - Yes !gate_._.__ 811 12018 -" _Day of the Week_ Weather Conditions: Rain H=89 L=74 CONTRACTOR _Farman _ Operator -- - PERSONNEL: Laborers Truck Driver _ EQUIPMENT- Backhoe Loader Haul Truck�� Misc_E ui menta Compressor,sawcutters Progress: • Designation:_ Cooks Ln_ - From: 1-30 To: Brentwood Stair De"inatiom -_ - From: To: Qesignattorr_ — _ From: Designation: From: To: Qesignation_� _ -Fram: To: Desi nation: Fram: To: General Remarks: Rained Out (Use Aft+Enter for Line Breaks) Concrete Joint SeaU 2018 Day Number 16 Chargeable Qay?: Yes Date: 8/14/2018 Day afthe Week Tuesday - - - - -- -- -- Week:. -. Weather Conditions: Rain H=92 L=7fi CONTRACTOR Farman Operator Pipe Laver�� _ PERSONNEL: LaborersEEE____' Truck Driver EQUIPMENT BackhoeLoa Loader Haul Truck Misc_E ui ment: Compressor,sawcutters PTTess: Qesi nation: _ Cooks Ln_ Fro 1-30 To: Brentwood Stair Qesi nation: Fro To: Qesignation: _ Fra To: Qesi nation_ i Frorrt To: Designation: - -_ Fra To: Desi nation: Fro To: General Remarks: Rained Out (Use Alt+Enter for Line Breaks) Concrete Joint Sealing 2018 - _ Day Number., _ 17 Chargeable Day?: Yes _ __ _ Date__ 811512018 Day of the Week:.rt Wednesday_ I ----------- Weather Conditions: Partly cloudy H=98 L=79 CONTRACTOR Farman Operator 1 -- Pipe Layerr.�_ i PERSONNEL: I Laborers Truck Driver i EQUIPMENT: Backhoe _ Laader� Haul Truck I Misc_Equipment: Com ressor,sawcutters Progress: Designation: Cooks Ln. From: 1-30 To: Brentwood Stair Designation_ From: To: Designation: Fram: To: Designation: From: To: Designation. From: _ _To: Desi nation: From: To: General Remarks: Rained Out (Use Alt+Enter far Line Breaks) Concrete Joint Sealing 2018 Day Number 3& Chable Day?: Yes Date; 9131c�078 rgeaDay of the Week:' Monday Weather Conditions: Rain CONTRACTOR Farman _ Operator _ Pim LayerO� I PERSONNEL: Laborers Truck Driver T __.__; i - – - EQUIPMENT. Backhoe Loader0 _ Haul Truck Misc. Equipment: Progress:' Designation: From: To: _..----- __.._ --_-.__— Designation: _From: _ Ta: Designation: From: To: Designation: _ From: To: Designation: From: To: Designation: From: To: I General Remarks: Rain out (Use Aft+Enter for Line Breaks) Concrete Joint Sealing 2018 Day Number: 37 Chargeable Day?: Yes Date: 9/4/2018 Day of the Week: Tuesday Weather Conditions: Rain CONTRACTOR Forman Operator Pipe Laygr� PERSONNEL: Laborers Truck Driver EQUIPMENT: Backhoe Loader 0. Haul Truck �Misc.Equipment: Progress: i Designation_ FrGav, Ta: Designation: FrorriF To: iDesignation: Frorn- To: Designation: From: To: Designation: Fra To: Desi nation: Fro : To: General Remarks: Rain Out (Use ARtEnter for Line Breaks) I I J Concrete Joint Seating 2018 { Day Number: 38 Chargeable Day?: Yes Date: 915/2018 Day of the Week: Wednesday Weather Conditions: Rain CONTRACTOR Forman Operator Pipe Lay PERSONNEL: Laborers Truck Driver (EQUIPMENT: Backhoe Loader Haul Truck Misc. Equipment: Progress: Designation: Fra To: Designation: From: To: __ .__ -__-_. Designation: From: To: Designation: Fro,,!I- To: Designation: From- To: Desi nation: I From< To: General Remarks: Rain out T (Use ARtEnter for Line Breaks) Concrete Joint Sealink 2018_, Day Number:. 39 Chargeable DayT- bte: 131612018Day of the Week: Thursday Weather Conditions: Rain CONTRACTOR PERSONNEL: -__ _. _..___P___Y _0-_ _��___.______, Laborers Truck Driver Loader Haul VIS--c--Equip,ment: Desi atian: From: To: Des�ignation:. From: -Tq; Designation: From: To: PLs:jqnatiGn--__ - From: To: _Desi q,�ation: From: To: Designation: From:, To:, General Remarks: Rain Out (Use Ai� ter for Line Breaks)____ Concrete Joint Sealing Day Number: 40 Chargeable e ay. Date: 91712018 Da of the Week: Frid WeatherConditions: Rain __Operator erl------ - PERSONNEL: Labors LayTruck Driverl EQUIPMENT: Backhoe Loader Haul Haul-Truck I Progress_Misc. E ui menta :pisia�afl�mFrom- To: From: To: From: To: Designation-_ _ From: To: _pesignatiGn- From. To: Desi nation: From:, To: General-Remarks-:- Rain Out (Use Ak+Eriter for Line Breaks) Concrete Joint Sealing 2018 Day Number: 43 Chargeable Day?: Yes Date: 911012018 Day of the Week: Monday Weather Conditions:IRain CONTRACTOR Forman Operator Pipe Layer PERSONNEL: Laborers Truck Driver EQUIPMENT: Backhoe Loader Haul Truck Vis-C.-Equipment: Pr ress: D _ To: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: General Remarks: Rain Out (Use AR=Enter far Line Breaks} Concrete Joint Sealing 2018 I Day Number:_ 44 Chargeable Day?-- Yes Date: 91 112018 Day of the Week Tuesday I Weather Conditions: Rain CONTRACTOR Forman Operator Pipe Lay r0 PERSONNEL: Laborers Truck Driver _ EQUIPMENT- Backhoe Loader Haul Truck. �Misc_Equipment: Progress: Designation: Fro : To: Designation: Fns - To: Designation: From: To: Designation: Fro To: Designation: Fro : To: Desi nation: Fro!p:, To: General Remarks: Rain Out (Use Ai-Enter far Line Breaks) 1 Concrete Joint Sealing 2018 Day Number: 45 Chargeable Day?: Yes Date: 911212018 Day of the Week: Wednesday Weather Conditions: Rain CONTRACTOR FormanOperator Plpe LayerO PERSONNEL_ Laborers. _ Truck Driver _ EQUIPMENT: Backhoe Loader0 Haul Truck Misc_Equipment: Progress: D ,__.___esignati_._on:__ From: To: _ . _ _ Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: General Remarks: Rain Out (Use AR+Enter for Line Breaks) Concrete Joint Sealing 2018 Day Number 46 Chargeable Day?: Yes Date: 911312018 Day of the Week: Thursday Weather Conditions: Rain CONTRACTOR Forman Operator Pipe LayerO PERSONNEL: Laborers Truck Driver.. EQUIPMENT: BackhoeLoader Haul TruckO Misc. Equipment: Progress: Designation_ From_ To: designation: From: To: Designation: From: To: Des gnation: From: To:. Designation: From: To: Desi nation: From: To: _Gen_eral Remarks: Rain Out (Use Alt=Enter for Line Breaks) Concrete Joint Sealing 2018 Day Number: 47 Chargeable Day?: Yes Date: 91 412018 Day of the Week: Friday Weather Conditions: Rain ]PO ONNE©R Laba ears. TruOk DperavertorF:El -, -1 Pipe La,_r EQUIPMENT: Backhoe Loader Haul Truck �Misc-Equipment: 11 Progress: Designation. From: To: Designation: From: To: Designation: From: To: Designation: Frain: Ta: Designation: From: _To: Designation: From: To: General Remarks: Rain Out (UseAft+Eater for Line Breaks) 1 1 1 Concrete Joint Sealing 2018 Day Number 64 Chargeable Day?: Yes Date: 10/1/2018 Day of the Week: Monday Weather Conditions: Rain H=87 L73 CONTRACTOR Forman Operator Pipe La r0_. PERSONNEL: Laborers Truck Driver EQUIPMENT: Backhoe Loader Haul Truck Misc. Equipment: Progress: Designation: Sycamore School Rd_ Frori To: Designation: Fror t Ta: Designation: Fror�i To: Designation: Frori To: Designation: Fronir To: Designation: iroj To: General Remarks- Rain Out (use AR+Enter for Line Breaks) Concrete Joint Sealing 2018 Day Number. 72 Chargeable Day?: F Yes Date- 101912018 Day of the Week: Tuesday Weather Conditions: Rain H=75 L=65 CONTRACTOR Forman Operator Pipe LayerO PERSONNEL: Laborers Truck Driver EQUIPMENT: Backhoe Loader Haul Truck Misc. Equipment: Com ressor, blowers, pump truck, Sawcut machines Progress: Designation: Sycamore School Rd. From: To: meadow creek Designation. From: To: Designation_ From: To: Designation: From: To: Designation: From: To: Designation: From: Ta: General Remarks: Rain Out (Use A f Enter for Line Breaks) i Concrete Joint Sealing 2018 Day Number: 75 Chargeable Day?: Yes Date: 9011212018 Day of the Week: Friday Weather Conditions: Rain H=65 L=50 CONTRACTOR Forman I Operator 4 Pipe LayerO PERSONNEL: Laborers 5 Truck Driver EQUIPMENT: Backhoe Loader Haul Truck I ivlisc_ Equipment: lCompressor, blowers, pump truck,Sawcut machines Progress: Designation: Hulen Rd. From: south dr. To: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From.- To: General Remarks: Rain Out (Use Aft-Enter for Line Breaks) Concrete Joint Sealing 2018 Day Number 78 Chargeable Day?: Yes Date: 1015/2018 Day of the Week: Monday Weather Conditions: Rain H=51 L=42 CONTRACTOR Forman Operator Pipe Lay r PERSONNEL- Laborers Truck Driver EQUIPMENT: Backhoe ,Loader 0 Haul Truck Misc.Equipment: Progress: Designation: Fr ar ti To: Designation: Front: To: Designation: Fra To: Designation: Fro : To: Designation: Fro : To: ! Designation: Fro To: General Remarks: Rain Out (Use Aft+Enter for Line (Breaks) i 1 i i Concrete Joint Sealing 2018 Day Number: 79 Chargeable Day?: Yes Date: 1011612018 Day of the Week: Tuesday Weather Conditions: Rain H=53 L=46 CONTRACTOR Forman Operator Pipe Layer PERSONNEL Laborers Truck Dever EQUIPMENT: Backhoe LoaderHaul Truck !Misc. Equipment: Progress: Designation: Fro To: : To: !Designation: Fro Designation: Frori. To: _.._ Designation_ Fron_ To: Designation: Fron[r: To: Designation: Fro To: General Remarks: Rain Ouit (Use AR+Enter for Line Breaks) j Concrete Joint Sealing 2618 Day Number 94 Chargeable Day?: Yes Date: 10/31/2018 Day of the Week: Wednesday Weather Conditions: CONTRACTOR Forman —Operator Pipe Layer PERSONNEL: Laborers Truck Driver EQUIPMENT_ Backhoe 0 Loader 0 Haul Truck Misc. E q ui menta Progress: Designation. From: To: Designation: From: To: Designation: From: To: Designation: From: To: Designation- From: To: _--_ _. . . _____.v_ Designation: From: To: General Remarks: Rain Out (Use Alt+Enter fur Line Breaks) Concrete Joint Sealing 2018 Day Number: 95 Chargeable Day?. Yes Date: 11/1/2018 Day of the Week: Thursday Weather Conditions: Cloudy H=65 L 50 CONTRACTOR Forman Operator Pipe Layer _ _ �. PERSONNEL- Laborers Truck Driver EQUIPMENT- Backhoe Loader Haul TruckQ Misc.E ui ment: Progress: Designation: From: To: Designation: From: To: I Designation: From: To: Designation: From: To: Designation: From: To: Desi nation: From: To: General Remarks: Rain Out (Use Aft,Enter for Line Breaks) L 1 int Concrete almg8ayNube130 Chargeable Day?: Date: 7 6!2018 Day of the Week: Thursday Weather Conditions: CONTRACTOR Forman -Operator Pipe La er0 PERSONNEL: Laborers Truck Dnver EQUIPMENT- Backhoe Loader Haul Truck Misc- Equipment: Cam ressor,Savvcut macnines, pump truck Progress: Designation: Fro :I To: Designation: From: To: _.._._.....-__-- Designation: From: To: Designation: From: To: Designation: Fro : To: Desi nation: I Fro : To:, i !General Remarks: Rain Out {Use Alt}Enter far Line Breaks) I I Concrete Joint Sealing 2018 Day Number: 131 Chargeable Day?: Yes Date: 127I2018 Day of the Week: Friday Weather Conditions: CONTRACTOR Forman Operator Pipe Lay r0 PERSONNEL: Laborers Truck Driver EQUIPMENT: Backhoe0 Loader0 Haul Truck Misc. Equipment: Progress: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: Designation: From: To: General Remarks: Rain Out (Use Rtt.Enter Tr Line Breaks)