HomeMy WebLinkAboutContract 50124-CO2 rSC�,tIVf=�
JUN 1 1 2019
CITY OF FORT WORTH CITY SECRETARY
CITY SECRETARY
FORT WORTH City of Fort Worth CONTRACT NO. 5 O 14 -C1 3-
�'' — Change Order Request
Project Namel 2014 CIP Year 3 Contract 5 City Sec# 50124
Client Pmject#(s)l 02694
Project Description 2014 CIP Year 3 Contract 5,Combined Street Paving Improvements and Water and Sanitary Sewer Main Replacements
project
Contractor JLB Contracting Change Order# 0 Date 5123/2019
City Project mgr.1 Mary Hanna City Inspector F Daniel Roy
Dept. Water Unit 1 Sewer Unit 2 TIPW Unit 3 Contract Time
Totals (WD
Original Contract Amount $1,859,812.75 $967,037.88 $1,864,066.79 $4,690,917.42 425
Extras to Date $83,919.40 $83,919.40 21
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $1,859,812.75 $967,037.88 $1,947,986.19 $4,774,836.82 446
Go to ADD&DEL Tabs to Enter CO Backup $0.00 $0.00 $0.00 34
Revised Contract Amount $1,859,812.75 $967,037.88 $1,947,986.19 $4,774,836.82 480
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO 1 $0.00 1 $0.00 1 $0.00
Additional Funding(if necessary)
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 1 1.79%
MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+255/6) 1 $5,863,646.78
We are requesting 34 additional days for abnormal rain days in the summer and fall during the months of August,September and October.
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.
JLB Contracting
Inspectorfinspection Supervisor Date 'ect Manager/Program Manager
Assistant Director(Dept) Date Director,Contracting Department Dole
Assistant C4 Attorney Date Assistant City Manager Date
Council Action aired
M&C Number M&C Date Approved
rr=1CIAL RECORD
CITY SECRETARY
FT. WORTH,TX
F()krwoKr H City of Fort Worth
� — Change Order Additions
Project Name 2014 CIP Year 3 Contract 5 City Sec# 50124
Client Project# 02694
Project Description 2014 CIP Year 3 Contract 5,Combined Street Paving Improvements and Water and Sanitary Sewer Main Replacements project
Contractor JLB Contracting Change Order# 0 Date 5/2 312 01 9
City Project Mgr. Mary Hanna City Inspector F Daniel Roy
ADDITIONS
yUnit- Unit s o a
Water Unit 1 $0.00
Sewer Unit 2 $0.00
T/PW Unit 3 $0.00
u lotalAdclitions
Change Order Additions Page 2 of 4
FORT WORTH City of Fort Worth
T Change Order Deletions
Project Name 2014 CIP Year 3 Contract 5 City Sec# 50124
Client Project# 02694
Project Description 2014 CIP Year 3 Contract 5,Combined Street Paving Improvements and Water and Sanitary Sewer Main Replacements project
Contractor JLB Contracting Change Order# Date 5/23/2019
City Project Mgr. Mary Hanna City Inspector FDamel Roy
DELETIONS
y Unit Units o a
Water Unit 1 $0.00
Sewer Unit 2 $0.00
T/PW Unit 3 $0.00
�;ulb TotalDeletions
Change Order Deletions Page 3 of 4
MIWBE 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.
Name k Employee/Signature
Title U
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,TX
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