HomeMy WebLinkAboutContract 35764-CO1 CITY SECRETARY
CONTRACT NO.
DEPARTMENT OFENGINEERING
CHANGE ORDER JUSTIFICATION RECORD AND PROJECT SUMMARY SHEET
PROJECT NAME:
CHANGE ORDER: DOE NO.: W5764CLIENT PROJECT NO.:
CITY SECRETARY NO.: F55TON INSPECTOR: I PHONE NO.:
PROJECT MANAGER: PHONENO.0
COMBINED WATER SEWER TIPW
ORIGINAL CONTRACT AMOUNT $ 417.250.50
EXTRAS TODATE $ -
CREDITS TDDATE $ -
ORIGINAL AMOUNT TDDATE $ 417.250.50 $ 7385650 $ 81.157.50 $ 262,23880
AMOUNT OF PROPOSED CHANGE ORDER $ 12`858.35
REVISED CONTRACT AMOUNT $ 430.106.75 $ 73.858.50 $ 81.157.50 $ 275.092.75
ORIG. CONTINGENCY FUNDS AVAILABLE
FORCHAN[�EORDERG � 3�.i12.00
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REMAINING FUNDS AVAILABLE
FOR THIS CHANGE ORDER $ 25.112.00 $ 8,000.00 $ 8,000.00 $ 13.112.00
ADDITIONAL FUNDING(IF NECESSARY) $ - $ - $ - $ -
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DlireFtoir of Managing- Dept. Dat6 Manager of ConstKjqKn Services 0 -eooikn�o
Director of ContracAng Dept.
Ade8W by
OFFICIAL RECORD 0
FT. WORTH, TX MEtry J. Kaysei�,jbt�
DLSTROUTIOR CITY OF FORT WORTH /
WOTE-FILE
CANART-CORSTRUCTaON SERVICES CHANGE ORDER REQUEST
PIIe(-PROJECT WINGER
GOLOENWOO-CONTRACTOR
CHANGE ORDER NO I DATE D.O.E.M PROJECT W
1 10/26/2007 6644 C200-641200-204It00076W3
FRWECT 13ESCRIPTION CITY SECRETARY CONTRA
2004 CIP Year 1 Contract 6 3574
WATER SEWER TIPW TOTALS
ORIGINAL CONTRACT AMOUNT i 73,956.50 i 81,157.50 i 262,236.50 i 417,250.50
EXTRAS TO DATE -
CREDITS TO DATE
CONTRACT COST TO DATE i 73,856.50 i 81,157.50 i 262,236.50 i 417,250.50
AMOUNT OF PROPOSED CHANGE i - i - i 12,8W.25 i 12,8W.25
REVISED CONTRACT AMOUNT i 73,856.50 i 81,157.50 i 275,092.75 i 430,106.75
ORIGINAL FUNDS AVAILABLE FOR i 6,000.00 i 6,000.00 i 13,112.00 7,,-?
REMAINING FUNDS AVAILABLE FOR THIS CHANGE ORdEV i 6,000.00 i 6,000.00 i 13,112.00 a :: � .. 11
ADDITIONAL FUNDING(IF NECESSARY) $ - $ - $ - ip
-CHANGE ORDERS TO DATE(INCLUDING THIS 0NE1 AS%OF ORJOINAL CONTRACT COST 1f. 3.08
WAX.ALLOWABLE CONTRACT ANOUNT(ORIGINAL CONTRACT COST t 26%) $21,60.13
MENT OTY UNIT UNIT COSTAL
em ran rent
SEWER 6 -
TIPW
SUB-TOTAL A
DESCRIPTIONITEM P TY UNIT UNIT COST TOTAL
WATER $
SEWER
TIPW -
SUB-TOTAL B, - j /
TOTAL(SUB-TOTAL A-SUB-TOTAL B) $ 12,856.W
IN ACCORDANCE WITH THIS CHANGE ORDER THE CONTRACTOR SHALL:
It if NadeNtoed eOd Speed flat Ne samo M of Oft ChwW ONdx by Ne COIIbef1OT CONgflbl an so mrd WW sede*Wm nM tad aOOOey)W eA Costs edsip of oI,oT IOOde l to,flm
abo"ChmVe ONdx.
CONTRACTOR'S NAME: CONTRtpr0j( CONTRAC DATE:
McClendon Const Pj
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ORNRNILL CONTRACT TSAE ADDL APPROVED TIME TO DATE APPROVED CONTRACT TRAE TO DATE ADDITIONAL 14ME FOR THIS CHANGE ORDER
90 WD 0 WD 90 WD 1 WD
MANAGER!CONEY.SER. DATE -/ PROJECT DATE
DIRECTOR/MANAONG DEPT. DATE IbR7ftOR I 4AMTkACTWG DEPT. DATE
.
d�) {I1l T 'L' p i ;"` 1 //
ATTORNEY DATE f /; !�' ASSISTANT CITY ER DATE
fell AqW
COUNCIL ACTION QF REQUIRED) DATE
APPROVED _DISAPPROVED _OTHER