HomeMy WebLinkAboutContract 51257-CO2 CITY SECRETARY
a' 5►a5�-cc�
FORT WORTM City of Fort Worth �NTRACT IdO.
Change Order Request
Project Namel Concrete Restoration(2019-3) City Sec# 1 51257
Client Project#(s)l 101602
pmw
DescriptionI Concrete Restoration at Various Locations
Contractorl Select Striping,LLC Change Order# 0 Date 10122/2019
City Project Mgr. Tariqul Islam City Inspector Lame Pitts
Dept. TPW-Storm Contract Time
Water Totals D
Original Contract Amount $940,678.00 $940,678.00 150
Extras to Date $169,500.00 $169,500.00 60
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $1,110,178.00 $1,110,178.00 210
Amount of Proposed Change order $288,00 $288.00 82
Revised Contract Amount $1,110,466.00 $1,110,466.00 292
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $0.00
Additional Funding(if necessary) 1 $288.00 $288.00
CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 18.05%
MAX ALLOWABLE CONTRACTAMOUNT(ORIGINAL CONTRACT COST+25%J $1,175,847.50
jWMATM OMM)FOR CFIAtW ONM
This change order is to add 192 linear feet of joint sealant to the contracl.The major item for this contract is to remove and replace 7 inch
concrete pavement sections.The original quantity for this item was 4,500 square yards.However,the actual pavement failures requiring
replacement increased by 2,186 square yards to 6,686 square yards.To complete this additional work,a total of 82 calendar days are required
to be added to the contract for the pavement repairs and ancMary work,
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 ProjectlProgram Manager signing below
acknowledges that helshe is the person responsible for the monitoring and administration of this contract,including ensuring all performance and
reporting requirements.
iwontracbdes C.UMWW Name Contractor NarrmA Cn+dract�JOIWSelect Stn in ,LLIr L -t I Id .3c
sor DWe Project M DaW;,
Date . Director,Con6drig DWMent Date Qi
A Date Assfstent Ike
. Couriir�Atli d iced - - �I
M&C Number M8C Date Approved
C
PAR '
i FT. WORTH,TX
FORT WOKrH City of Fort Worth
-1 Change Order Additions
Project Name Concrete Restoration(2019-3) City Sec# 51257
Client Project# 101602
Project Description Concrete Restoration at Various Locations
Contractor Select Striping,LLC Change Order# 0 Date 10/22/2019
City Project Mgr. Tariqul Islam City Inspector Lorrie Pitts
ADDITIONS
ty Unit Unit Cost I ota
Joint Sealant - torm ater
TPW-Storm Water $288.00
ub Total Additions 288.00
Change Order Additions Page 1 of 3
FORT WORTH City of Fort Worth
Change Order Deletions
Project Name Concrete Restoration(2019-3) City Sec# 51257
Client Project# 101602
Project Description Concrete Restoration at Various Locations
Contractor Select Striping,LLC Change Order# Date 1 0/2 212 01 9
City Project Mgr. Tariqul Islam City Inspector Lonne Pitts
ITEM DELETIONS
unit Unit Cost Total
TPW-Storm Water $0.00
Sub Total Deletions 00
Change Order Additions Page 2 of 3
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
Change Order Additions Page 3 of 3
>o
3 a � a�
o a =m > o
Y n z m N O o o ; o o °1 o i x c o
v N o S @l ; @J E C a q N @l o
O w @J z ; o a
d 6 E o Im 'E .o -i N .o U Y' Y «O G o L d 3
P
A O d A ; .0 6 -i a W L W d N d a y L P a
a S z a o E t z m a a 5 E" A d
z z E � T E — E E,« 3 o E Q n m d
'Q 3 ' d Vd a ° a o a v° n q ° o v c
Fo
0
7E F- m S 3 m n
.C. C C ¢ 6
n
E $
c
co
CD
0
n o
o $&
a �7
E iO
o X Lo
O cVo
E
M W
vo s zo o
m v
C
Y m
z v
z \
O
co
� Mil
� o
0
v
5 Q�
142
m
oa
N �
o ❑
O
o N
o
a Eco
N
M
8 C c Lo
cn
o Cco
.o C
o �
. m
a fO o a
r
ul 7
� �sr �
a C o m � co
a �
a OFFICIAL RECORD
o o 0
° CITY SECRETARY
O ¢ w n
z L0
FT WORTH TX
t
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.
Tariqul Islam
Graduate En ig neer
Title
❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH,T