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CONTRACT NO,
Change Order Number: 3
CWOTS No: 1865T11
Applicant: City of Fort Worth
THIS CHANGE ORDER IS EXECUTED IN DUPLICATE AS FOLLOWS:
0 First Original (SWBT dba AT&T) El Second Original (Applicant)
Contract Change Order No: 3 Date: September 14, 2012
3. The following is an amendment to the terms and conditions of CWOTS No. 1865T11
Item No. 1 Additional costs for contractor, additional splicing and contract coordinator hours needed.
TOTAL EXTRA: $33,478.30
4. The estimated cost in the CWOTS issued in this matter is adjusted to the following amount:
TOTAL ESTIMATED COST: $ 1559153.06 � Ip
Review of CWOTS Estimated Cost S
F. Original CWOTS Estimated Cost $100,040.84
G. Net Sum of Previously Authorized Change Orders $ 21,633.92
H. Present CWOTS Cost $121,674.76
I. This Change Order $ 339478.30
J. New CWOTS Estimated Cost $155,153.06
This Change Order entered into as of the day and year indicated below, by sicanature, amends and modifies the original CWOTS
agreement between Southwestern Bell Telephone Company,and Applicant. By signature below, Applicant agrees to make payment to
Southwestern Bell Telephone Company in the amount of this Change Order within ten (10)days of the date of signature below.
Southwestern Bell Telephone Company City of Fort Wo
By: By: &J
Title: Manager Construction & Engineering Title:
Printed Name: Karen Rose Printed Name:
Date: 14Z - 2 U 12- Date:
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