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POuxm° .cOm"""E"nvLlm CHANGE ORDER REQUEST
CHANGE ORDER M I DATE PROJECT Ng O.E.16
4 1 10/12/2010 000453 5410
PROJECT DESCRIPTION
2004 CIP CONTRACT 51(HUDSON,COLLARD,HAZELINE,PERKINS) 38026
WATER SEWER T/PW TOTALS
ORIGINAL CONTRACT AMOUNT.................................................................... $ 436,284.45 i 19,352.40 '$ 1,353,364.25-$ 1,809,001.10-
EXTRAS TO DATE. ........................................................................ $ 3f571.W '$ - $ 75,714.93' $ 79,286.18,
CREDITS TO DATE.......................................................................... i 1 - $ 241.00 $ - $ 241.00
CONTRACT COST TO DATE............................................................................ $ 439,855.70" $ 19,111.40' $ 1,429,079.18' $ 1,888,046.28-
AMOUNT OF PROPOSED CHANGE ORDER.................................................. $ - $ - $ 3,612.34- $ 3,612.34
REVISED CONTRACT AMOUNT...................................................................... $ 439,855.70-$ 19,111.40• $ 1,432,691.52• $ 1,891,658.62
ORIGINAL FUNDS AVAILABLE FOR CHANGE ORDERS............................... $ 21,814.55- $ 1,934.89• $ 25,000.00-
REMAINING FUNDS AVAILABLE FOR THIS CHANGE ORDER..................... $ 18,243.30- $ 2,175.89• $
ADDITIONAL FUNDING(IF NECESSARY)....................................................... $ - $ - $ 3,612.34 11 3,612.34
CHANGE ORDERS TO DATE(INCLUDING THIS ONAP,AS%OF ORIGINAL CONTRACT COST % 4.60
ATAX ALLOWABLE CONTRACT Al*OUNT(ORIGINAL CONTRACT'COST+25%) $ 2,2111,251.38
ITEM DESCRIPTION-ADDITIONS DEPARTMENT TY UNIT UNIT CO TOTAL
5. QNC.)W LIME SUBGRADE T/PW 1,156.23 SY $ 2.36. $ 2,728.70
8. INC. 7-CURB T/PW 360.60 IF $ 2.73 $ 984.44
10. (INC.)CONCRETE STEPS T!PW 24.70 SF $ 25.00 $ 617.50
14. (INC.)W REINFORCED CONCRETE DRIVEWAY T/PW 104.34 SF S ,4.61• $ 481.01
16. (INC.)6-HMAC TRANSITION T/PW 47.02 TO $ 130.00 S 6,112.60
29. (INC.)REMOVE MAILBOX BRICK T/PW 1.00 EA $ 53.00 $ 53.00 ,
31.1(INC.)INSTAL.BRICK MAIL BOX T/PW 1.00 EA i 735.00- $ 735.00
-
- -
i - $ -
WATER $ -
SEWER $ -
T I PW $ 11,712.25
SUBTOTAL A $ 11,712.25
ITEM DESCRIPTION-DELETIONS DE PA TMENT OTY UNIT UNIT COST TOTAL
9. (DEC.)4-CONCRETE SIDEWALKS AND LEADWALKS T/PW 1 338.52 SF $ 3.97• $ 1,343.92
15. (DEC.)CONCRETE RETAINING WALL T/PW 1 4.411 CY 420.00 $ 1,852.20
34.1(DEC.)7-REINFORCED CONCRETE PAVING(ITEM 34-A) T/PW 1 132.93 SY $ 36.89 $ 4,903.79
WATER $ -
SEWER $ -
T/PW $ 8,089.91
SUBTOTAL B $ 8,099.91
TOTAL(SUB-TOTAL A-SUB-TOTAL B) $ 3,61134
tN ACCORDANCE WITH THIS CHANGE ORDER THE CONTRACTOR SHALL:
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DATE: 10/12/2010
TRANSPORTATION AND PUBLIC WORKS
CHANGE ORDER JUSTIFICATION RECORD AND PROJECT SUMMARY SHEET
PROJECT NAME: 2004 CIP CONTRACT 51 (HUDSON,COLLARD,HAZELINE-,PERKINS)
CHANGE ORDER Ng: 4 D.O.E. Ng: 5410 CLIENT PROJECT Nit: SPQW '_ .
INSPECTOR: 1010i BRENZ PHONE Nil: (817)392-8306 CITY SECRETARY Ng: 38=1
PROJECT MANAGER: RICHARD ARGOMANIZ PHONE Nil: (817)392-SM
COMBINED WATER SEWER T/PW
ORIGINAL CONTRACT AMOUNT $ 1,809,001.10' $ 436,284.45 $ 14,=40: $; 1,353,364.2W.
EXTRAS TO DATE $ 79,286.18 $ 3,571.25• $ $ 75,714.$$
CREDITS TO DATE $ 241.00 _ $' - $ 241.W,, $ -
ORIGINAL AMOUNT TO DATE $ 1,888,046.28 $ 439,855.70- $ 19,111.40• $ 1,429,079.18
AMOUNT OF PROPOSED CHANGE ORDER $ 3,612.34- $ - $ - $ 3,612.34
REVISED CONTRACT AMOUNT $ 1,891,658.62 - $ 439,855.70- $ 19,111.40 - $ 1,432,691.52-
ORIG. CONTINGENCY FUNDS AVAILABLE
FOR CHANGE ORDERS $ 48,749.44 $ 21,814.55_ .:; 1,934.89 $ 25,000.00
REMAINING FUNDS AVAILABLE
FOR THIS CHANGE ORDER $ 20,419.19 $ 18,243.30A $ 2,175.89 • $ -
ADDITIONAL FUNDING(IF NECESSARY) $ 3,612.34 $ - $ - $ 3,612.34-
REASON(S)FOR CHANGE ORDER:
This change order is necessary to cover over nuns on various line items,These inns were inadverfiwtlSr left off of change
ords#3:In order to offset the cost of this Change order,various line items that wi#not be used are being deletu3 L
rOFFICIAL RECORD.
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PROJECT SUMMARY SHEET
(Change Order Attachment)
PROJECT NAME: Hudson /Perkins/Hazeline/Collard
BuySpeed No (T/PW): CSCO-09-00051704
BuySpeed No (Water): CSCO-09-00051973
City Project No: 00453
Contract No: CS38026
D.O.E. No: 5410
Attachment to Change Order No: 4
Today's Date: 10/18/10
TOTAL ?/PW Water Sewer
Original Contract Amount: $ 1,809,001.10 $ 1,353,364.25 $ 436,284.45 $ 19,352.40
Extras to Date: $ 79,286.18 $ 75,714.93 $ 3,571.25 $ -
Credits to Date: $ (241.00) $ - $ - $ (241.00)
Contract Amount to Date: $ 1,888,046.28 $ 1,429,079.18 $ 439,855.70 $ 19,111.40
Amount of Proposed Change Order: $ 3,612.34 $ 3,612.34 $ - $ -
® ' Revised Contract Amount: $ 1,891,658.62 $ 1,432,691.52 $ 439,855.70 $ 19,111.40
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o r Contingency Funds Avail. for Admin. Change Orders: $ 48,749.44 $ 25,000.00 $ 21,814.55 $ 1,934.89
M Remaining Funds Available for Change Orders: $ 20,419.19 $ - $ 18,243.30 $ 2,175.89
n Additional Funding (if necessary): $ (3,612.34) $ (3,612.34) $ - $
X 0
Prepared By: Christy Ezemack T/PW Construction Services
PROJECT SUMMARY SHEET
(Change Order Attachment)
PROJECT NAME: 2004 CIP, Contract 51 - Hudson, Perkins, Hazeline & Collard
T/PW BuySpeed No: CSCO-09-00051704
Water BuySpeed No: CSCO-09-00051973
Contract No: CS38026
D.O.E. No: 5410
Attachment to Change Order No: 4
Today's Date: 11/3/10
TOTAL IM Water Sewer
Original Contract Amount: $ 1,809,001.10 $ 1,353,364.25 $ 436,284.45 $ 19,352.40
Extras to Date: $ 79,286.18 $ 75,714.93 $ 3,571.25 $ -
Credits to Date: $ (241.00) $ (241.00)
Contract Amount to Date: $ 1,888,046.28 $ 1,429,079.18 $ 439,855.70 $ 19,111.40
Amount of Proposed Change Order: $ 3,812.34 $ 3,812.34 $ - $ -
Revised Contract Amount: $ 1,891,668.62 $ 1,432,891.52 $ 439,855.70 $ 19,111.40
n O
= ontingency Funds Avail. for Admin. Change Orders: $ 48,749.44 $ 25,000.00 $ 21,814.55 $ 1,934.89
on
m 8 emaining Funds Available for Change Orders: $ 20,419.19 $ - $ 18,243.30 $ 2,175.89
i � = dditional Funding (if necessary): $ 3,612.34 $ 3,612.34 $ -
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Prepared By: Karen Striker T/PW- Business Support