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CITY OF FORT WORTH
CHANGE ORDER REQUEST
CITY SECRETARY c.o4
CONTRACT NO . 3 $gLDd-
CANARY -CONSTRUCTION SERVICES
PINK -PROJECT MANAGER
GOLDENROD -CONTRACTOR
CHANGE ORDER NO. 4 DATE
03/08/2012
D.O.E.NO
NIA
PROJECT NO.
C291-541200-202240090983
PROJECT DESCRIPTION
Litsey Road Phase II Interim Improvements
CITY SECRETARY CONTRACT NO.
38362
ORIGINAL CONTRACT AMOUNT.. ..................... .
EXTRAS TO DATE .............................. $
CREDITS TO DATE .................................. $
$ 1,081 ,883.13
$ 109,484.87
- 0 -
CONTRACT COST TO DATE ................................................................................................................................................ .
AMOUNT OF PROPOSED CHANGE ORDER ......................................................................................................................................... .
REVISED CONTRACT AMO UNT ................................................................................................................................................................ ..
ORIGINAL FUNDS AVAILABLE FOR CHANGE ORDERS ..................................................................................................... ..
REMAINING FUNDS AVAILABLE FOR CHANGE ORDERS ..................................................................................................... .
ADDITIONAL FUNDING (IF NECESSARY) .............................................................................................................................. .
$1,191,368 .00
2 ,063 .75
1,193,431.75
$ 270,470.78
$ 158,922.16
0.00
PERENTAGE (INCLUDIN G THIS CHANGE ORDER) OF THE ORIG. CONTRACT COST -----------------------------10 .31 %
MAX. ALLOWABLE CONTRACT AMOUNT (ORIG. CONTRACT +25 %) --------------------------------$ 1,352,353.91
IN ACCORDANCE WITH THIS CHANGE ORDER, THE CONTRACTOR SHALL:
En2ineer's Estimate
ITEM DESCRIPTION UNIT QTY NO. UNIT EXTENDED
PRICE PRICE
Change Order No. 4
Item Descrij?tion Uni t ~ Ouanti Unit Cost Total tv
12 Ty I Construction Exit SY -170.00 $ 17 .33 $ (2 ,946.10)
14 Tv 3 Rock Filter Darn LF 77.00 $ 42 .00 $ 3,234 .00
15 Remove Rock Filter Darn LF 77 .00 $ 5.25 $ 404 .25
31 Trench Safety for Box Culverts LF -3.00 $ 1.05 $ (3.15 )
35 Remove/Relocate Type 3 Barricade EA -1.00 $ 787 .50 $ (787.50)
37 Install Object Marker Assy . EA -2 .00 $ 194 .25 $ (3 88 .50)
62 15-Inch Diam. Galvanzied CMP (16 ga LF -20.00 $ 4 0.00 $ (800 .00)
63 15 " Diam . Precase Safety End Treatment EA -2.00 $2,12 5.00 $ (4 250.00)
72 Item 38 Reflectorized Pavement Marking Type I (W) 4 " (SLD) (90 MIL) LF 422.00 $ 1.00 $ 422.00
73 Item 40 Reflectorized Pavement Marking Type II A-A EA 14 .00 $ 3.10 $ 43.40
74 Item 43 Traffic Button Ty Y (Yellow) EA 60.00 $ 2 .68 $ 16 0.80
75 Item 44 Wire Fence (Type C) LF -77 .00 $ 3 .25 $ (250 .2 5)
77 Den se-Grade Hot-Mix Asp halt (Tvoe B) -TN 76 .00 $ 91 .30 $ 6 ,938.80
78 HDPE Flexible Drainage (4 ") ------LF 13 .00 $ 22 .00 $ 286.00 .----• a~CO\\ll
\ ni:f\~II" ... -__ ... l\.tti \ Net Change $2,063 .75
\ -c\"ff s~v--:~ 11. \
It is understood and agreed that the acceptance of this Change Or d~r~an accord and satisfaction and represen ts payment i n full
(both t ime and money) fo r all costs arising out of, or inc idental to, t ea ove C ...,,uer.
' -. .
CONTRACTOR'S NAME:
JRJ Paving, LP
ORIGINAL CONTRACT TIME
260 working days
CONTRACTOR
MA AGER/CONST. SER.
DIRECTOR/CONTRACTING DEPT
APPROVED CONTRACT TIME TO DATE ADDmONAL TIME FOR TIDS CHANGE ORDER
0 working days
COUNCIL ACTION (IF REQUIRED) J.J I A
9 APPROVED 9 DISAPPROVED ( ~
OTHER
OFFICIAL RECORD
CITY SECRETARY
FT, WORTH , TX
DATE :j z 7 / , z_
DATE l( • 3 , ( z.._
DATE
DATE 03/08/2012
TRANSPORTATION AND PUBLIC WORKS DEPARTMENT
CHANGE ORDER JUSTIFICATION RECORD
PROJECT NAME: Litsey Road Phase II Interim Improvements
CHANGE ORDER: 3 DOENO. N/A
INSPECTOR: Michael Barbier, Halff Associates
PROJECT MANAGER: Tariqul Islam
REASON (S) FOR CHANGE:
PROJECT NO C29 l-54 l 200-202240090983
PHONE NO: (972) 956-0801
PHONE NO: (817) 392-2486
This change order rectifies the final quantities (quantities over and under). See detailed items in table on 1st
page of change order.
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DIRECTOR OF ANAGING DEPT.
DIR. OF CONTRACTING DEPT.