HomeMy WebLinkAboutContract 38672-CO4, -.. -~. I)-~ •
FORT,ORTQ. City of Fort Worth
Change Order Request
CITY SECRETARY
CONTRACT NO. 3ili>JJ,-C(&)L.-f
Project Name! Edwards Ranch Rd. Ph.II
crient Project#(s~ C221-541200-303230010783 DOE 5994 ,
Project Descrip., Paving and Drainage
Contractor! LH. Lacy
City Project Mgr.jL-Leon.;..;...._Wi_11son __________ __,
Dept
Original Contract Amount
Extras to Dale
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
ange
Revised ontract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
I NO M&C REQUIRED
TPW
City Sec # 38672
Change Order# 4 Date
City Inspector George Leone
Totals
1/3/2011
Contract Time
CD
210
210
30
240
'·( 1
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.
n O Project Name Edwards Ranch Rd. Ph.II
City of Fort Worth
Change Order Additions
City Sec#
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C221-541200-303230010783 DOE 5994
o m OJ Description
~ ~ ,a ~ ~ ~ Contractor
-t ; 0 Ci Project Mgr . >< -< ~
IIEM
Paving and Drainage
l.H. Lacy
Leon Wilson
----"' IIUN
15A-New !"avers-1,;1ty stone IV ~mega, 1 an ts1ena
Change Order # 4 Date 1/3/2011
City Inspector George Leone
ADDITIONS
Ul:t' I Yrf Unit Unit 1.,0St
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TPW
sut> Tota Addmons
Change Order Additions Page 1 of 1
38672
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$50,l:1t> r .50
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FORT WORTH ---......--City of Fort Worth
Change Order Deletions
Edwards Ranch Rd. Ph.II City Sec# 38672
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Paving and Drainage
ntractor L.H. Lacy
ject Mgr. Leon Wilson
Cl
-'!:~'.."\II'" 1 IVN
!"'avers m Me01an on Kemrorceo (.;oncrete
DELETIONS
I !"'VY
Change Order #
,.......,,.........::::==~---===:::::::: City Inspector George Leone
4 Date 1/3/2011
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suo 1 ota Deletions
Change Order Deletions Page 1 of 1
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CITY SECRETARY
FT, WORTH, TX
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PROJECT SUMMARY SHEET
(Change Order Attachment)
PROJECT NAME:
BuySpeed No:
Edwards Ranch Road, Phase II, Unit 2
CSC0-09-00054509
City Project No: 00107
Contract No : CS38672
D.0.E. No: 5994
Attachment to Change Order No: 4
Today's Date : 1/4/11
Original Contract Amount:
Extras to Data:
Credits to Date:
Contract Amount to Date:
Amount of Proposed Change Order:
Revised Contract Amount:
Contingency Funds Avail. for Admin. Change Orders:
Remaining Funds Available for Change Orders :
Additional Funding (if necessary):
TOTAL C221 /TPW
$ 3,931,769.09 3,931,769.09
$ 277,117.88 $ 277 ,117.88
$ $
$ 4,208,886.97
$ (9,973.64)
$ 4,198,913.33
$ 118,000.00
$
$ 9,973.64
4,208,886.97
(9,973.64)
4,198,913.33
118,000.00
9,973 .64
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:JE~ ,,,c-r:>c-n . " ... ,_.., JAN 1 0 2011
Prepared By: Christy Ezernack T/PW Construction Services
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