HomeMy WebLinkAboutContract 44334-CO1 (2)FORT WORTH$
Project Narr
Client Project #(
HMAC Surface
City of Fort Worth ��� gECR�ETA� �, ' ,� _ �, ;
Change Order Request BreakdownC���� ���
Contract 2013-03 City Sec # 44334
# 2072, DOE # 6996
Change Order Submittal # �
Dept.
Original Contract Amount
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
Amount of Proposed Change Order
Revised Contract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
TPW
u
170.00-
363.00
533.00
�0:00 I I
$68,363:00'
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT
MAX ALLOWABLE CONTR,4CT AMOUNT (ORIGINAL CONTR,4CT COST + 25%J
Date 4/18/2014
Totals
)20,17(
II17
� $68,363.00 �
.7:43%
$1;150,212:50 `
Contract Time
(CD)
180
120
300
�- JUSTIFICA_'TION (REASONS� FOR`-�H;4NG� QRD�R �-.F �" ` � ' � § P -
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Additional construction time and quantifies need to be added to existing items to account for adding the paving on Travis Avenue (Biddison to
Dickson), and for construction over-runs on the contract.
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OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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Change Order Additions
Project Name HMAC Surface Overlay Contract 2013-03 City Sec # 44334
Client Project # Project # 2072, DOE # 6996
Change Order Submittal # �1
ADDITION5
Change Order Additions Page 1 of 1
Date 4118I2014
° FOFT WORTH
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c�ty of Fort wo�tn
Change Order Deletions
Project Name HMAC Surface Overlay ConUact 2013-03 Gity Sec # A4334
Client Project # Project # 2072, DOE # 6996
Change Order Submittal # �1
DELETIONS
Date 4/18/2014
m ni os o a
TPW 0.00
u ota e etions
Change Order Deletions Page 1 of 1
Breakdown
F�> ,�w<� r� City of Fort Worth
ACCEPTANCE OF PREVtOUS M/WBE C�MMITMENT F�RM
Language to be inserted in fhe M&C for this Contract
JL.B CONTRACTING, L.LC. agrees to maintain its initfal M/WBE commitment of 17% that It made
on the ariglna) contract and extend and maintain that same M/WB� cammitment of 17% to thfs
fiirst change order, Therefore JLB C�NTRACTING, LLC, remains in compliance with the Clty's
M/WBE Ordinance and attests to its commitmant by Its signature on the Acceptance of Prevfous
M/WBE Comm(tment form executed by an authorized representative of its company,
To be Completed by the Representattve of the Contractor
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�Printed Sfgnature Title Authorized Signature/Date
JLs CONTRACTING, LLC,
Company Name Contacf Name (if different)
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Address E-mail address ,
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(for use with CHANGE ORD�Rs or AM�NDMENTS greater than �60,000)
CFW Change Order Approval St-COApp01
Routin
Assigned To:
Assigned By;
Page 1 of 3
Due Date:
Due Time:
Links 2
fortworthqov/Infrastructure Proiects/02072 - HMAC Surface Overlav (2013-3)/Contractor/Chanae Orders/20140424030555887.pdf
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CFW Change Order Approval St-COApp01
���'���,�T��, c�ty of Fo�t wo�tn
. Change Order Request Approvai
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 1
Change Order No.: St-COApp01
City Sec. No.: 44334
Project Name: HMAC Surface Overlay (2013-3)
02072
Project Numbers:
DOE 6996
Date Started: 2014-04-24
Date Due: 2014-06-13
DOE Numbers:
PrOjeCt Removal and replacement of broken curb/gutter, driveways and
Description: base repairs; pulverization and stabilization of existing
pavement with a 2" overlay of surface course HMAC.
Project Manager: Kristian Sugrim
Contractor: JLB Contracting, LLC.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number:
COST AND DAYS SUMMARY:
Department: Cost($)
Transportation & Public Work $ 68,363.00
Total Cost: � 68,363.00
Approval Status:
City Inspector: Ali Motamed
M&C Date:
Requested
Days:
Fund Account Center:
C293-541200-202620207283
120
Total Requested Days: 120
Page 2 of 3
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CFW rhange Order Approval St-COApp01
Approved: Yes
Comments:
User: Tara Fishback
Date: 2014-04-25 8:47 AM
Approved: Yes
Comments:
User: Sam Davis
Date: 2014-04-25
11:54 AM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2014-04-25 1:12 PM
Approved: Yes
Comments:
User: Najib Fares
Date: 2014-04-25 1:44 PM
Approved: Yes
Comments:
User: Andy Anderson
Date: 2014-04-28 10:34 AM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2014-04-30 12:58 PM
Approved: Yes
Comments:
User: Grant Jordan
Date: 2014-05-12 11:32 AM
Approved: Yes
Comments:
User: Fernando Costa
Date: 2014-06-13 9:37 PM
Action Required:
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Page 3 of 3
6/16/2014