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Contract 44954-CO1 (2)
FORT WORTH� City of Fort Worth Change Order Request Breakdown Project Name Bridge Repair and Rehabilitation at Nine Locations Client Project #(s) GG01-539590-0202003 _ -�+,� _ ��t 1 . y.. ';. �' �. - - City Sec # 44954 Change Order Submittal # �1 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 Revisetl Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) TPW Date Totals 245.00 100.00 5/5/2014 Contract Time 150 150 156 .00 100.00 CHANGE ORDERS to DATE (INCLUD/NG THIS ONE) AS % OFORIGINAL CONTRACT MAX ALLOWABLE CONTR,4CT AMOUNT (ORIGINAL CONTR,4 CT COST + 25%) rior� ORDER � $26,100.00 � 6.79% $480,306,25 During cleaning and painting of existing bridge bearings at Norfhside Dr. (two bridges) and Beach St. locations, it was discovered that existing rocker bearing anchor bolts (total 34 nos.) have rusted compietely through. New line items are added for repair/replacement of anchor bolts. Removal of 2 trees at Ranch View Rd. bridge location is also added t�#��'s�a��,�er. 6 days are requested to be added to the contract for r• � � G.2 0 i� � � � this additional work. 7 � ������� ,� _�oonao�;'�' r .� R. , "��. �- H •� �•�� i • .r, • 1 ti.. � .,� "_,r 1� ,�, ; - � h �: "'. 1 r_ . � . � .' � F + Foxr Wox•rx City of Fort Worth --�-- Change Order Additions Project Name Bridge Re air and Rehabilitation at Nine Locations City Sec # 44954 ClientProject# GG01-539590-0202003 Change Order Submittal # 01 ADDITIONS Date 5/5/2014 �IL�u� ' ' " •' �'L�i� "+ �� � '' ��� �1� •- � . •�Ilil'� ���:i��. �� �� .ii �� f'3�1� �-. �. •. • •. , ''�1`� ' "�::�E � ' � �.,_ �� `. . � . �� - � , . , •,1�'� , � � �::'�� � � � �. : � � � � �1�`� �•� ��- . �� • :•. � ��- r��' . ����.�..�i� � -���- � ����� � -���- � ����� � ----� � -���- � -�--� � -���- � -�--� � -���- � ����� � --��- � ����� � --�-- � ����� � ---� - � ����� � --��- � ����� � --��- � -���- � ---- � - -���- � ---- � - -���- � -�-- �� � -���- � ��--� � -���- � ���-� � -���- � ����� � --��- � ����� � --�� � � -���- � ---- � � -���- � -�--� � -���- � ----� � -���- � -�--� � -���- � ----� � -���- � -���� . �i �� - - � �. •�� . ��DI� Change Order Additions Page 1 of 1 Fox,___ �* ox�_x c�ty of Fort wortn Change Order Deletions Project Name Bridge Re air and Rehabilita8on at Nine Locafions City Sec # 44954 ClientProject# GG01-539590-0202003 Change Order Submittal # �1 DELETI�NS Date 5/5/2014 �IL�1'�� ' ' '' ���" !'��il� � •' ��� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ���� �� � ����� � ���s�� � ����� � ������ � ����� � ����� � ����� � a���� � ����� � ����� � ����� � ����� � ������ � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ������ � ����� � ����� ,,. � � ...,--. � Change Order Deletions Page 1 of 1 ■�/Al11�l1'___t__I_"___" i___i1_�_ A�. _ w � Previous Change Orders �FW Change Order Approval St-COApp01 Routina Assigned To: Assigned By: Page 1 of 3 Due Date: Due Time: Links 1 fortworthaov/Infrastructure Proiects/Brid4e Repair and Rehabilitation at Nine Locations f2013-25)/Contractor/Chan4e Orders/Copv of Chanae Order S�readsheet- Anchor Bolt Bearina Reolacement and Tree Removal xls No Attachments have been added to this form. https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 5/30/2014 CFW Change Order Approval St-COApp01 ��RT�VC}RTH� c�ty of Fort wo�tn - Change Order Request Approval (Change Order Breakdown Available in Links) Page 2 of 3 For Change Order Submittal No.: COApp01 Change Order No.: St-COApp01 Date Started: 2014-05-16 City Sec. No.: '44954 Date Due: '2014-05-30 Project Name: Bridge Repair and Rehabilitation at Nine Locations (2013-25) GGO1-539590-0202003 'DOE Numbers: Project Numbers: '!DOE 7165 PfOj2Ct Bridge Repair at Nine Locations Description: I Project Manager: Tariqul Islam Contractor:'Gibson & Associates, Inc. COUNCIL ACTION (If Required): M&C Log Name:' M&C Number: :: COST AND DAYS SUMMARY: City Inspector: Martina Salinas M&C Date: ' Requested Department: Cost($) Fund Account Center: Days: TPW $ 26,100.00 GGO1-539590-0202003 6 _ __. _ . . Total Cost: � 26,100.00 ; Approval Status: Total Requested Days:'6 https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 5/30/2014 CFW Ghange Order Approval St-COApp01 Approved: Yes _. _ Comments: User: Lane Waters Date: 2014-05-19 4:31 PM ,'Approved: Yes 'Comments: No M&C Required 'User: Tariqul Islam ''Date: 2014-05-19 4:58 PM Approved: Yes Comments: User: Najib Fares Date: 2014-05-19 5:06 PM Approved: Yes Comments: User: Andy Anderson Date: 2014-05-22 8:14 AM Approved: Yes Comments: User: Doug Wiersig Date: 2014-05-22 5:51 PM Approved: Yes Comments: User: Grant Jordan Date: 2014-05-29 12:29 PM Approved: Yes Comments: User: Fernando Costa Date: 2014-05-29 10:12 PM Action Required: Please review and approve Page 3 of 3 https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 5/30/2014