HomeMy WebLinkAboutContract 44993-CO1 (2)FORT WORTH,�
City of Fort Worth
Change Order Request Breakdown
Project Name Bridge Repair and Rehabilitation at Eleven Locations (2013-26)
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City Sec # 44993
ClientProject#(s) GG01-539590-0202003
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
nt of Proposed Change Order
Revised Contract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
TPW
$OA�
Date
Totals
18.830.00
14,889.60
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CHAN�E ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTR,4CT
MAX ALLOWABLE CONTR,4CT AMOUNT (ORIGINAL CONTR,4CT COST + 25%)
2,87%
$648,537.50
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JUSTIFICATION (REASONSj FOR CHANGE ORI3ER
This change order is to add striping on bridge deck at Allen Ave. once epoxy overlay was complete. 136 SF of sidewalks atljacent to new
approach slab at Allen Ave. were replacetl due to tripping hazard. To jack Allen Ave. britlge existing street light contluit was modifietl with a
new junction box and concrete bridge rail was repaired. Allen Ave, bridge was re-jacked to install correct bearing pads. Re-jacking cost will be
reimbursed by engineer to City.
RECEIVED
�FFICfAL �3E��RD
CITY SEC�ETQ�gy
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5/20/2014
Contract Time
JUL 0 8 1014
FORT WORTH
c�ry of Fort wortn
Change Order Additions
Project Name Bridge Repair and Rehabilita6on at Eleven Locafions (2013-26 City Sec # 44993
Client Project # GG01-539590-0202003
Change Order Submittal # 01
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Date 5I20/2014
R p ty nit nit ost ota
en ve. Pavement triping
28 Allen Ave. Sidewalk Replacement TPW 136.00 SF 15.00
29 Alien Ave. Bridge Re-Jacking Cost TPW 0.50 LS 2,700.00
30 Ailen Ave. Electrical Modifications for SUeetlight TPW 1.00 LS 2,287.60
31 Allen Ave. Concrete Bridge Raii Repair TPW 1.00 LS 350.00
32 Allen Ave. Portabie Message Sign TPW 2.00 WK 800.00
TPW $14,889.60
Sub Total Additions 14,889.60
Change Order Additions Page 1 of 1
FORT WORTH
City of Fort Worth
Change Order Deletions
Project Name Bridge Repair and Rehabilitafion at Eleven LocaUons 2013-26) City Sec # 44993
ClientProject# GG01-539590-0202003
Change Order Submittal # 01
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Date 5/20/2014
R ry mt nit ost ota
TPW $0.00
Sub Total Delefions
Change Order Deletions Page 1 of 1
CFW Change Order Approval St-COApp01
Routina
Assigned To:
Assigned By:
Page 1 of 5
Due Date:
Due Time:
Links 1
fortworthqov/Infrastructure Proiects/Bridae Repair and Rehabilitation at Eleven Locations (2013-26)/Contractor/Chanqe
Orders/ChanQe Order Breakdown #1 revised 5.xls
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CFW Change Order Approval St-COApp01
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Page 2 of 5
For Change Order Submittal No COSub01
Change Order No.: St-COApp01
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City Sec. No.: 44993 '
Date Started: 2014-05-30 '
Date Due: 2014-07-15 ;
Project Name. iBridge Repair and Rehabilitation at Eleven Locations (2013-26
GG01-539590-0202003
Project Numbers:
7172
Project
Description:
DOE Numbers:
_ __ ___.
Bridge repair and rehabilitation at eleven locations.
Project Manager: Tariqui Islam ; City Inspector: Edward Davila ;
Contractor
Gibson & Associates, inc.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: i , r..
_ __ __ _
COST AND DAYS SUMMARY:
M&C Date: :
__ _ _____ _ __.
Requested
Department: Cost($) Fund Account Center: Days:
_ _ _ . , __ _
;.
;TpW $ 14,889 60 GG01-539590-0202003 '
Total Cost $._14,889.60 Total Requested Days:.�
Approval Status:
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CFW Change Order Approval St-COApp01
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CFW Change Order Approval St-COApp01
Page 4 of 5
Approved: Yes
Comments:
User: Lane Waters
Date: 2014-06-02 8:50 AM
iApproved: Yes
�Comments:
'User: Lane Waters
'Date: 2014-06-02 10:32 AM
Approved: Yes
Comments: No M&C required
User: Tariqul Islam
Date: 2014-06-02 1:33 PM
roved : Yes
Comments:
User: Najib Fares
Date: 2014-06-02 1:40 PM
Approved: Yes
Comments: Discussions are being held with Designer re: missed shop drawing issue
User: Andy Anderson
Date: 2014-06-12 8:12 AM
pproved: Yes
omments:
User: Doug Wiersig
Date: 2014-06-13 3:08 PM
Approved: Yes
Comments:
User: Lane Waters
Date: 2014-07-02 8:10 AM
4pproved: Yes
�omments:
Jser: Lane Waters
�ate: 2014-07-02 3:56 PM
4pproved: Yes
�omments: Bearing pad cost has been
-eimbursed from consultant services.
Jser: Tariqul Islam
�ate: Z014-07-02 8:58 PM
onroved: Yes
removed. 50% re-jacking cost is included which will be
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CFW Change Order Approval St-COApp01
Comments:
User: Najib Fares
Date: 2014-07-03 8:42 AM
Approved: Yes
Comments:
User: Andy Anderson
Date: 2014-07-03 3:36 PM
roved : Yes
Comments:
User: Doug Wiersig
Date: 2014-07-03 4:34 PM
Approved: Yes
Comments:
User: Grant Jordan
Date: 2014-07-07 9:20 AM
roved : Yes
�ments:
User: Fernando Costa
Date: 2014-07-07 3:04 PM
Page 5 of 5
Action Required: ;Please review, approve and submit
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