HomeMy WebLinkAboutContract 38859-CO1 (2010)-(
CITY OF FORT WORTH
CHANGE ORDER REQUEST
Cffl 541200 20N20131483
HMAC SURFACE O~Y AT VARIOUS LOCATIONS 200M
ORIGINAL CONTRACT AMOUNT.................................................................... $
~ T~ D.:I:e·:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :
CONTRACT COST TO DATE ............................................................................ $
AMOUNT OF PROPOSED CHANGE ORDER.................................................. $
REVISED-CONTRACT AMOUNT ...................................................................... $
ORIGINAL FUNDS AVAILABLE FOR CHANGE ORDERS ............................... $
REMAINING FUNDS AVAILABLE FOR THIS CHANGE ORDER ..................... $
ADDITIONAL FUNDING (IF NECESSARY) ....................................................... $
CHANGe ORDERS TO DA TE (INCLUDING THIS ONE)AS " OF ORIGINAL CONTAACT COST
MAX. AilOWABLE CONTRACT AMOUNT (ORIGINAL, CONTRACT COST+ 25%1 · .
• $
$
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$
$
$
$
$
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$
$
$
$
$
$
$
$
8211' "
T/PW TOTALS
175,11&00 $ 975,858.00
95.~.oo $ 95,000.00 -' $
1,070,858.00 $ 1,070,858.00
$
1,070,~80 ..
$
$
$
T/PW
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$ 1,211,1572.SCJf
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SUBTOTAL A....,$,....-------1
IN ACCORDANCE WITH THIS CHANGE ORDER THE CONTRACTOR SHALL:
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CONTIIACTOll'I -JLB CONTRACTING, LLC
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OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
10-1 2 -1 0 P04 :5 5 I N
I NO M&C REQUIRED I
DATE: 09/02/2010
TRANSPORTATION AND PUBLIC WORKS
CHANGE ORDER JUSTIFICATION RECORD AND PROJECT SUMMARY SHEET
PROJECT NAME: HMAC SURFACE OVERLAY AT VARIOUS LOCATIONS 2009-6
CHANGE ORDER N2: a__ D.O.E . N2: 6261 CLIENT PROJECT N2: C293 541200 209620131483
INSPECTOR: DAVID W . BOWERS PHONE l'R: (817) 350-3522 CITY SECRETARY N2 : 38859
PROJECT MANAGER: KRISTIAN SUGRIM PHONE N2: (817) 944-4936
COMBINED T/PW
ORIGINAL CONTRACT AMOUNT $ 975,658.00 $ $ $ r 975,658·.oo
EXTRAS TO DATE $ 95 ,000.00 $ $ $ 95,000.00
CREDITS TO DATE $ $ $ $
ORIGINAL AMOUNT TO DATE $ 1,070,658.00 $ $ $ 1,070,658.00
AMOUNT OF PROPOSED CHANGE ORDER $ $ $ $
REVISED CONTRACT AMOUNT $ 1,070,658.00 $ $ $ 1,070,658.00
ORIG . CONTINGENCY FUNDS AVAILABLE
FOR CHANGE ORDERS $ $ $ $
REMAINING FUNDS AVAILABLE
FOR THIS CHANGE ORDER $ $ $ $
ADDITIONAL FUNDING (IF NECESSARY) $ $ $ $
REASON(S) FOR CHANGE ORDER:
This change. order is for 40 additional calendar days to be added to this contrad due to utility conflicts preventing work from
beirig completed on Stanley; Odell and Fuller. Additional money is not being requested in this change order.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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Date
Director of Contralng Dept. Date
1 0 -1 2 -1 0 P04 :5 5 I N,
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Date
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