HomeMy WebLinkAboutContract 38917-CO1\Ntltt-Fl.E
CNM«Y -CONITIIUCTION SElMCU
PINK-PIIOJECT-
OOUIENIIOD -COIITRACTOII
CITY OF FORT WORTH
CHANGE ORDER REQUEST
C293-641200-202t201315U
HMAC SURFACE OVERLAY AT VARIOUS LOCATIONS (2009-7)
ORIGINAL CONTRACT AMOUNT.................................................................... $
EXTRAS TO DATE .....................................•..................................... $
CREDITS TO DATE ...................................•...................................... $\.
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) ....................................................... $
T/PW
902,834.S $
$
~ $
902,834.50 $
$
902,834.50 $
$
$
$
CHANGE ORDERS TO DATE. (INCLUDING THIS ONE) AS" OF ORIGINAL CONTRACT COST
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%}
DEPARTMENT
T/PW.
IN ACCORDANCE WITH THIS CHANGE ORDER THE CONTRACTOR SHALL:
TOTALS
$ $ 902,834.50
$· $
l $
$ $ 902,834.50
$ $
$ $ 902,834.50
$
$
$
%.
$'. 1,128,543.13,
U COST TOT
$ $
T/PW $ '""s~-----1
$
SUBTOTAL A,_$ _______ _,
It Is ...-and ogrNd 1h11 tho ocx:epar,co of this Change Olm by tho --an ac:conl and -and --P.,..-ii ful (both un. and mono,) for al cooll lltling cu of, or-to, tho -Change
Olm .
. -. JLB ~CTING
I NO M&C RBQUIRBD I
OFFICIAL RECORD .
CITY SECRETARY
FT. WORTH, TX
I "2.01 o
30 \,'Vl>i·.
DATE: September 18, 2010
TRANSPORTATION AND PUBLIC WORKS
CHANGE ORDER JUSTIFICATION RECORD AND PROJECT SUMMARY SHEET
PROJECT NAME: HMAC SIJRFACEOVERLAY AT VARIOUS LOCATIONS (200&.-7). ________ _..;. ______________ ____,:.....;...._..:...:... ____ _
CHANGE ORDER Nil : 1 D.O.E. Nil: 62SS >· 'CLIENT PROJECT Nil: · C293-541200-202620131583 -------'-_.;.;;;;..;;..;;;...;;.....;..;;.......;..;;..;........;.__
INSPECTOR: ____ M_IKE_G_L_O_VE_R __ .. ___ PHONE Nil : .. (817) 944-0914 . CITY SECRETARY Nil: 3891 7'
PROJECT MANAGER : KRISTIAN SUGRIM · PHONE Nil: . , . (817)· 392-8902 •
COMBINED T/PW
ORIGINAL CONTRACT AMOUNT $ 902,834.50 • 902,834 .50'' $: $,. ~:'I ..... ,
·:>
EXTRAS TO DATE $ $> ,, '. $' ·_,;;_ .•, ;..-., ;
CREDITS TO DATE $ s, $". $,
ORIGINAL AMOUNT TO DATE $ 902,834.50 $ 902,834.50 $ $
AMOUNTOFPROPOSEDCHANGEORDER $ $ $ $
REVISED CONTRACT AMOUNT $ 902,834.50 $ 902,834.50 $ $
ORIG. CONTINGENCY FUNDS AVAILABLE
FOR CHANGE ORDERS $ $ $ $
REMAINING FUNDS AVAILABLE
FOR THIS CHANGE ORDER $ $ $ $
ADDITIONAL FUNDING (IF NECESSARY) $ $ $ $
Date Project Manager Date
.!!j/.~ /P-J,/,//)
Date
Ja-/1-( ,(}
Asst. Dir. -TPW Infrastructure Design & Const.
7 Dale
10 -2 2 -/Q A I 0 :39 I N