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Contract 44926-CO1 (2)
FORT WORTH� c�ty of Fort worth Ci°�Y ��CR�T� l f� �� �(�, �((;i l Change Order Request Breakdowno��� �� Project Name Bridge Repair and Rehabilitation at Three Locations (2013-27) City Sec # 44926 ClientProject#(s) GG01-539590-0202003 Dept, � TPW Original ContractAmount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date of Proposed Chanqe Order Revised Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) Change Order Submittal # �1 Date 5119/2014 Contract Time Totals CD ?25,421.00 100 ?25,421.00 100 $5,500.00 2 230,921.00 102 $0.00 $5.500.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 2.44% MAXALLOWABLE CONTR,4CTAMOUNT (ORIGINAL CONTRACT COST+ 25%) $289,776.25 �„�.� ` JUSTIFiCATION (REASON$) FOR CHANGE OR13�R' = ` ;� TRWD has requested that the City of Fort Worth address drainage off of City of Fort Worth Bridges. This change order is to plug the existing scuppers over the levee at S. Riverside Bridges over Trinity River, �;� � ,. ���Y� `;� 1 1 ' -,� ��/:, c �'" �Y . o� (`G'�' �.� J � �r-� �k. +�c�N. ��} �I � 4r.r� � � �"'s o,. � � �� �`�_..,,��.,.; �� �o � n � ° e�' 0 �o � '�� 0 o�� oo� ��,°?m 0000c�uo�c,° � lr " 6' ' qa �,�� -�s'��"*�� _�sS13��%' .._._._,...�.��� - �r� ��� ��:�������;,� -�---.-�.,�.��, .�-_... r.. 4FFICIAL �ECORD �I'6'Y ��C9tET'DaFdY �1'0 �II�ii1'6i, �'X F�K��w�K���H c�ty of Fort wortn �'�`—� Change Order Additions Project Name Brid e Re air and Rehabilita6on at Three Locations 2013-27 City Sec # 44926 Client Project # GG01-539590-0202003 Change Order Submittal # � Date 5119/2014 ADDITIONS �IL�u� � . . � � �'L�i�tl" t'��� � '' ��� ��' , : „- � . •�tli1'� ���::' i� �� �.� :�� �� � �1���� � ����� � ���1�� � ������� � ����� � �11����� � ����� � ���1�� � ����� � ����� � ��1■1���� � ����� � �1��1��� � ����� � ���1�� � �111■���� � ����� � ���1��� � �1������ � ����� � �1■�1�11��� � ����� � ����� � �■1�1���� � ����� � �11111��■�� � ����� � ����� � �■�11���� � ����� � ��■���1�� � ����� � ����� � �111������ � ����� � ����1� � ����� � ����� � �■1���� � � ����� � ������ � ����� � ����� � ������ � ����� � ����� � ����� � ����� � �■��1�� � ����� ��1� � � � �11 � �. ��� � ���� Change Order Additions Page 1 of 1 FORl' WOK'PH City of Fort Worth �—�—� Change Order Deletions Project Name Bridge Re air and Rehabilitation at Three Locations (2013-27 City Sec # 44926 ClientProject# GG01-539590-0202003 Change Order Submittal # 07 Date 5/19/2014 DELETIONS �IL�1'� ' ' '' �'l�i�L"l�'��� � ' ��� � ����� � ����� � ����� � ����� � ����� �1 ����� � ����� '� ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ���1�� � ����� � ����� � ����� � ����� � ������ � ����� � ����� � ����� � ����� � ����1�� � ����� � ����� � ������ � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ������� � ����� � ����� � ����� � ����� � ������ � ����� � ����� �.� �� � �� � , ,. ���, � Change Order Deletions Page 1 of 1 Previous Change Orders �� � �� � ; � Co # � � ; �� : , � � �-��; DAT� ,��� � � � �� �� AMOUNT � � ' � � N/A Total � � � �d��� CFW Change Order Approval St-COApp01 Routin Assigned To: Assigned By: Page 1 of 3 Due Date: Due Time: Links 1 fortworthaov/Infrastructure Proiects/BridQe Repair at Three Locations f2013-27)/Contractor/Chanae Orders/ChanQe Order Breakdown #1 Revised 3.xls Attachments (0) No Attachments have been added to this form. � _. _. _ _ _ _ _ _ __ � https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessId... 6/6/2014 l:'FW Change Order Approval St-COApp01 F'o��r'Wo�TH���ty of Fo� Wo�h Change Order Request Approval (Change Order Breakdown Available in Links) Page 2 of 3 For Change Order Submittal No.: COSub01 Change Order No.: St-COApp01 Date Started: '2014-05-28 ' City Sec. No.:'44926 Date Due: 2014-06-13 Project Name: Bridge Repair at Three Locations (2013-27) GGO1-539590-0202003 ;DOE Numbers: Project Numbers: . _ 7163 PrOjeCt Bridge repair and rehabilitation at three locations ' Description: "'`' Project Manager: Tariqul Islam City Inspector: Carlos Vasquez Contractor: Gibson & Associates COUNCIL ACTION (If Required): M&C Log Name: _ M&C Number: M&C Date: COST AND DAYS SUMMARY: Requested Department: Cost($) Fund Account Center: Days: TPW $ 5,500.00 'GGOl-539590-0202003 '2 _ __ _ _ __ _ _ _ _ ___ _ _ ___ _ _ _ __ Total Cost: $ 5,500.00 '; Total Requested Days: 2 Approval Status: https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessId... 6/6/2014 CFW Change Order Approval St-COApp01 Page 3 of 3 'Approved: Yes Comments: ' User: Lane Waters 'Date: 2014-06-03 8:45 AM 'Approved: Yes ' 1Comments: No M&C required 'User: Tariqul Islam Date: 2014-06-05 10:42 AM 'Approved: Yes Comments: ,,,User: Najib Fares 'Date: 2014-06-05 11:03 AM ;;Approved: Yes 'Comments: Bridge Drainage Modifications made at the requrest of TRWD ,User: Andy Anderson Date: 2014-06-05 1:38 PM '!,Approved: Yes Comments: User: Doug Wiersig Date: 2014-06-05 5:19 PM 'Approved: Yes 'Comments: 'User: Grant ]ordan 'Date: 2014-06-06 12:50 PM 'Approved: Yes 'Comments: ' User: Fernando Costa ' Date: 2014-06-06 7:41 PM Action Required: Please review, approve and submit https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessId... 6/6/2014