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Contract 44850-CO2 (2)
C6T1� ��GR�TA� �06�9�R��'� ��. � � ` \ e� ��� � �=- �'- FORT WORTH� City of Fort Worth Change Order Request Breakdown Project Name HMAC Surface Overlay 2013-13 City Sec # 44850 Client Project #(s) DOE 7074, City Project # 02132 Change Order Submittal #�2 Date 8I28/2014 Contract Time Dept. TPW Water Sewer Totals CD OriginalContractAmount $777,205.85 $388,602.93 $388,602.92 $1,554,411.70 210 Extras to Date $36,412.63 $13,163.82 $13,163.82 $62,740.27 75 Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date $813;618.48 $401;Z66,Z5 . '$401;766:74 ' $1,617,151.97 285 Amount of Proposed Chan e Order $1 680.00 $840.00 '$840.00.: $3,360,00 Revised Contract Amount $815;298.48 $402,606:75 $402,606.74 $1,620,511.97 285 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 , $0.00 $0,00 Additional Funding (if necessary) $1,680:00 $840.00 $840.00 $3,360.00 CHANGE ORDERS to DATE (INCLUDING THIS ONEJ AS % OF ORIGINAL CONTRACT ``,4,25% ' MAXALLOWABLE CONTR,4CTAMOUNT (ORIGINAL CONTRACT COST+ 25%J $1;943;014:63 . . ..�y.� V�7illrj�'%{e �e F �t i ��� h T(��.{ �f/� -7�C ��,��g.�, a� xd�` ty � } i � . � t a_: � 3�. . F�'" - �,.,�,r��-r•�!v�.' T Q�L�w,',HS�tu��,.s�.a/.L��R-�Y'£"-�LYU„ �y,��`L'JGi�.�.�"'S=3ir+,�,qi.'��:rY-�"'ny�'b�� -u"t -,. � E �' ���-�:�T,� Change order is to cover the cost of traffic signal loops required on Magnolia, Main, Henderson and Pennsylvania l�ary J. OFFICIAL RIECORD RECEIVED SEP 0 2 2Q1� CI'6'Y SECRETARV �'. VV�RT6i, 7'X Fo►zr Wox•rx City of Fort Worth �� Change Order Additions Project Name HMAC Surface Overlay 2013-13 City Sec # 44850 Client Project # DOE 7074, City Pro'ect # 02132 Change Order Submittai # �2 Date 8I2812014 ADDITIONS �Il�l'1� ' ' •' �'.�'i�s:l!'��'l�lt� � '' ��1� �i��� � . ��� �r�l'- �i ���� '. ii �. �:� �� �i�� . , . ��, � � i��� ', �� �.:�� �i �� .' � . ��� � i i��� ', i� ,:�� �� � ���� � � -��� � � -���� � ����� � ����� � -���� � -���� � ����� � -���� � -���� � ������ � -���� � ������ � -���� � -���� � ����� � -���� � ����� � -���� � -���� � ����� � -���� � ����� � ����� � ����� � ����� � -��� � � ����� � -���� � ����� � ����� � -���� � -���� � ����� � ����- � -���- � -���� � -���� � ����� � -���� � -���� � -���� � ����� � -���� � -���� � -��� � � ����� � ����� �, .:� �� 'r. • � �,:�� �� �' °I� ��i �� � � . ��� . �, o� i� Change Order Additions Page 1 of 1 Fokr WoK•i•x City of Fort Worth --"'!""�--� Change Order Deletions Project Name HMAC Surface Overlay 2013-13 City Sec # 44850 Client Project # DOE 7074, Ci Pro'ect # 02132 Change Order Submittal # �2 Date 812812014 DELETIONS �tL�i'1� ' ' '' ���t��J'i� 11��911t�'1����' � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ���� � � ���� � � ����� � ����� � ����� � ����� � ����� � ���� � � ����� � ����� ,� �� �.� �� �,� �� � ..�••• � Change Order Deletions Page 1 of 1 Previous Change Orders � � co#' , ' „ ., "; ; DATE , " AMOUNT - - N/A Total $O:f00 MISBE Breakdown for this Change Order CFW Ch�nge Order Approval St-COApp02 Ro�tinq Assigned To: Assigned By: Page 1 of 3 Due Date: Due Time: Links 1 fortworthgov/Infrastructure Proiects/02132 - HMAC Surface OverlaY (2013-13)/Contractor/Chanqe Orders/Chanqe Order Breakdown co 2.xls Attachments (0) No Attachments have been added to this form. _ _ _ https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessId=466&ActiveF... 9/2/2014 CFW Change Order Approval St-COApp02 ��}I�T �V'(��T��� c�ty of Fo�t wo�th �� Change Order Request Approval �� (Change Order Breakdown Available in Links) For Change Order Submittal No.: 2 Change Order No.: St-COApp02 Date Started: 2014-08-29 City Sec. No.: 44850 Date Due; 2014-10-18 Project Name: HMAC Surface Overlay (2013-13) 02132 DOE Numbers: Project Numbers: 7074 _. _. Project HMAC Surface Overlay at multiple locations within the City of Description: Fort worth Project Manager: Kristian Sugrim Contractor: JLB Contracting, LLC COUNCIL ACTION (If Required): M&C Log Name: M&C Number: City Inspector: Jeff Wolff _ _ __ _ M&C Date: COST AND DAYS SUMMARY: Department: Cost($) Fund Account Center: Transportation & Public Work $ 1,680.00 C293 541200 208620213283 Water $ 840.00 P253 541200 608170213283 Sewer $ 840.00 P258 541200 708170213283 Requested Days: 0 0 0 Total Cost: � 3,360.00 Total Requested Days: � Approval Status: Page 2 of 3 https://projectpoint.buzzsaw,com/ bz_web/Forms/FormPrint.aspx?SiteId=51500&ProcessId=466&ActiveF... 9/2/2014 CFW Charige Order Approval St-COApp02 Approved: Yes Comments: User: Tara Fishback Dafie: 2014-08-29 10:01 AM Approved: Yes Comments: User: Sam Davis Date: 2014-08-29 11:06 AM Approved: Yes Comments: User: Kristian Sugrim Qate: 2014-08-29 1:46 PM Approved: Yes Comments: User: Najib Fares Date: 2014-OS-29 1:48 PM Approved: Yes Comments: User: Andy Anderson Date: 2014-09-02 7:41 AM Approved: Yes Comments: User: Doug Wiersig Date: 2014-09-02 11:19 AM Approved: Yes Comments: User: Grant ]ordan Date: 2014-09-02 12:33 PM Approved: Yes Comments: User: Fernando Costa Date: 2014-09-02 5:52 PM Action Required: Page 3 of 3 https://projectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&Processld=466&ActiveF... 9/2/2014