HomeMy WebLinkAboutContract 44779-CO1 (2)FORT WORTH,
Project Name' HMAC Surface Overlay 2013-14
Client Project #(s)I DOE # 7085
City of Fort Worth
Change Order Request
Dept. TPW
Original Contract Amount
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
Amount of Proposed Change Order
Revised Contract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
$1,051,922.60
$1,051,922,60
$10,350.00
$1,062,272.60
$0.00
$10,350.00
CITY SECRETARY
CONTRACT NO. 141/`7gi-(0l
I City Sec # I --!1; 4_%-v-rici
I1
Change Order Submittal # I 1
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%)
JUSTIFICATION (REASONS) FOR CHANGE ORDER
Pay item for remove and replace ramps was needed on project
by: r
onald P. Gonzales, Mat. City Sec
Date I 10/22/2013
Totals
$1,051,922.60
$1,051,922,60
$10,350.00
$1,062,272.60
$0.00
$10,350.00
0.98%
$1,314,903,25
Contract Time
(CD)
150
150
5
155
OFFICIAL RECORD
CITY SECRETARY
FT MIORTH, TX
RECEIVED NOV 2 0 2013
Fc>tt�rH
City of Fort Worth
Change Order Additions
Project Name 1 HMAC Surface Overlay 2013-14 1 City Sec # 1 -24 -1—" 1 qt el et
Client Project # 1 DOE # 7085
Change Order Submittal # 1 Date 1 10/22/2013
ADDITIONS
HEM tM U1SCRIP I ION DEP I Oty Unit Unit Cost I otal j
1 Remove & Replace AUA Ramps I PW 9.UU to $1,15U.UU $10,350.UUI
T'W $10,350,001
Sub Total Additions $10,350.00
Change Order Additions Page 1 of 1
HEM
ToK_ii City of Fort Worth
Change Order Deletions
Project Name I HMAC Surface Overlay 2013-14 City Sec # I 2111
Client Project # I DOE # 7085 j `i-t.Y11
Change Order Submittal #
DELETIONS
DESCHIP I ION
1 �
I j
1
Date I 10/22/2013 I
DEP I Uty Unit Unit Cost I otal
TPW
Sub Total Deletions
$0.00
$0.00
Change Order Deletions Page 1 of 1
MISBE Breakdown for this Change Order
M/SBE Sub Type of Service Amount for this CO
Cowtown Redimix Concrete Supplier $1,800.00
Total $1,800.00
Previous Change Orders
co# DATE AMOUNT
n/a
Total $0.00
FW Change Order Approval St-COApp02 Page 2 of
FORT WORTH® City of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
For Change Order Submittal No.: 1
Change Order No.: St-COApp02
City Sec. No.: 44779
Project Name: HMAC Surface Overlay (2013-14)
Date Started: 2013-10-28
Date Due: 2013-11-22
02141 DOE Numbers:
Project Numbers:
DOE 7085
Project Pavement improvements with the inclusion of ADA Curb Ramps at
Description: multiple locations.
Project Manager: Kristian Sugrim City Inspector: Mike Glover
Contractor: JLB Contracting, LLC.
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number:
COST AND DAYS SUMMARY:
M&C Date:
Requested
Department: Cost($) Fund Account Center: Days:
TPW/Infrastructure/Street ME $ 10,350.00 C293 541200 205620214183 5
Total Cost: $ 10,350.00
Approval Status:
Total Requested Days: 5
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FW Change Order Approval St-COApp02 Page 3 of
Approved: Yes
Comments:
User: Tara Fishback
Date: 2013-10-28 10 : 50 AM
Approved: Yes
Comments:
User: Sam Davis
Date: 2013-10-28 11:01 AM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2013-10-28 11:24 AM
Approved: Yes
Comments:
User: Najib Fares
Date: 2013-10-28 1:42 PM
Approved: Yes
Comments:
User: Andy Anderson
Date: 2013-10-29 8:03 AM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2013-11-18 3:24 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2013-11-19 4:43 PM
Approved: Yes
Comments:
User: Fernando Costa
Date: 2013-11-19 11:19 PM
Action Required:
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FW Change Order Approval St-COApp02 Page 1 of
;outing
\ssigned To:
\ssigned By:
Due Date:
Due Time:
inks (11
)rtworthgov/Infrastructure Proiects/02141 - HMAC Surface Overlay (2013-141/Contractor/Change Orders/Change Order 1 Breakdown.xls
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