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Contract 45641-CO2 (2)
�i"�'� ��������'' �� ��y �-j i .' � l,; ,�. FORT�ORTH<., City of Fort Worth ���T��� �°r� Change Order Request Breakdown Pr,'oject Name HMAC Surface Overlay 2014-2 (50/50 Water) City Sec # 45641 ClienY Project #(s) Project# 02226 DOE# 7184 Contractor JLB Contracting, LLC PM K. Sugrim Inspector Ali Motamed Change Order Submittal #�2 Date 9/15/2016 Dept. I TIPW I Water I Sewer I Totals Original Contract Amount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date nt of er Revised Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) 58 $452,450.28 36 $111,994.50 94 $564,444.78 00 $0.00 94 $564,444,78 00 I $0,00 452,450.29 $1,809,801.1� 112,294.50 $448,353.3E 564,744.79 $2,258,154.51 $0.00 564,744.79 $2,258,154.51 $O.00 $0.00 Contract Time 190 78 268 75 343 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 24,77% MAXALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25%) $2,262,251,44 JUSTIFICATION (REASONS) FOR CHANGE ORDER This Change Order became necessary due to the addition of the following street segment, May St. (W. Cannon St. to Pennsylvania Ave.). This street was added at the request of the Water Department, since they upgraded the water line on the street. While no atlditional funds are needed, 75 calendar days are requested for the completion of this added street segment. At�� by: , ;. �i I� J. , City Socretary ���' �m �������" ,��„U�Adao�� � �.. � O��il � �4'y��� K� � ��`) %�� � � � o a ,�� <<: -1--�. �o°� l, Qf C, ` � �°'r��'J. �f��t�nCp�tYC30(Ii50 �-�1�.. fis' ,(��' f 1(f�.^y� ' �; a`�.`:' 'A.l�SA 4s/ AFFIC6AL IRECORD CITv �ECRETARx �Y.1lII�RiH, �'� :� � � 1 wA� C, ,y���'an �`� � � ( M Foirr Woirrr� , City of Fort Worth Change Order Additions Project Name HMAC Surface Overlay 2014-2 (50I50 Water City Sec # 45641 Client Project # Project# 02226 DOE# 7184 Contractor Jl8 Contracling, LLC PM K. Sugrim Inspector Alf Motamed Change 0rder Submittal #� Date 9I15I2016 ��� • �lL�u� � ' •' �'l.�i���� � ' �� - ' ' � � ��_��1.1�� � � � � � � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � �� �� � � � �-"i�i� � �� � � . •�� . � i� Change Order Additions Page 1 of 1 I'oirr Wotrry , Clty of FOrt WOrth Change Order Deletions Project Name HMAC Sudace Oveda 2014-2 50/50 Water City Sec # 45641 Client Project # Pro ecl# 02226 DOE# 7184 Contractor JLB ConUac6ng, LLC PM K. Sugrim Inspeclor Ali Motamed Change Order Submitlal # �2 Date 9/1512016 �_ _ �� � � . . � � ����� � � � �� � ����� � ������ � ����� � ��1���� � ����� � ������ � ����� � ����� � �0��� � ����� � ������� � ����� � ����� � ���■��� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ��1■��� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ������ � ����� � ����� � ������ � ����� � ����� � ����� � ����� � ����� � ����� � ��■1��� � ����� � ����� � ������ � ����� � ����� � ������ � ����� � ������ � ����� � �1���� � ������ � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ����� � ������ � ����� � ����� � ����� � ����� � ����� � ����� � ����� ��� �'��� � � � �� ,� �� � . �� � � Change Order Deletions Page 1 of 1 CFW Change Order Approval St-COApp03 Page 1 of 5 Routinq Assigned To: Due Date: Assigned By: Due Time: Links 1 fortworthqov/Infrastructure Proiects/02226 - HMAC Surface Overlav (2014-2)/Contractor/Chanae Orders/Chanqe Order Breakdown #2 DOE 7184.x1s Attachments (0) No Attachments have been added to this form. https://projectpoint.buzzsaw.com/ bz_web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 10/4/2016 CFW Change Order Approval St-COApp03 �� o��� F, c�ty of Fo�t wo�tn �-- Change Order Request Approval (Change Order Breakdown Available in Links) Page 2 of 5 For Change Order Submittal No.: 2 Change Order No.: St-COApp03 Date Started: 2016-09-16 City Sec. No.: 45641 Date Due: 2016-11-05 Project Name: 02226 - HMAC Surface Overlay (2014-2) '02226 DOE Numbers: Project Numbers: 'DOE No. 7184 Project Description: Project Manager: Kristian Sugrim City Inspector: Ali Motamed Contractor: ',JLB Contracting, LLC. COUNCIL ACTION (If Required): M&C Log Name: M&C Number: COST AND DAYS SUMMARY: Department: TPW Approval Status: M&C Date: Cost($) Fund Account Center: '$ 0.00 Total Cost:'� 0.00 Requested Days: '75 Total Requested Days:'75 https://projectpoint.buzzsaw.com/ bz_web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 10/4/2016 CFW Change Order Approval St-COApp03 Page 3 of 5 https://projectpoint.buzzsaw.com/ bz_web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 10/4/2016 CFW Change Order Approval St-COApp03 Approved: Yes Comments: User: Tara Fishback Date: 2016-09-16 2:31 PM Approved: Yes Comments: User: Sam Davis Date: 2016-09-16 3:06 PM Approved : Yes Comments: User: Kristian Sugrim Date: 2016-09-16 3:14 PM Approved: Yes Comments: This Change order is for additional days only. User: Najib Fares Date: 2016-09-16 3:46 PM Approved: Yes Comments: User: Tara Fishback Date: 2016-09-20 10:03 AM Approved: Yes Comments: User: Sam Davis Date: 2016-09-20 10:13 AM Approved: Yes Comments: User: Kristian Sugrim Date: 2016-09-20 11:14 AM Approved: Yes Comments: User: Najib Fares Date: 2016-09-29 10:31 AM Approved: Yes Comments: User: Bryan Beck Date: 2016-09-29 3:33 PM Approved: Yes C�mments� Page 4 of 5 https://projectpoint.buzzsaw.com/ bz_web/Forms/FormPrint.aspx?Siteld=51500&ProcessI... 10/4/2016 CFW Change Order Approval St-COApp03 User: Doug Wiersig Date: 2016-09-29 12:03 PM Approved: Yes Comments: User: Doug Black Date: 2016-09-29 5:07 PM Approved : Yes Comments: User: Jay Chapa Date: 2016-09-30 8:35 AM Action Required: Page 5 of 5 https:Uprojectpoint.buzzsaw.com/ bz web/Forms/FormPrint.aspx?SiteId=51500&ProcessI... 10/4/2016