HomeMy WebLinkAboutContract 45771-CO1 (2)FORTwORTH�� City of Fort Worth CITYS�CRETARYt >�'�j�� _-���
CONT�4�T Nt�, �
Change Order Request Breakdown
Project Name HMAC 2014-5 HIR Street Rehabititation City Sec # 45771
Client Project #(s) 02297
Contractor Cutler Repaving, Inc. PM Kristian Sugrim Inspector William Mason
Change Order Submittal #�1 Date 212812017
Dept. � TIPW
Original Contract Amount
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
Go to ADD & DEL Tabs to Enter CO Backu�
Revisetl Contract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
,986,315.00
,986,315.00
$0.00
,986,315.00
$0.00
Contract Time
Totals CD
$5,986,315.00 290
46
$5,986,315.00 336
,986,315.00 336
$0.00
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORI('i1NAL CONTRACT 0.00%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTR,4CT COST+ 25%) $7,482,893.75
JUSTIFICATION (REASONS) FOR CHANGE ORDER
This Change Order is to request additional time to the contract for the following reasons: 35 days delay in getting striping plans and 11 days
delay for abnormal amounts of Spring rain.
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Change Order Additions
Project Name HMAC 2014-5 HIR Street Rehabititation City Sec # A5771
ClientProject# 02297
Contractor Cutler Repaving, Inc. PM Knstian Sugnm Inspector William Mason
Change Order Submittal # �1 Date 2/2812017
ADDITIONS
y mt nit ost ota
T/PW $0.00
Sub Total Additions
Change Order Additions Page 1 of 1
FoKrWoxi�H City of Fort Worth
Change Order Deletions
Project Name HMAC 2014-5 HIR SUeet Rehabititation City Sec # 45771
ClientPraject# 02297
Contractor CutlerRepaving, Inc. PM� Kristian Sugrim Inspector Wlliam Mason
Change Order Submiital #�1 Date 2/2812017
DELETI�NS
ty nd nit ost ota
T/PW $0.00
Sub Total Deletions
Change Order Deletions Page 1 of 1
Previous Change Orders
co# DATE AMOUNT
Total $0.00
MISBE Breakdown for this Change Order
CFW Change Oi•der Approval St-COApp02 Page 1 of 3
Routinq
Assigned To: Due Date:
Assigned By: Due Time:
Links 1
fortworthaov/Infrastructure Proiects/02297 - HIR Street Rehabilitation (HMAC 2014-5)/Contractor/Chanqe Orders/HIR
2014-5 Chanae Order 1 Breakdown.xis
Attachments (0)
i No Attachments have been added to fhis form. i
_ _ _ _
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CFW Change Order Approval St-COApp02
O�RT i�RT�� City of Fort Worth
Change Order Request Approval
(Change Order Breakdown Available in Links)
Page 2 of 3
For Change Order Submittal No.: 1 ;
Change Order No.::St-COApp02 Date Started: 2017-07-07
City Sec. No.: 45771 Date Due: 2017-08-26
Project Name: 02297 - HIR Street Rehabilitation (HMAC 2014-5) ;
_
�229� :DOE Numbers:
Project Numbers:
DOE No.
PI"Oj2Ct Removal and replacement of nonfunctional curb and gutter,
Descripti0n:';driveways and sidewalks; followed by wedge milling / surface
,milling, then hot-in-place recycle and overlay with 1" virgin
, HMAC .
Project Manager: Kristian Sugrim City Inspector: ,William Mason
Contractor: Cutler Repaving, Inc. !;
COUNCIL ACTION (If Required):
M&C Log Name:
M&C Number: :
COST AND DAYS SUMMARY:
M&C Date: ,
Requested
Department: Cost($) Fund Account Center: Days:
TPW 46
Total Cost: $ 0.00 Total Requested Days:'46
Approval Status:
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CFW Change Order Approval St-COApp02
Approved: Yes
Comments:
User: Bob Veskerna
Date: 2017-07-10 10:54 AM
Approved: Yes
Comments:
User: Kristian Sugrim
Date: 2017-07-11 9:30 AM
Approved: Yes
Comments:
User: Najib Fares
Date: 2017-07-17 10:03 AM
Approved: Yes
Comments:
User: Kim Arnold
Date: 2017-07-26 11:45 AM
Approved: Yes
Comments:
User: Doug Wiersig
Date: 2017-07-26 1:47 PM
Approved: Yes
Comments:
User: Doug Black
Date: 2017-08-10 5:56 PM
Approved: Yes
Comments:
User: Jay Chapa
Date: 2017-08-14 9:51 AM
Page 3 of 3
Action Required:
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Contract Compliance Manager:
By signing I acknowledge that I am the person �•esponsible
for the monitoring and administration of this contract, including
ensurin�; all perfoi-mance and 1•eporting requi�•ements.
ICristian Sugrim / 1'�S
Name of Employee/Signat�u•e
Project Mana�er
Title
❑ This form is N/A as No City Funds are associated with this Contract
I<ristian Su rim � 4
Printed Name Signature