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Contract 54210-FP1
FORT WORTH, WATER DEPARTMENT NOTICE OF PROJECT COMPLETION -FP1 City Secretary No:_54210 Date Received: 6/29/2023 City Project Ns: CO2383 Regarding contract 54210 for Water & Sewer Replacement Contract 214 WSM-B Part 1 as required by the WATER DEPARTMENT as approved by City Council on 6/2/2020 through M&C 20-0377 the director of the WATER DEPARTMENT upon the recommendation of the Assistant Director of the Water Department has accepted the project as complete. Original Contract Prices: Amount of Approved Change Orders: Revised Contract Amount: Total Cost Work Completed: Less Deductions: Liquidated Damages: Pavement Deficiencies: Total Deduction Amount: Total Cost Work Completed: Less Previous Payments: Final Payment Due Recommended for Acceptance Asst. Director, WATER DEPARTMENT Christopher Hat der Christopher Harder (Jun 29, 2023 07:03 CDT) Accepted Director, WATER DEPARTMENT Client Department 7J— Bu Dana Bu rghdoff (J 29, 20 36 CDT) Asst. City Manager $6,614,912.00 $1,465,265.63 Ns 8 $8,080,177.63 $7, 841,3 82.04 0 Days @ $650.00/ Day $0.00 $7,841,382.04 $7,449,312.93 $392,069.11 J u n 28, 2023 Date J u n 29, 2023 Date J u n 29, 2023 Date Comments: OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX C-620 Signature Page Contractor's Application for Payment Invoice No. 23-FINAL To (Owner) City of Fort Worth Invoicing Period (From - To): Invoice Date: 03/03/2023-03/03/2023 6/6/2023 P. O. FW020-0000004254 From (Contractor): Remit to ( If Not Automatic Deposit): Number: JACKSON CONSTRUCTION Project: 02383 Contractor's CFW Vendor No.: 0000008063 City secretary Contract 54210 Contract Number: Name: WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 Application For Payment Change Order Summary Approved Change Orders 1. ORIGINAL CONTRACT PRICE.......................................................... $ $6,614,912.00 Number Additions Deletions 2. Net change by Change Orders................................................................. $ $1,465,265.63 1 $125,775.00 $78,600.00 3. Current Contract Price (Line 1 f 2)........................................................ $ $8,080,177.63 2 $134,550.00 $112,200.00 4. TOTAL COMPLETED AND STORED TO DATE 3 $37,752.70 $52,000.00 (Progress Estimate, Construction Allowance and Change Orders)....... $ $7,841,382.04 4 $155,239.29 $156,075.00 5. RETAINAGE: 5 $5,950.00 $5,940.00 a. X $7,841,382.04 Work Completed.......... $ 6 $100,261.75 $10,000.00 b. X Not Used $ 7 $663,976.00 c. Total Retainage (Line 5a + Line 5b) ............................... $ 8 $656,575.89 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5c)............................. $ $7,841,382.04 TOTALS $1,880,080.63 $414,815.00 7, LESS PREVIOUS PAYMENTS (Line 6 from prior Application)......... $ $7,449,312.93 NET CHANGE BY $1,465,265.63 8. AMOUNT DUE THIS APPLICATION ................................................. $ $392,069.11 CHANGE ORDERS 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G on Progress Estimate+ CA + COs + Line 5 above) ............... $ $238,795.59 Contractor's Certification The Contractor certifies with the submittal of this document and associated Payment Request Submittal on the City of Fort Worth Buzzsaw system that to the best of their knowledge: (1) all previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Applications for Payment (2) title of all Work, materials and equipment incorporated in said Work or otherwise listed in or covered by this Application for Payment will pass to Owner at time of payment free and clear of all Liens, security interests and encumbrances (except such as are covered by a Bond acceptable to Owner indemnifying Owner against any such Liens, security interest or encumbrances); and (3) all Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Liquidated Damages @ $630.00 x Day Carmen Esters Carmen Estep (Jun 26, 202� 10:04 CDT) 10. CONTRACT TIME: a, Days Awarded 540 b, Days Added by CO 375 C. Total Days 915 d. Days Charged 906 e, Days Remaining 9 Consent of Surety Affidavit of Bills Paid This document has been modified from its original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Progress Estimate City S-tery Contract Nunn: For (COnhaC1) WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 Applicafon Period 03/03/2023-03/03/2023 A item Specification Unit of Bid Quantity Unit Price Bid Item No Descnpl- Section No. Measure Und 1 - Water Imp. merits 1 3311.0461 12" f/VCVWater PiDe (DR-14) LF 4029.000OOU $95A 2 3311.0451 12" DIP Water LF 359.00OOOU $245.OU 3 3311.0457 12" DIP with CLSM Backfll at Hulen Dr LF 132.00OOOU $1 4 3311.0261 8" PVC Water P e LF 7230.00OOOU p125.OU 555.0d 5 3311.0161 6" PVC Water Ipa LF 340.00OOOU $75.00 6 0241.1001 Water Groulin CY 10.00000U $925.00 L(�ine BELOWI' $1 8 3305.01ofi tP�� 9 casem 1 cet$I�SPPNOTE 3311.0761 Si (ii dU"S! LF SO.000OOU $1��50.00 1 10 3311.0941 42" PCCP LF 20.00OOOU MM TI300.0-5 1 11 3312.0917 Connection to Exishc 4" to 12" Water Main EA 16.00OOOU $6 000.00 12 3312.0111 Connection to Existino 42" Water Main EA 2.00OOOU lin po0.00 13 3312.20031"Water Service EA 210.00OOOU $1MM 0.0� 14 3312.2001 1" Water Service. Meter Reonnechon EA 210.00OOOU D 00.0` 15 3312.22032"Water Service EA S.00OOOU $ F50.O1 16 3312.2201 2" Water Service. Meter Reonnechon EA S.00OOOU ti450.00 17 3312.3002 6" Gate Valve EA S.000OOU $925.00 18 3312.3003 8" Gate Valve EA 23.00OOOU $1 400.00 19 3312.3005 12" Gate Valve EA 33.00OOOU $2 500.00 19A 3339.1001 4' MH fort 2" Gale Valve EA 1.00000U $6/.500.0: 1 20 3311.0001 Ductile Iron Water Fittins w/Restraint TN 6.00OOOU $11=�].0� 1 21 0241.1510 Salvaoe Fire Hvdrant EA 5.00000U � 000.00 1 22 3312.0001 Fire Hy(l(ant $5 23 33010109 Trenchh Ss �( LF 11370.00OOOU 5025 24 3201.0112 5' Wide Asnli fart Pv R,XallhaResidential LF 400.00OOOU 25 26 3201.0614 Conc Pvm k og Re. 3312.1002 2" Combination Alu Valve Assemblv for Water BY EA 330.000OOU 3.00OOOU $175.OJ $14000.OJ 27 3471.0001 TreRc Control MO S.00OOOU $5rU00.OJ 1 28 3471.0001 TmRCControl atHulenDr MO 1.00OOOU $1J oO.oJ 1 29 3201.0400 Te r AsEit vinair (2" HMAC on 6" CTB) 15230 $35 30 - Excavation 3305.0002 De�h 11q oj�jj�aP EA OOOOOOU OOOOU $ 0- 1 31 3137.0101 Concre a kioKa❑ BY 41.000OOU 1 32 3305.0001 8"ra LCL 12 OOOOOU �jtia�`1]75.0- 0 0- $ti$75.0- 1 33 3341.003 9 36" III LF OOOOOU 1 34 0171.0001 Construction Stakino Ls 1.00000U $20p0O.0. 1 35 0171.0002 Construction Surveemovi`t� LS 1.00OOOU $d O.O. 36 `` \\ 0241.1300 7i LF 1073.00OOOU $10.04 3216 0102 7-inch Concrete Curb and 24" Gulte0r/(mah h existing) (50150) 37 LF 10730150) .00OOOC $75.00 C DIeV 3.0401 7-1.0401 i nch Concrete D`1� SF 5778.000OOr 1250 $65.Or 40 7-inch Concrete VaImove Gv.wa� r550�01 32�fi 0301 BY $900000- 1 41 3212.0302 2-inch As halt Pavement TyyjjT1� D"/5U/50) BY 9378.00000M $14.00 42 3305.0111 Water Valve Box Ad11Nst w/C`ollar (SO/501 EA 5.00000M $375.00 43 3305.0108 Miscellaneous Ad)Nslmenfs-Water Meter Box l50/501 EA 5.00000d $525.00 1 44 3305.0107 Manhole AdlusL MMinor w/Collar (50150) EA 6.00000d $950.(ll 1 45 3217.5001 Curb Address Pamtino 50/50) EA 22.00000d $75.Or 1 46 1 47 3291.0100 ToJ�ys it/50150) 3292.0100 B(o k Sod Placement (50/50 CY SY 29.00000d 485.000000 $95.Or $9.Or 1 48 0241.1700 10" Pavement Pulven-tion (L/50) BY 9378.00000d $9.Or 1 49 3201.0201 Permanent Pavement Reoav Becy�ed Trench Width BY 110.00000 $32.Oe 3201.0201 Permanent Pavement Rapsv at Hut n Dr IF HMAC over 2'27 50 Concrete To Match Existing Condition, BY 251.000000 $100.00 1 51 3217.0001 4" SILO Pvnid arkinf�HASfW) LF 6366.00000'/%I, $1.4J 1 52 3217.00024"SLDPvmt Markin HAS4��) LF 723900000U' 1 53 3217.0501 24" SILO Pvmt Markin HA LF $$B.OJ' 1 54 3217.2003 Raised Marker 4" EA 85.000000 $5.00 1 55 9999.0000 Water Construction Allowance LS 1.000000 $100.000.00 Unit 2- Sanila(y Sewe''((Imorovements 1 3331.4115 8"Sewer Floe LF 4620.000OOU $65.0U 2 3311.0251 8" DIP Sewer with Protection 401 Coatino LF 240.00000C- $125.00 3 3331.4409 30" Fiberglass Sewer Pioe. CSS Backfill LF 90.00000. $320.00 4 3339.1001 4' Manhole EA 37.000000 $q.p00.O0 5 3339.1003 4' Extra DeDth Manhole VF 25.000000 3000000 $7T`140.0` 7 3339.1103 5' Extra 1)7th Manhole VF 6.000000 MtiPP150.0-5 8 3301.0101 Manhole Vacuum Testing EA 40.00000� $275.ON 9 0241.2201 Remove 4' Sewer Manhole EA 21.00000� $950.O0 54210 B I C D Bid Value a M Estimated Quantity Installed 134.000000001 134.000000001 5.000000001 5.000000001 8.000000001 30.000000001 34.000000001 1.00005`001 800001 8.000000001 8.000000001 11748.000000001 4150010000 1 133.000000001 2.000000001 7.000000001 1.000000001 14460.000000001 111i'A4PPPPP191 1300�300.00 $3J000.00 $24,800.00 4203.000000001 231.000000001 82.000000001 $141000 $J 750.00.00 32.000000001 29.000000001 $21 U00.00 $1 a 0.00 $11 U00.00 $14, 950.00 2.000000001 15000000001 10.00000001 14.000000001 Value Previously Installed Value I Value This Period W $12,872.501 $12,872.501 $1%-0.001 $71..8.001 1835.521 $16,200.001 $73,908.001 $835.521 $6400.001 $J//�326.801 $6,400.001 $9,326.801 $9481.201 $'1 8.001 b450.001 I $8,481.201 $3,888.001 $450.001 I I $273195.001 $2Jo0o.00� I $273, 195.001 $29.000.001 $26240.001_ $26,240.001 $12WOOO 001_ $128,000.001 a�350.001 $4,350.001 $1�000.001 $14.000.00: $1320.001 $1,320.001 $1/7so.00i $i J.300.001_ $zasO.aa1 $13,300.001 This document has been m,d,fted from its original form as an E1CDC document and the user did not highlight the modificanons. You are encouraged ro read the document carefully and consult Legal Counsel prior ro us ex uh- C-620 Unit Price Progress Estimate Contractor's Application Application Number: 23-FINAL Appliwtroa Date' 6/6/2023 E F Materials Presently Toml Completed % Soed (mr w C) avd Stored ro Date (F) (D+E) B $368//410.00 963% $91/100.0. IN 8% $9000.0. 6.1% $39J720.Or 98.3% $2J 950.O. 113.5% $17(5000r 200.0% 6000.0. 100.0% $1/S00.O. 12.5% $1100.0- 100.0% $174.000.OJ 181.3% $201000.Old 63.8% $4J,2OO Old 63.8% $2?250.OJ 100.0% $1�250.Old 100.0% $7,400.Old 100.0% $41/,000.Old 130.4% $86000.Old 103.0% $J/SOO.OJ 100.0% $91757.5J 140.5% ROOO.OJ 160.0% $4J000.Old 160.0% $'J�r937.Old 103.3% $b//r812.5d 11.5% $21275.0r 40.3% $29000.0r 66.7% $36000.Or 140.0% $1J000.0r 100.0% $506'100.Or 94.9% $2JU00.0r 924.0% $81/307.50 730.0% $66/000.Or 91.7% $1ri750.0r 100.0% $2j,O000r 100.0% $Z,� OO.00 100.0% R..160.Or 132.0% $106�00.00 132.0% $'7//888.Or 68.1% $49r300.Or 68.1% $21605.0� 175.6% $11� 68.00 87.6% 781.2i 415.0% $1.900.00 33.3% $12/872.51. 467.2% $1600.00 371.1% $7ON 87.6% t5511 26.1 % $6400.00 25.5% $J/326.8 f 104.6% $Z�(/44�81.21 83.7% $ &() 100.5% 50.OJ 105.9% $273195.Or 91.0% $2J000.Or 96.7 $2J/,240.Or 91.1% $12ri'000r 86.5% W..350.Or 116.0% $14,OOO.pr 66.7% $�/320.0: 91.7 % $1//7500r 25.0% $1..300.00 66.7% G Balance fo Fmrsh (B-F) $14/'345.00 -SS/ 145.00 $1313 �500.00 $W930.00 _S' 450.00 _S .250.00 $17,500.00 $6//000.00 -$79,000.00 546000.00 $14000.00 $21.800.00 -S9/ 800.00 -S 500.00 -$26 757.50 -$11 00.00 -$I i-CO.00 94.50 $44 187.50 $3�475.00 $1�000.00 -$, 000.00 $26150.00 $ 000.00 -$71 b32.50 $6600.00 -$3.430.00 -$25/725.00 $S/690.00 $23/062.50 �E 735.00 TZ324.00 -$6906.25 $1625.00 $:�\�00.00 $1 170.00 -$1J 17.50 -$I t )135.00 $IJ494.00 $1.364.48 $18 700.00 - 14.40 $1 �53.40 18.00 -$25.00 $100,000.00 $27 105.00 $11100.00 $1560.00 $2Jpp000.00 -b600.00 $7p000.00 b120.00 $8 250.00 $'.650.00 C-620 Unit Price Progress Estimate Progress Estimate cityS-tom 54210 Contractor's Application Contract Nunn: F°r(COnhaC1) Apphosti-Penad Brit Item No 10 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 03/03/2023-03/03/2023 A hem Spxifica[ion Um[ of Hid Quantity Descnptmn Section No. Measure 0241.2202 Remove 5'Sewer Manhole EA 2.000000 Unit Price $1,250.00 H Bid Value $2,500.06 C Esumated Quantity Installed 2.00000006 D Value $2,500.Od Previously lustalled Value $2,500.06 $10,500.00 $78,000.00 $32,300.00 $52,890.00 $2,258.50 $14,680.25 $40,653.00 $23,275.00 $3,960.00 $30,000.00 $195,35000 $32,000.00 Value This Period Appltea°°nNntr'be` ApphrennnDate E Materials Presently Stored (vo[ m C) 23-FINAL 6/6/2023 F ToW Completed % Balsece suit Stored to Date (F) (D t E) B $2,500.00 100.0% $10,500.00 100.0% $78.000.00 81.3% $32.300.00 89.5% $52.890.00 80.6% $2,258.50 94.9% G m Frmsh (B - F) $18,000.06 $3,800.00 $12,710.00 $121.50 11 3305.0113 Trench Water Stops EA 7.000000 $1,500.00 $10,500.00 7.00000000 $10,500.00 12 3331.3101 4"Sewer Service FA 48.000000 $2,000.00 $96,000.00 39.00000000 $78,000.00 13 3305.0112 Concrete Collar FA 38.000000 $950.00 $36,100.00 34.00000000 $32,300.00 14 3339.0001 Epoxy Manhole Liner VF 160.000000 $410.00 $95,600.00 129.00000000 $52,890.06 15 3305.0109 Trench Safety LF 4760.000000 $0.50 $2,380.00 4517.00000000 $2,258.50 16 3301.0001 Pre -CCTV Inspection LF 4930.000000 $3.25 $16,022.50 4517.00000000 $14,680.25 $14,680.25 91.6% $1,342.25 17 3301.0002 Post -CCTV Inspection LF 4930.000000 $9.00 $44,370.00 4517.00000000 $40,653.00 $40.653.00 91.6% $3,717.00 18 0241.2001 Sanitary Line Grouting CY 5.000000 $950.00 $4,750.00 $4,750.00 19 3201.0112 5'Wide Asphalt PEE: Repair Residential LF 100.000000 $125.00 $12,500.00 $12,500.00 20 3201.0614 Conc Pvmt Repair, Residential SY 130.000000 $175.00 $22,750.00 133.00000000 $23,275.00 $23,275.00 102.3% -$525.00 21 3292.0100 Block Sod Placement SY 440.000000 $9.00 $3,960.00 440.00000000 $3,960.00 $3,960.00 100.0% 22 3471.0001 Traffic Control MO 5.000000 $5,000.00 $25,000.00 6.00000000 $30,000.00 $30,000.00 120.0% $5,000.00 23 3201.0400 Temporary Asphalt Paving Repair (2" HMAC on 6"CTB) LF 5700.000000 $38.00 $216,600.00 5141.00000000 $195,358.00 $195,358.00 90.2% $32,000.00 80.0% $21,242.00 $8,000.00 24 3305.0103 Exploratory Excavation of Existing Utilities FA 20.000000 $2,000.00 $40,000.00 16.00000000 $32,000.00 25 0171.0001 Construction Stating LS 1.000000 $15,000.00 $15,000.00 1.00000000 $15,000.00 $15,000.00 $15,000.00 100.0% 26 0171.0002 Construction Survey LS 1.000000 $5,500.00 $5,500.00 1.00000000 $5,500.00 $5,500.00 $5,500.00 100.0% 27 0241.1300 Remove Concrete Curb & Gutter (50/50) LF 1073.000000 $10.00 $10,730.00 960.00000000 $9,600.00 $9,600.00 $9,600.00 89.5% $1,130.00 28 3216.0102 7-inch Concrete Curb and 24" Gutter (match existing) (50150) LF 1073.000000 $75.00 $80,475.00 2401.00000000 3943.00000000 3943.00000000 137.00000000 7093.00000000 15.75000000 $180,075.00 $7,886.00 $49,287.50 $22,605.00 $141,860.00 $5,906.25 $180,075.00 $180,075.00 223.8% -$99,600.00 29 0241.0401 Remove Concrete Driveway (50150) SF 5789.000000 $2.00 $11,578.00 $7,886.00 $49,287.50 $7,886.00 68.1% $3,692.00 30 3213.0401 6-inch Concrete Driveway(50/50) SF 5789.000000 $12.50 $72,362.50 $49,287.50 68.1% $23,075.00 31 3216.0301 7-inch Concrete Valley Gutter (50150) SY 78.000000 $165.00 $12,870.00 $22,605.00 $22,605.00 175.6% $9,735.00 32 3212.0303 3-inch Asphalt Pavement Type "D" (50/50) SY 9378.000000 $20.00 $187,560.00 $141,860.00 $141.860.00 75.6% $45,700.00 33 3305.0111 Water Valve Box Adlust w/Collar(50/50) FA 5.000000 $375.00 $1,875.00 $5,906.25 $5,906.25 315.0% 44,031.25 34 3305.0108 Miscellaneous Adjustments -Water Meter Box (50/50) FA 5.000000 $525.00 $2,625.00 $2,625.00 35 3305.0107 Manhole Adlust, Minor w/Collar(50150) FA 6.000000 $950.00 $5,700.00 2.00000000 $1,900.00 $1,900.00 $1.900.00 33.3% $3,800.00 36 3217.5001 Curb Address Painting 50/50) FA 22.000000 $75.00 $1,650.00 $1,650.00 37 3291.0100 Topsoil (50/50) CY 29.000000 $95.00 $2,755.00 129.50000000 840.00000000 7057.00000000 $12,302.50 $7,560.00 $70,570.00 $12,302.50 $12,302.50 446.6% $9,547.50 38 3292.0100 Block Sod Placement (50/50) SY 485.000000 $9.00 $4,365.00 $7,560.00 $7,560.00 173.2% $3,195.00 39 0241.1700 11" Pavement Pulverization (50/50) SY 9378.000000 $10.00 $93,780.00 $70,570.00 $70,570.00 75.3% $23,210.00 40 3305.0110 Utility Markers LS 1.000000 $500.00 $500.00 1.00000000 $500.00 $500.00 $500.00 100.0% 41 3303.0001 Bypass Pumping LS 1.000000 $70,000.00 $70,000.00 1.00000000 $70,000.00 $70,000.00 $70,000.00 100.0% 42 9999.0004 Sewer Construction Allowance LS 1.000000 $60,000.00 $60,000.00 $60,000.06 Unit 3 - Paving Improvements 1 0241.0100 Remove Sidewalk BY 265.000000 $14.00 $3,71000 28.00000000 $39200 $392.00 $39200 10.6% $3,31800 2 3213.0301 4-inch Concrete Sidewalk BY 265 000000 $82.00 $21,730.00 28.00000000 4.00000000 $2,296.00 $1,000.00 $2,296.00 $2,296.00 10.6% $19,434.00 3 0241.0300 Remove ADA Ramp FA 2000000 $250.00 $500.00 $1,000.00 $1,000.00 200.0% -$500.00 4 9999.0002 ADA Ramp FA 2.000000 $2,700.00 $5,400.00 4.00000000 1916.00000000 $10,800.00 $19,160.00 $10,800.00 $10,800.00 200.0% $5,400.00 5 0241.1300 Remove Concrete Curb & Gutter (50150) LF 2145.000000 $10.00 $21,450.00 $19,160.00 $19.160.00 89.3% $2,290.00 6 3216.01027-inch Concrete Cum and 24" Gutter (match -a1mg) (50/50) LF 2145.000000 $75.00 $160,87500 4399.00000000 $329,92500 $329,925.00 $329,92500 205.1% -$169,05000 7 0241.0401 Remove Concrete Driveway(50/50) SF 11578.000000 $2.00 $23,15600 7992.00000000 $15,98400 $15,984.00 $15,98400 69.0% $7,17200 8 3213.0401 6-inch Concrete Driveway(50/50) SF 11578000000 $12.50 $144,725.00 7885.00000000 275.00000000 12412.00000000 $98,562.50 $45,375.00 $248,240.00 $98,562.50 $98,562.50 68.1% $46,162.50 9 3216.0301 7-inch Concrete Valley Gutter (50150) SY 156000000 $165.00 $25,740.00 $45,375.00 $45,375.00 176.3% -$19,635.00 10 3212.0303 3-inch Asphalt Pavement Type "D" (50/50) SY 18755.000000 $20.00 $375,100.00 $248,240.00 $248,240.00 66.2% $126,860.00 11 3305.0111 Water VaNe Box Adjust w/Collar(50150) EA 11.000000 $375.00 $4,125.00 35.50000000 $13,312.50 $13,312.50 $13.312.50 322.7% $9,187.50 12 3305.0108 Miscellaneous Adjustments -Water Meter Box (50/50) EA 10.000000 $525.00 $5,25000 $5,25000 13 3305.0107 Manhole Adjust, Minor w/Collar(50150) EA 12000000 $950.00 $11,400.00 4.00000000 $3,800.00 $3,800.00 $3,800.00 33.3% $7,600.00 14 3217.5001 Cum Address Painting 50/50) EA 44000000 $75.00 $3,300.00 289.00000000 1670.00000000 12412.00000000 $27,455.00 $15,030.00 $124,12000 $3,300.00 15 3291.0100 Topsoil (50150) CY 58.000000 $95.00 $5,510.00 $27,455.00 $27,455.00 498.3% -$21,945.00 16 3292.0100 Block Sod Placement (50/50) SY 971.000000 $9.00 $8,739.00 $15,030.00 $15,030.00 172.0% $6,291.00 17 0241.170011" Pavement Pulvenzation(50/50) SY 18755.000000 $10.00 $187,55000 $124,120.00 $124.12000 66.2% $63,43000 1B 3211.0600 Cement MUdificabon, 26lbs./sy. TN 488.000000 $195.00 $95,16000 431.92000000 $84,22440 $84,224.40 $94,22440 88.5% $10,93560 19 0241.1800 Remove Speed Cushion BY 44000000 $45.00 $1,980.00 44.00000000 $1,980.00 $1,980.00 $1,980.00 100.0% 20 3441.1301 Traffic Loop Detector Cable Saw cut LF 240 000000 $26.00 $6,240.00 8.31700000 $83,170.00 $6,240.00 21 3441.1302 AWG Loop Detector Cable LF 240.000000 $2.00 $480.00 $480.00 22 3305.0108 Miscellaneous Adjustments, Sprinkler systems LS 1.000000 $10,000.00 $10,000.00 $83,170.00 1 $83,170.00 831.7%jA$351$,",�500.000 23 3217.0305 Pavement Markings, Stop Bar LF 200.000000 $18.00 $3,60000 40.00000000 $72000 $720.00 $72000 20.0% 24 3217.0002 4-inch SLID Pavement Marking, HAS (Yellow) LF 3B25A00000 $1.40 $5,355 00 25 3217.0301 124nch solid pavement marking LF 60 000000 $9.00 $540.00 10.00000000 $45,000.00 26 3110.0105 244nch and larger, tree removal FA 1 000000 $3,500.00 $3,500.00 27 9999.0000 Remove and Replace 5' Stormdrain Cum Inlet Top FA 3.000000 $4,500.00 $13,500.00 $45,000.00 $45,000.00 333.3% Tbs document has been modified from its original form es so EJCDC document sad the user did not highhghl the modifications. You are encouraged to read the document carefully end ...soil Legal Counsel prior b as ex -n. Progress Estimate En` (COnhaC1) WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 Applreafion Period 03/03/2023-03/03/2023 A hem Bid I[em No Descnptmn 2g 34.Rtrol 29 9999.0096710001 TmPavm9cConConslruchon Allowance I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Totals city sci-ery 54210 Connect Num: Specification Unit of Bid Quantity UWt Pdce Section No. Measure MO 7.000000 $5.000.00 LS 1.000000 $55.000.00 e Bid Value EstimatedC Quantity Installed $35.000 OO 7.0000OOOO $55,000 001 I C-620 Unit Price Progress Estimate Contractor's Application Applicanon Number: 23-FINAL Appli—c. Data 6/6/2023 D E F G Told Completed % Balance to Fi—h Value Previously Installed Value Value Tide Period Materials Pre5en0y avd Stored W Dak (F) (B - F) Smred(rotw C) (DaE) B $35,000001 $35,000.001 $35.00000 100.0% I $55,000 00 Th,s document has been modified from ns original form as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document —Uly and consW1 Legal Counsel prior W rta c—oli . $6,017,012.17 91.0% $597.899.83 C-620 Change Order Progress Estimate Construction Allowance Usage ADDITIONS For (eontmet): 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 IAppli`anon P-1 03/03/2023-03/03/2023 city seeretary 54210 Contact Naaa A B Item Item Nmnbee Desenpnon Speeifiwtion Uno ofMeasure Quantity to Add Unit Pnce Addition Value Section No C D Estimated Quantity Value Installed This document has been modified from its original f as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel pnor to its execunon Previously Value This Installed Value Period Contractor's Application appoemmn rva r— 23-FINAL Applteation Date6/6/2023 E F Taal Completed / Balance to Finish Materials Praeently and Stated toDate (F) (B - F) Stored (not in C) F B C-620 Change Order Totals Progress Estimate Construction Allowance Usage CONSTRUCTION ALLOWANCE ITEMS TO BE REDUCED IFor (.,aa&): 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 IAppli a"°" Fenoa 03/03/2023-03/03/2023 A B C I Item Bid Item Number Descnphon Specification Umt of Measure Quantity to Delete Unit Price Reduction Value Not Used Section No I I I I I Totals Contractor's Application Application Number: 23-FINAL Application Date 6/6/2023 D E F Not Used Not Used Not Used Not Used Not Used Not Used Not Used This document has been modified from its original f as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel p= to its execution C-620 Change Order Progress Estimate Change Order Number 1 1 1 Contractor's Application ADDITIONS IF., (contract): 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 City Secretary 54210 Applmatioa Number: 23-FINAL Contract Nam: IAppficanon P—d 03/03/2023-03/03/2023 Application Date 6/6/2023 A Item Change Order Item Dsscupt— No. I 56 1.5" Water Service I 57 1 5" Water Service, Meter Reconnection 58 1.5" Private Water Service, as needed I I I -CO1 Add 30 d— I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I B C D E F Addition Tots] Completed on Unto ofMeasme Spcc on CO Quantity to Add Unit Puce Change Order Estimated Quantity Installed Value Previously Value This Insmlled Value Period Materials Presently and Stored to Date Stored (not in C) (F) SecnoN n No Value (D y E) B EA 27.00000000 $3.900.00 $105.300.00 27.00000000 $105300.00 $$105,300.00 100.0% EA 2700000000 $42500 $11,475.00 27.00$11,47500 %05,300.00 1.475.00 IL47500 100.0% LF 100.00000000 $90.00 $9.000.00 This document has been modified from its original f as an EJCDC document and the aser did not highlight the modifications. You an, encouraged to read the document carefully and consult Legal Counsel pnor to its execunon Balance to Finish (B - F) C-620 Change Order i Totals $125,775.00 M1.175.00 $1f6,775.00 $116,775.00 12R°fo $9,000.00 Progress Estimate Change Order Number 1 1 Contractor's Application DELETIONS For (contmc): WATER & SEWER REPLACEMENT 02383 CONTRACT 2014 WSM-B, PART 1 Application Number: 23-FINAL IApp1""`nn per`na 03/03/2023-03/03/2023 Avolt°atinn Date 6/6/2023 A B C D E F I Item CO Quauttty to Deletion Change Order Item Descnphon Specification Umt of Measure Delete Unit Pnce Change Order Not Used Not Uscd Not Used Not Used Not Used Not Used Not Used Not Used No. I 13 114 " WATER Section No EA 27.00000000 $1 500.00 Value $40 SOO.OG [S`'EFRVIICCE Q p���[� I 55 WA %N&UK�N ALLOWICE LS 030000000 $100.000.00 $ OOOOOG I I I I I Totals $78.600.04. This document has been modified from its original f as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel p— to its execution C-620 Change Order Progress Estimate Change Order Number 1 2 ADDITIONS For (contract): 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 City Secretary 54210 Contract Num: Application Period: 03/03/2023-03/03/2023 A B C D Item Change Order Item Specification Unit of CO Quantityto Add Umt Price Addition Change Estimated Quantity Value No Description Section No. Measure Order Value Installed 56 1.5" WATER SERVICE EA 1800000000 $3,900.00 $70,200 00 I8 00000000 $70,200.00 57 1.5" WATER SERVICE, METER RECONNECTION EA 1800000000 $425.00 $1,610 00 I8 00000000 $7,650.00 59 2" WATER SERVICE EA 1100000000 $4,250.00 $46,75000 900000000 $38,250.00 60 2" WATER SERVICE METER RECONNECTION EA 1100000000 $450.00 $4,950 00 900000000 $4,050.00 61 2" PRIVATE WATER SERVICE: AS NEEDED LF 50 00000000 $100.00 $5,000 00 *CO2 Add 40 days Contractor's Application 23-FINAL Application Date: 6/6/2023 E F Balance to Finish P—ousl Value This Materials Present) Total Completed (B - P) Installed Value Period Stored (not in C)y and Stored to Date (F) (D+E) B $70,200.00 $70,200 00 100.0% $7.650.00 $7,650 00 100.0% $38,250.00 $38,25000 818% $8,500.00 $4,050.00 $4,05000 818% $900.00 $5,000.00 This document has been modified from its original fiction as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Totals $134.550.00 1 $120.150.001 $120.150.001 50.00 89 3% Progress Estimate Change Order Number 1 2 DELETIONS IFor (contract); 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 Application Number: Application Period: 03/03/2023-03/03/2023 Application Date: A B C D E I Item CO Quantity to Deletion Change Change Order Item Description Specification Unit Delete Unit Price Order Value Not Used Not Used Not Used Not Used Not Used No. Section No. Measure I 13 2"WATER SERVICE EA 29.00000000 $1.500.00 $43500.00 I 14 2" WATER METER RECONNECTION EA 29.00000000 $300.00 $8.700.00 I 55 WATER CONSTRUCTION ALLOWANCE LS 0.60000000 $100.000.00 $60.000.00 Totals $112.200.00 This document has been modified from its original firrin as an EXEC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Contractor's Application 23-FINAL 6/6/2023 F Not Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 3 ADDITIONS IFor (contract): 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 (Application Period: 03/03/2023-03/03/2023 City Secretary 54210 Contract Num: A B Item Addition Change Order Item Description Specification Unit of CO Quantity to Add Unit Price Change Order No. Section No. Measure Value 62 42" x 12" Tapping Sleeve & Valve EA 100000000 $33,696.00 $33,696.00 63 Abandon 1.5" Water Service, capping (N main EA 500000000 $811.34 $4,056.70 •CO3 Add 15 days C D Estimated Quantity htstalled Value 1.00000000 $33,6960 5.00000000 1 $4,056 7 Contractor's Application Application Number: 23-Fl Application Date: 6/6/] E F Previously Value This Materials Presently Total Completed Installed Value Period Stored (not in C) a and Stored to Date (F) (D +E) B $33,696 001 $33,696.00 100 0% $4,056 70 $4,056.70 100 0% This document has been modified from its original f as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Balance to Finish (B -F) C-620 Change Order Totals $37.752.70 1 $37.752.701 $37.752.701 1 1 $37.752.70 1000, Progress Estimate Change Order Number 1 3 DELETIONS For Icontiaal: 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 W SM-B, PART 1 Application Number Application Period: 03/03/2023-03/03/2023 Application Date: A B C D E I Item Deletion COO to Change Order Item Description Specification Unit of Delete Unit Rice Change Order Not Used Not Used Not Used Not Used Not Used No. Section No. Measure Value I 10 42"PCCP LF 20.00000000 $300.00 $6.000.00 I 12 Connection to Existin¢ 42" Water Main EA 2.00000000 $23.000.00 $46.000.00 Totals $52.000.06 This document has been modified from its original firrin as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Contractor's Application 23-FINAL 6/6/2023 F Not Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 4 For (contract): Application Period: Change Order Item No 63 64 43 44 ADDITIONS 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 03/03/2023-03/03/2023 Item Description 24" Steel Casing Pipe (BOTC) 12 DIP Carrier Pipe Favored Backfill Material Removal and Replacement of manhole bottom -004 Add 15 days Contractor's Application City Secretary 54210 Application Number: 23-Fl Contract Num: A B Addition Specification Unit of CO Quantityto Add Unit Price Change Order Section No. Measure Value LF 9500000000 $1,025.00 $97,375.00 LF 95.00000000 $245.00 $23.275.00 CY 1000.00000000 $32.00 $32,000.00 LS 1.00000000 $2,589.29 $2,589.29 Application Date: 6/6/] C D E F Total Completed % Estimated Quantity Value Previously Value This Materials Presently and Stored t) Date (F) Installed Installed Value Period C) Stored (not in(D+E ) B 124 00000000 1121 100 01 1121 100 01 $127,100.00 130.5% 124.000.0000 $30,380.00 $30,380.0. $30,380.00 130.5% 660.00000000 $21,120.00 $21,120.00 $21,120.00 66.0% 1.00000000 $2,589.29 $2,589.29 $2,589.29 100.0% This document has been modified from its original f as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Balance to Finish (B -F) -$29,725.00 1 -$7,105.001 $10,880.001 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 C-620 Change Order Totals $155,239.29 $181,189.29 $181,189.29 $181.189.29 1167%-$25,950.001 Progress Estimate Change Order Number 4 Contractor's Application DELETIONS For (contract). 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 W SM-B, PART 1 Application Number 23-FINAL Application Period: 03/03/2023-03/03/2023 Application Date: 6/6/2023 A B C D E F I Item CO Quantity to Deletion Change Order Item Description Specification Unit of Delete Unit Price Change Order Not Used Not Used Not Used Not Used Not Used Not Used Not Used Not Used No, Section No. Measure Value I 3 12" DIP with CLSM Backfill at Holm Street LF 95.00000000 $1.125.00 $106.875.00 I I 50 Permanent PavemenAmr (P HNIAC over 2:27) at Holm St. Sy 144.00000000 $100.00 $14.400.00 I I 42 Sewer Construction Allowance LS 0.58000000 $60.000.00 $34.800.00 I Totals $156.075.06 This document has been modified from its original ficarn as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Contractor's Application ADDITIONS For (connact): WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 City Secretary Appficatmn Number 02383 Contractxum: 54210 23-FINAL IApplieati- Peruxl: 03/03/2023-03/03/2023 Application Date: 6/6/2023 Item Change Order Item Descnptaa No. 30 Unclassified Excavation Progress Estimate Change Order Number 1 5 A B C D E F Addition Total Completed Specification CO Quantity to Add Unit Pnce Change Order Omt Measure Estimated Quantity Installed Value Pre —sly Value Thal Installed Value Period Matenals Presently and Stored to Date Stored (not in C) (F) of Section No Value (D + E) B CY 20000000000 $2975 $5,950.00 200.00000000 I $5,950.00 $5,950001 I $5.950.00 1000% This document has been modified from its original f as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel pnor to its execution Balance to Furish (B-F) C-620 Change Order Totals 55.950.00 55.950.00 55.950.00 Progress Estimate Change Order Number 1 5 DELETIONS IFor (contract). 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 Application Number: (Application Period: 03/03/2023-03/03/2023 Application Date: A B C D E I Item CO Quantity to ty Deletion Change Order Item Spi"" non Description Unit of Measure Delete Unit Price Change Order Not Used Not Used Not Used Not Used Not Used No. Section No. Value I 29 Pavine Contract —Allowance IS 010800000 $55,00000 $5.940.00 I I I I I Totals S5.940.06 This document has been modified from its original f as an EJCDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel pnor to its esecunon $5.950.00 100.0% Contractor's Application 23-FINAL 6/6/2023 F Not Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 6 ADDITIONS IFor (contract): 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 (Application Period: 03/03/2023-03/03/2023 Contractor's Application City Secretary, 54210 Application Number: 23-Fl Contract Num: A B Item Addition Change Order Item Specification Unit of CO Quantityto Add Unit Price Change Order No Description Section No. Measure Value I 4 8" PVC Water Pipe Unit 1 - Water LF 227.00000000 $118.00 $26,786.00 I 5 6" PVC Water Pipe Unit 1 - Water LF 13 00000000 $75.00 $975.00 I 11 Correction to Existing 4" to 12" Water Main Unit 1 - Water EA 200000000 $6,000.00 $12,000.00 I 13 1" Water Service Unit 1 - Water EA 400000000 $1,500.00 $6,000.00 I 14 1" Water Service, Meter Reconnection Unit 1 - Water EA 400000000 $300.00 $1,200.00 I 17 6" Gate Valve Unit 1 - Water EA 1.00000000 $925.00 $925.00 I 18 8" Gate Valve Unit 1 - Water EA 3.00000000 $1,400.00 $4,200.00 I 20 Ductile Iron Fittings Unit 1 - Water TN 0.50000000 $ 11,000.00 $5,500.00 I 21 Salvage Fire Hydrant Unit 1 - Water EA 1.00000000 $500.00 $500.00 I 22 Fire Hydrant Unit 1 - Water EA 1.00000000 $5,000.00 $5,000.00 I 23 Trench Safety Unit 1 - Water LF 407.00000000 $0.25 $101.75 I 66 8" Ductile Iron Water Pipe Unit 1 - Water LF 167.00000000 $222.00 $37,074.00 I 'Add 15 days I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I Application Date: 6/6/] C D E F Total Completed % Estimated Quantity Value Previously Value This Materials Presently and Stored to Date (F) Installed Installed Value Period Stored (not In C) (D+E) B 227 00000000 $26,786 00 $26,786 00 $26,786.00 1000% 13.00000000 $975 00 $975 00 $975.00 1000% 2.00000000 $12,00000 $12,00000 $12,000.00 1000% 2.00000000 $3,000.00 $3,00000 $3,000.00 50.0% 2.00000000 $600.00 $60000 $600.00 50.0% 1.00000000 $925.00 $925 00 $925.00 100.0% 3.00000000 $4,200.00 $4,200.00 $4200.00 100.0% 0.50000000 $5,500.00 $5,500.00 $5,500.00 100.0% 1.00000000 $500.00 $500.00 $500.00 100.0% 100000000 $1 ('00.00 $5,000.00 $5,000.00 100.0% 407.00000000 $101.75 $101.75 $101.75 100.0% 167.00000000 $37,074.00 $37,074.00 $37,074.00 1000% This document has been modified from its original f as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Balance to Finish (B -F) I I $3,000.001 $600.001 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I C-620 Change Order Totals $100,261.75 $96,661.75 $96,661.75 $96.661.75 96.4% SM00.001 Progress Estimate Change Order Number 1 6 DELETIONS For /commetl: 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 W SM-B, PART 1 Application Number Application Period: 03/03/2023-03/03/2023 Application Date: A B C D E I ltem Deletion COO to Change Order Item Description Specification Unit r Delete Unit Price Change Order Not Used Not Used Not Used Not Used Not Used ure No. Section No. MeasValue I 55 Water Construction Allowance Unit 1-Water LS 0.10000000 $100.000.00 $10.000.00 Totals $10.000.06 This document has been modified from its original f as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Contractor's Application 23-FINAL 6/6/2023 F Not Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 7 ADDITIONS WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 City Secretary For (contract): 02383 Contract Nu - Application Period: 03/03/2023-03/03/2023 A B Item Addition Change Order Item Specification Unit of CO Quantityto Add Unit Price Change Order No Description Section No. Measure Value I 36 Remove Curb and Goner LD 420.00000000 $10.00 $4,200.00 I 37 7" Curb and Goner LD 420.00000000 $75.00 $31,500.00 I 38 Remove Concrete Driveway SF 257.00000000 $2.00 $514.00 I 39 6" Concrete Driveway SF 257.00000000 $12.50 $3,212.50 I 41 2" Asphalt Pavement Type D SY 590.00000000 $14.00 $8,260.00 I 48 10" Pavement Pulverization SY 590.00000000 $9.00 $5,310.00 I 67 Cut & Plug 20" outlets on 42" main LS 1.00000000 $66,794.00 $66,794.00 I 68 16" Concrete Water Line Connection LS 1.00000000 $13,205.00 $13,205.00 I 69 SWPPP>IAcm LS 1.00000000 $1,864.00 $1,864.00 I 70 Cement Modification, 261bs./SY TN 18.00000000 $195.00 $3,510.00 I 27 Remove Curb and Goner LF 420.00000000 $10.00 $4,200.00 I 28 7" Curb and Goner LF 420.00000000 $75.00 $31,500.00 I 29 Remove Concrete Driveway SF 2590.00000000 $2.00 $5,160.00 I 30 6" Concrete Driveway SF 258 00000000 $12 50 $3,225 00 I 32 3" Asphalt Pavement, Type D SY 5500.00000000 $20.00 $110,000.00 I 39 11" Pavement Pulverization SY 5500.00000000 $10.00 $55,000.00 I 43 Cement Modification, 26Lbs./SY TN 18.00000000 $195.00 $3,510.00 44 SWPPP>IAcre LS 1.00000000 $1,864.00 $1,864.00 I 5 Remove Curb and Goner LF 840.00000000 $10.00 $8,400.00 I 6 7" Curb and Goner LF 840.00000000 $75.00 $63,000.00 I 7 Remove Concrete Driveway SF 408.00000000 $2.00 $816.00 I 8 6" Concrete Driveway SF 515.00000000 $12.50 $6,437.50 I 10 3"Asphalt Pavement, Type D SY 5500 00000000 $20 00 $110,00000 I 17 I1"Pavement Pulverization SY 5500 00000000 $10 00 $55,000 00 I 18 Cement Modification, 261bs./SY TN 36.00000000 $195 00 $7,020 00 I 34 Pavement Markings LF 1700 00000000 $20 00 $34,000 00 I 32 SWPPP>IAcre LS 1.00000000 $3,72800 $3,72800 I 33 I I I I I I I I I I I I I I I I I I I 6' Sub -Drain LF 408 00000000 $55 75 $22,746 00 Contractor's Application 54210 Application Number: 23-FINAL Application Date: 6/6/2023 C D E F Balance to Finish Total Completed % Estimated leti n ry value Previously Value This Materials Presentl and Stored to Date (F) (B - F) Installed Installed value Period Stored (not intly (DIE) B 420 00000000 $4,200 00 $4,200 00 $4,200.00 1000% I 42000000000 $31,50000 $31,50000 $31,500.00 1000% I 257 00000000 $514 00 $514 00 $514.00 1000% I 257 00000000 $3,212 50 $3,212 50 $3212.50 1000% I 590 00000000 $8,260 00 $8,260 00 $8260.00 1000% I 59000000000 $5,31000 $5,31000 $5,310.00 1000% I 1.00000000 $66,794.00 $66,79400 $66,794.00 100.0% I 1.00000000 $13,205.00 $13,20500 $13.205.00 100.0% I 1.00000000 $1,864.00 $1,864.00 $1,864.00 100.0% I $3,510.001 420.00000000 $4,200.00 $4,200.00 $4,200.00 100.0% I 420.00000000 $31,500.00 $31,500.00 $31,500.00 100.0% I 258.00000000 $516.00 $516.00 $51600 100% $4,644.001 259.00000000 $3,225 00 $3,225 00 $3,225.00 1000% I 550000000000 $110,00000 $110,00000 $110,000.00 1000% I 550000000000 $55,000.00 $55,000.00 $55,000.00 100.0% I $3,510.001 1.00000000 $1,864.00 $1,864.00 $1,864.00 100.0% I 840.00000000 $8,400.00 $8,400.00 $9,400.00 100.0% 840.00000000 $63,000.00 $63,000.00 $63,000.00 100.0% I 408.00000000 $816.00 $816.00 $816.00 100.0% 515.00000000 $6,437.50 $6,437.50 $6,43750 100.0% I 5500.00000000 $110,000.00 $110,000.00 $110,00000 100.0% 5500.00000000 $55,000.00 $55,000.00 $55,00000 100.0% 3600000000 $7,020.00 $7,020.00 $7,02000 100.0% I $34,000.001 100000000 $3,728.00 $3,728.00 $3,72800 100.0% I 408.00000000 $22,746.00 $22,746.00 $22,746.00 1000% I I I I I I I I I I I I I I I I I I I This document has been modified from its original f as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. C-620 Change Order Totals $663,976.001 $618312.001 $618.312.001 1 1 $618312.00 93.1% S4&664.001 Progress Estimate Change Order Number 1 7 DELETIONS For (contract); 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 W SM-B, PART 1 Application Number Application Period: 03/03/2023-03/03/2023 Application Date: A B C D E Item Deletion COO to Change Order Item Description Specification Unit of Delete Unit Rice Change Order Not Used Not Used Not Used Not Used Not Used No. Section No. Measure Value Totals This document has been modified from its original fierm as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Contractor's Application 23-FINAL 6/6/2023 F Not Used Not Used Not Used C-620 Change Order Progress Estimate Change Order Number 1 8 ADDITIONS IFor (contract): 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 WSM-B, PART 1 IApplica'ion Period: 03/03/2023-03/03/2023 Item Change Order Item No Description I 1-36 REMOVE CURB AND GUTTER 1-37 7" CURB AND GUTTER I 1-71 2" ASPHALT PAVEMENT TYPE D I 1-72 WEDGE NULLING I 1-73 UNCLASSIFIED EXCAVATION 0-27 REMOVE CURB AND GUTTER 0-28 7" CURB AND GUTTER I 0-45 UNCLASSIFIED EXCAVATION 10-5 REMOVE CURB AND GUTTER I 10-6 7" CURB AND GUTTER O1-30 I UNCLASSIFIED EXCAVATION I I •C08 Adding 180 days I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I *C09 Adding 80 claw Contractor's Application City Secretary 54210 Application Number: 23-Fl Contract Num: A B Addition Specification Unit of CO Quanfityto Add Unit Price Change Order Section No. Measure Value LF 2342.00000000 $10.00 $23,420.00 LF 2341.00000000 $75.00 $175,575.00 SY 3202.00000000 $12.32 $39,448.64 SY 1800.00000000 $6.21 $11,178.00 CY 876.00000000 $29.75 $26,061.00 LF 2341.00000000 $10.00 $23,410.00 LF 900.00000000 $75.00 $67,500.00 CY 875.00000000 $29.75 $26,031.25 LF 4693.00000000 $10.00 $46,830.00 LF 220000000000 $75.00 $165,00000 CY 1752 00000000 $29 75 $52,122 00 Application Date: 6/6/] C D E F Total Completed % Estimated QuantiTy Value Previously Value This Materials Presently and Stored tDate (F) Installed Installed Value Period Stored (not m C) (DIE) B 225600000000 $22,56000 $22,56000 $22,560.00 96.3% 225600000000 $169,20000 $169,20000 $169,200.00 96.4% 3059 00000000 $37,686.88 $37,686.88 $37,686.88 95.5% 180000000000 $11,178.00 $11,17800 $11,178.00 100.0% 87600000000 $26,061.00 $26,061.00 $26,061.00 100.0% 2341.00000000 $23,410.00 $23.410.00 $23,410.00 100.0% 900.00000000 $67,500.00 $67,500.00 $67,500.00 100.0% 875.00000000 $26,031.25 $26,031.25 $26,031.25 100.0% 4683.00000000 $46,930.00 $46,830.00 $46,830.00 100.0% 2200.00000000 $165,000.00 $165,000.00 $165,00000 100.0% 1752.00000000 $52,122.00 $52,122.00 $52,12200 100.0% This document has been modified from its original f as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Balance to Finish (B -F) $860 001 $6,375 001 $1,761.761 I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I C-620 Change Order Totals $656,575.89 $647579.13 $647,579.13 $647.579.13 98.6% $8,996.761 Progress Estimate Change Order Number 1 8 DELETIONS For (contract); 02383 WATER & SEWER REPLACEMENT CONTRACT 2014 W SM-B, PART 1 Application Number Application Period: 03/03/2023-03/03/2023 Application Date: A B C D E Item Deletion COO to Change Order Item Description Specification Unit of Delete Unit Rice Change Order Not Used Not Used Not Used Not Used Not Used No. Section No. Measure Value Totals This document has been modified from its original fierm as an E1CDC document and the user did not highlight the modifications. You are encouraged to read the document carefully and consult Legal Counsel prior to its execution. Contractor's Application 23-FINAL 6/6/2023 F Not Used Not Used Not Used City of Fort Worth Summary of Charqes City Secretary Contract Num: I 54210 I WATER & SEWER REPLACEMENT CONTRACT 2014 I P. O : FW020-0000004254 Project Number: 02383 WSM-B, PART 1 Application Period: I 03/03/2023-03/03/2023 I Application I 23-FINAL Application Date: Number: Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Orlinal Contract 156002-0600430-5740010-0O23 3-CO1780-9999 $3,200,383.77 $373,315.23 $0.0, 156002-0700430-574001O-CO2383-001780-9999 $1,611,082.00 $191,516.00 $0.00 130100-0200431-574001O-CO2383-CO2480-9999 $1,205,546.40 $33,068.60 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 1 $0.0, Chang�Order 1 156002-0600430-5740010-0O2383- 01780-9999 $116,775.00 ($69,600.00) $0.0( 156002-0700430-574001O-CO2383-001780-9999 $0.00 130100-0200431-574001O-CO2383-CO2480-9999 '0.00 10 0.00 10 10 10 10 10 10 10 Chang�Order 2 156002-0600430-5740010-0O2383- 01780-9999 $120,150.00 ($97,800.00) 156002-0700430-574001O-CO2383-001780-9999 130100-0200431-574001O-CO2383-CO2480-9999 10 10 10 10 10 10 10 10 Chang�Order 3 156002-0600430-5740010-0O2383- 01780-9999 $37,752.70 ($52,000.00) 156002-0700430-574001O-CO2383-001780-9999 6/6/2023 Net City of Fort Worth Summary of Charges City Secretary Contract Num: I 54210 WATER & SEWER REPLACEMENT CONTRACT 2014 L C: FW020-0000004254 WSM-B, PART 1Application Period: 03/03/2023-03/03/2023 I Applican I 23-FINAL Number: Funding Identification (FID) Total Completed Amt Remaining Gross 130100-0200431-574001O-CO2383-CO2480-9999 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 �0.00 I I Change Order 4 156002-0600430-574001O-CO2383-001780-9999 $157,480.00 ($158,105.00) 156002-0700430-574001O-CO2383-001780-9999 $23,709.29 ($23,920.00) 130100-0200431-574001O-CO2383-CO2480-9999 10 10 10 10 10 10 10 10 I I Change Order 5 156002-0600430-574001O-CO2383-001780-9999 156002-0700430-574001O-CO2383-001780-9999 130100-0200431-574001O-CO2383-CO2480-9999 $5,950.00 ($5,940.00) 10 10 10 10 10 10 10 10 I I Change Order 6 156002-0600430-574001O-CO2383-001780-9999 $96,661.75 ($6,400.00) 156002-0700430-574001O-CO2383-001780-9999 130100-0200431-574001O-CO2383-CO2480-9999 10 10 Project Number: �02383 Application Date: 6/6/2023 Retainage Net City of Fort Worth Summary of Charges City Secretary Contract Num: I 54210 WATER & SEWER REPLACEMENT CONTRACT 2014 L C: FW020-0000004254 WSM-B, PART 1Application Period: 03/03/2023-03/03/2023 I Applican I 23-FINAL Number: Funding Identification (FID) Total Completed Amt Remaining Gross 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 $0.00 10 1 $0 00 Chan_ a Order 7 156002-0600430-5740010-0O238M01780-9999 $134,859.50 $3,510.00 156002-0700430-574001O-CO2383-001780-9999 $206,305.00 $8,154.00 130100-0200431-574001O-CO2383-CO2480-9999 $277,147.50 $34,000.00 10 10 10 10 10 10 10 10 I Chan_ a Order 8 156002-0600430-5740010-0O238M01780-9999 $266,685.88 $8,996.76 156002-0700430-574001O-CO2383-001780-9999 $116,941.25 130100-0200431-574001O-CO2383-CO2480-9999 $263,952.00 10 10 10 10 10 10 10 10 I I Totals 156002-0600430-574001O-CO2383-001780-9999 $4,130,748.60 $1,916.99 156002-0700430-574001O-CO2383-001780-9999 $1,958,037.54 $175,750.00 130100-0200431-574001O-CO2383-CO2480-9999 $1,752,595.90 $61,128.60 10 10 10 10 10 Project Number: �02383 Application Date: 6/6/2023 Retainage Net City of Fort Worth Summary of Charqes City Secretary Contract Num: I 54210 I WATER & SEWER REPLACEMENT CONTRACT 2014 I P. O : FW020-0000004254 Project Number: 02383 WSM-B, PART 1 Application Period: I 03/03/2023-03/03/2023 I Application I 23-FINAL Application Date: 6/6/2023 Number: Funding Identification (FID) Total Completed Amt Remaining Gross Retainage Net 10 I 1 $0.00 $0.00 H $0.00 $0.00 H 10 I I $o.or 1 1 $0.00 1 1 $0.001 1 $0.00 1 1 10 I I 1 1 $0.00 1 1 $0.00 1 1 $0.00 1 1 Grand Total 1 1 $7,841,382.04 1 1 $238,795.59 1 1 $0.00 1 1 ($392,069.11)1 1 $392,069.11 1 CSC No. 54210-CO1 F )P,-r W() w1.1-1 City of tort Worth Change Order Request Project Name:1 Waler and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 Cily Sec No.: 1 54210 Projec(No.(s):1 VAOWOOMO)uao-seaotmC041001 I DOE No. I N/A I City Proj. NoJ 2383 Project Descdplion:Water, sever replacement and pavement rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and I Westcliff Read South f Conlraclod Jackson Construction, Lid. Change Order # 1 J Date: 1 10/12/2020 City Project Mgr,1 Scol(Taylor City Inspector: Ramon Chavez Phone Number: 817.392.7240 Phone Number: 817.392.8306 Dept, Water Sewer TPW Totals Contract Time (Celender clays) Original Contract Amount $3,573,699.00 $1,802,598.00 $1,238,615.00 $6,614,912.00 540 Extras to Dale Credits to Dale Pending Change Orders (in M&C process) Contract Cost (a Dale $3,673,699.00 $1,802,598.00 ) $1,238,616.00 $6,614,912.00 640 'Amount of Proposed Change Order $47,175.00 j $0,00 I som 147,176.00 030 Revised Contract Amount $3,620,874.00 $1,802,598.00 j $1,238,615.00 1$6,662,087.00 570 Original Funds Available for Change Orders $107,211.00 $54,078.00 j $0.00 $161,289.00 Remaining Funds Available for this CO $0.00 $0.00 $0.00 Additional Funding (if necessary) $77,175.00 I $77,175.00 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 1 0.71% MAXALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 2S%$8,268 ) ,640.00 JUSTIFICATION•(REASONS) FOR CHANGE ORDER Change Order No. 1 will provide for the installation of 1 1/2-inch meter and service relocation at 27 locations on the project instead of 1-inch meter as listed at the time of the project was advertised for bid. Staff recommends the addition of 30 calendar days on the project for the change order. It Is understood and agreed (hat [lie acceptance of this Change Order by [he can lradorconslilules an accord and satisfaction and represents payment In full (both lime and money) for all costs arising out of, or Incidental to, the above Change Order. Contractor's Company Name I Contractor Name. Haberslrough(f,I0, I / ConlfaA (ores na re /%r Dale jd Jackson Construction, Lld. Steve In peotor �� Dale Prajec a�nager .Dale Director Water D t) , Dale T. 5. J Oct 15, 2020 onslrucllon Su ervlsor (TPW Dept) 7�� u� ale 10/13/2020 "',l.,h,r Hard (-B, t010012—TD Assistant City Attorney Dale Assistant City Manager Dale oiTl6z020 i16-1 ct 16, 2020 a S�and .1.6dlor.:Ur 1161 Oct 16, 2020 Council Action (If Required) M&C Number j N/A + M&C Dale Approved NIA j 1Fc*1rr Woowri K City of fort Worth Change Order Additions Project Name I Water and Sanitary Server Replacement Contract 2014 WSM-B, Part 1 City Sec No.: 1 54210 Project No.(s): I 56002/0600430/C01780-5600210700430/C01780- I DOE No.1 N/A I City Pro). No.: I 2383 Project Water, sewer replacement and pavement rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and J Description Weslcliff Road South Contractor ' Jackson Construction, Ltd. Change Order: Date:1 10/1212020 I City Project Mgr. 1 Scott Taylor 1 City Inspector I Ramon Chavez ADDITIONS - I I tM - — - - VESGUIP HON DEPT Qly Unit Unit Cost Total 56 1.8' Water Service Water 27.00 EA $3,900.00 $105,300.00 57 1.5" Water Service, Meter Reconnection Water 27.00 EA $425.00 $11,476.00 58 1 .5" Private Water Service; a3 needed I I 1 aler 100.001 F f l l I I I 1 90.00 l I I I $9,000.00 I I 1 t 1 Page 2 of 4 I Water $125,775.00 Sewer TPW Addiltons Sub Total $125,775.00 F()r li~_.-r Wo YZ-r -4 City of Fort Worth Change Order Deletions Project Name Water and Sanilary Sewer Replacement Contract 2014 WSM-B, Part 1 City Sec No.: 54210 ProjectNo.(s):� �a+no�n�nn'JV/VVIIUV'JVVVLIVIVVIJVIVVIIVV' I DOE No. I N/A City Proj. No.: 2383 AgurmAnn Project Description I Water, sewur replacement and pavement rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Westcliff Road South Contractor ' Jackson Construction, Ltd. I Change Order: Dale 10/12/2020 City Project Mgr. Scott Taylor City Inspector: I Ramon Chavez ITEM IDESCIIPTION 13 V Water Service 14 1 V Water Meter Reconnection 55 lWater Construction Allowance I DELETIONS DEPT City lJnit Unit Cost Total lWater I 27.00 EA 1 $1,500.00 $40,500.00 IWaler 27.00 EA $300.00 $8,100.00 IWaler 0.30 LS $100,000.00 $30,000.00 I I I I I Page 3 of 4 I I i I I I I I I I Water 1$78,600.00 Sewer TPW Deletions Sub Total 1$78,600.00 — co MIW E Breakdown for this Change Order MWBE Sub Type of Service Amount for ihis CO I I I Total $0.00 Previous Change Orders DATE Total Page 4 of 4 AMOUNT $0.00 Contract Compliance Manager By signing I acknowledge that I ant rite person responsible for the monitoring and administration of this contract, including eustu•ing all perlbmranee and reporting requirements. c5Cb/C1/6/2� Signature Name of Employee , CS Title ATTEST; -For Ronald P. Gonzales for Ronald P. Gonzales (Oct 16, 202017:57 COT) Mary J. Kayser City Secretary CSC No. 54210-0O2 Fc,>iEz-r Wj >iz-rH City of Fort Worth Change Order Request Project Name: Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 ` Clly Sec No.: 54210 Project No,(s):1 I DOE No. ' N/A City Proj, No.: 2383 Project Description: Water, sewer replacement and pavement rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and I Westclif(Road South Contractor. Jackson Construction, Ltd. Change Order # 2 Dale: 11/18/2020 City Project Mgr.I Scott Taylor I City Inspector: Ramon Chavez Phone Number:1 817-392.7240 Phone Number: 817-392.8306 Dept, Water Sewer TPW Totals Contract Time f Calendar days) Original Contract Amount $3,573,699.00 $1.802,598.00 $1,238,616.00 $6,614,912.00 540 Extras to Date $47,175.00 $0.00 J $0.00 $47,175.00 030 Credits to Dale j 1 Pending Change Orders (in M&C process) I I Contract Cost to Date $3,620,874.Q0 1 $1,802,598.00 1 $1,238,615.00 $6 662,087.00 570 $22t350.00 $OAU Amount of Proposed Change Order 1 $0.00 22,350.00 040 Revised Contract Amount $3,643,224.00 $1,802,598.00 J $1,238,615.00 $6,6 ,437.00 1610 Original Funds Available for Change Orders $107,211.00 J $54,078.00 J $0.00 $161,289.00 Remaining Funds Available for this CO 1 1 Additional Funding (it necessary) J 1 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 1.05% MAX ALLOWABLE CONTRACr/T�AyMrOUN/T(ORIGINAL ..CONTRACT COST +25%) 1$8,268,640.00 a r .F % .� 1 �~M,1�M1. �� i:'1. ���p"'9'CM�c.tii�, n+.FppMTF:�2�A.'�".:��4Pi•_"^^�� ��i`[.�(� .�`T ti ,. 'R, M F w .. ar „i:._h 4�c `,� L• i��t� V Qv- .^4?L`_nt�,1..i .ti�Fti4�. ,/�rh i.,z �;, Change Order No. 1 will provide for the installation of 1 % and 2-inch meters and service relocations at 29 additional locations on the project in lieu of 1-inch meter that was listed at the time of the project was advertised for bid. Staff recommends the addition of 40 calendar days on the project for the change order, Ills understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment In full (both time and money) for all costs arising out of, or Incidental to, the above Change Order, , 11/19/2020 1112012020 n 7' $ , Nov 23, 2020 11 /20/2020 rn rs V'Xq R L��$L� a � r�wu<,++ ..�.L, .s:W. 9•� ^ MOM Nov za, zozo DanehdQ- Nov 24.2020 {;i.�- ;�>,. �ryp�„�.r'.�::ysl'�;:i;�,T p}iy�,,.��iAy� ;y pp ` `'':"Sint" `�:',',s:i:t'S'.:4� L�r,.`'rry �:kpv:;��;,'„•'• .y:'+t:.:;:��;;!.,: _;. j �� �t,,.r. ,: a�i'4•-,n..1u`,s� r'.T�f ..t K.� :L. IM&C Number 1 NIA I M&C Date Approved 1 N/A "\ F(>RT WO R-FI-1 City of Fort Worth Change Order Additions Project Name ' Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Pal 1 City Sec No.; 1 64210 Project No.(s): ' 56002106004301C01780.56002107004301C01780- j DOE No.' N/A I City Proj. No.: 1 2383 Project Water, sewer replacement and pavement rehabilitation on Bellaire Circle, Ranch View Road, South I Hills Circle and Description Weslcllff Road South Contractor Jackson Construction, Ltd, N Change Order: Dale:1 11118/2020 1 City Project Mgr. Scot( Taylor City Inspector Ramon Chavez ADDITIONS I I hm UhSURIN I IUN DEPT Qty Unit Unit Cost ! Total 56 1.5" Water Service Water 18.00 EA $3,900.00 $70,200.00 57 1,5" Water Service, Meter Reconneclion Water 18.00 EA $426.00 $7,660.00 59 2" Water Service Water 11.00 EA $4,250.00 $46,750.00 60 2" Water Service Meter Reconnectlon Water 11.00 EA $460.00 $4,950.00 61 2" Private Water Service; as needed I I Water 50.00 LF I I I I I $100.00 $5,000.00 I 1 Water $134,550,00 Sewer TPW Piige ] of 1 Additions Sub Total $134,550.00 F(.)i R-r Wc-3 R-r }-i City of Fort Worth 'lr*'�� Change Order Deletions Project Name I Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 I City Sec No,: j 54210 I �' Project No, s ProI VVVVLIVVVV'IJVIVV 1IVV'UVVVLIVfVV /UVIVV 11 DOE No, y j I on�nn�nonne�,rr+noeon N/A City Pro.No.; 2383 Project Description I Water, sewer replacement and pavement rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and I Westclitl Road South Contractor I Jackson Construction, Ltd. Change Order: F2—] Date 11/18/2020 City Project Mgr. Scott Taylor I City Inspector: I Ramon Chavez DELETIONS ITEM DESCRIPTION DEPT Qty Unit Unit Coat Total 13 2" Water Service Water 29.00 EA $1,500.00 $43,500,00 14 2" Water Meter Reconnection Water 29.00 EA $300,00 $8,700.00 55 Water Construction Allowance Water 0.60 LS $100,000.00 $60,000,00 !I I I Water $112,200.00 Sewer TPW Page 10 1 Deletions Sub Total $112,200.00 MMBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO Total $0.00 Previous Change Orders co # DATE AMOUNT Total $0.00 Page 1 of 1 Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements, Signature Name of Bmployee Title ATTEST: 01141 'r° Mary J. Kayser City Secretary CSC No. 54210-0O3 FORT WORTH City of Fort Worth !—" . Change Order Request Project Name:1 Water and Sanllary Sewer Replacement Contract 2014 WSM-B, Part 1 City Sec No,: 1 64210 Project No.(s):l 66o0b06w4=17604WM70013OX006WO100.92=ftCO2160 I DOE No, I N/A Clly Proj. Nod 2383 Project Description: Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Westclllf Road South Conlraclod Jackson Construction, Ltd, Change Order fI L 3 Date: 1121/2021 City Project Mgr.1 Scott Tayl or , City Inspector: Ramon Chavez Phone Numbed 817-392-7240 Phone Number: 817-392-8306 Dept, Water Sewer TPW Totals Contract Time (Calenderdays) OriginalConlractAmounl $3,673699,00 $1,802,698.00 $1,238,615.00 $6,614,9,12,00 540 Extras to Date $69,6K00 $0.00 $0.00 $09,625.00 . ' 070 Credits to Dale Pending Change Orders (In M&C Process) Contract Cost to Date $3,643 224:00 , $1,802,698,00 $1,238,615.00 $6,684 437.00_ : 610 JAmount of Proposed Change Order �$14!!)l47.30 $0,p0 ` _ _ _ 40.00 . _ _ 14��47P30;: ? 015 Revised Contract Amount $0,628,976.70 $1,802,59�M $1,238,616.00 $6,670;ll8930, 625 . Original Funds Available for Change Orders $107,211.00 $54/ 078. 0 $0.00 _$161,289,00 i Remaining Funds Available for this CO $37,686.00 $64,078.00 $0.00 $91;764,00 Additional Funding (If necessary) - CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.84% Mf.7f�lY►7 L'iPau MAXALLOWABLECONTRACT AMOUNT (ORIGINALCONTRACT COST ++25%)p $8,268,640.00 'S.V a�Ry s= w"` .. U . [] �A lii ; 1➢ -,t i.. s Change Order No. 3 provides for the following: • The Installation of a 42" x 12" tapping sleeve and valve at the Ranch View Road/Overton Park Drive West Inersectlon In lieu of the proposed 42" x 12" Tee and 16-feet of prestressed concrete pipe to minimize closure time of the Intersection. • The abandoment of five water services on a project water main. • The deletion of pay Items that are no longer needed on the project. Staff recommends.the approval of 15 additional calendar days on the change order. I ' It Is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment In full (both lime and money) for all costs arising out of, or Incidental to, the above Change Order, AA �alp"M' 1/25/2021 09U. 2� 1/21/2021 ��1d.�i4� C1' �l3' `Ql�l�t) IaI�WlE,lrrit+�ut' 5 Jan 25, 2021 A 1/25/2021 _�,�® lawn, �y. - wathob — Jan 27, 2021 uia io Sou J� l�Ulh+�e id " Y Jan 27, 2021 M&C Number ' WA I M&C Date Approved I NIA I V CART VVO RT)E I City of Fort Worth Change Order Additions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 ( Ctly Sec No.: 1 54210 Project No,(s): I 56002/0600430/C01780-56002/07004301C01780- I DOE No.1 N/A City Proj. No.: 12383 I Project I Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Description Weslcliff Road South Contractor i Jackson Construction, Ltd. 1 Change Order: 03 Date:1 1/21/2021 City Project Mgr. 1 Scott Taylor City Inspector Ramon Chavez 1 ADDITIONS y.,. ii P. h to 62 42" x 12" Tapping Sleeve and Valve Water 1.00 EA $33,696.00 $33,696.00 63 Abandon 1,5" Water Service, capping @ main Water 5.00 EA $811.34 $4,056.70 Paige 1 of! I II I I I I I I l I I I I I I I i I I I i I I I Water $37,752,70 Sewer TPW Additions Sub Total $37,762.70 ]F'or.-r 'moo 1zz-'H City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 City See No.: 54210 ProjeclNo.(s): I JVVVG/VVVVYVVIVVI/UV'JUVVLIv/VUYJVIVVIIUV' DOE No. N/A City Proj.No.: 2383 9,u nnrnonnn 9 d I"I'lI or' Project Description Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Westcliff Road South Contractor Jackson Construction, Ltd. Change Order: F3-] Dale 1/2112021 City Project Mgr. Scott Taylor City inspector Ramon Chavez DELETIONS ITEM; DESCRIPTION. t)EPT Qiy', Unit Unit Cost Total 10 42" PCCP lWater 20.00 LF $300.00 $6,000.00 12 Connection to Existing 42" Water Main Water 2.00 EA $23,000.00 $46,000.00 Page 1 of 1 `1 1` 1 I Water 1$52,000.00 Sewer TPW Deletions Sub Total 1$52,000.00 MMBE Breakdown for this Change Order MWBE Sub I Type of Service I Amount for.ihis CO co# Previous Change Orders 'DATE' i I I Total Page 1 of 1 Total I AMOUNT $000 $0.00 Contract Compliance Manager By signing X acknowledge that X am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. v Signature Name of Employee Title ATTEST: Mary J, Kayser City Secretary CSC No. 54210-004 FORT WOwi,H City of Fort Worth Change Order Request Project Name: Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 Cily Sec No.: 1 54210 Project No.(s):l 5soo2mw4m,xlveaM2lO7a]+30017eoaowa020ouirc0:4W I DOE No. I N/A I City Pro). No.:l 2383 Project Descdplion:� Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Weslcliff Road South Contraclor.' Jackson Construction, Ltd. Change Order # 4 Date: 3/3/2021 City Project Mgr.1 Scott Taylor City Inspector: Ramon Chavez Phone Number: 817-392-7240 Phone Number: 817-392-8306 Dept. Water Sewer TPW Totals Contract Time (Calendar days) Original Contract Amount $3,573,699.00 $1,802,698.00 $1,238,615.00 $6,614,912.00 540 Extras to Date $09,525.00 $0.00 $0.00 $69,626.00 085 Credits to Dale $14,247.30 $0.00 $0.00 $14,247.30 Pending Change Orders (In M&(; Process) Contract Cost to Dale $3,628,976.70 $1,802,698.00 1 $1,238,615.00 $6,670,189.70 625 Amount of Proposed Change Order 4625.00 -$210.71 1 $0.00 -$836.71 015 Revised Contract Amount $3,628,351.70 $1,802,387.29 1 $1,238,615.00 $6,669,353.99 640 Original Funds Available for Change Orders $107,211.00 1 $54,078.00 1 $0.00 $161,289.00 Remaining Funds Available for this CO $61,933.30 1 $54,078.00 1 $0.00 $106,011.30 Additional Funding (If necessary) I I CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.82% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $8,268,640.00 'JUSTIFjOATION�REASUNS)'EORiHANGE;ORbER=-::-,.. :-, _ _ • -.. .. ,. ..' Change Order No. 4 provides for the following: • The installation of a 95 feet segment of a project 12" ductile Iron water main by other than open cut method across the Ranch View Road/South Hulen Street In lieu of open cut, In order to minimize disruption to traffic and closure time of the Intersection. Imported backflll material to replace unsuitable backfill material that was encountered during construction. The removal and replacement of a deteriorated sanitary sewer manhole bottom that was encountered during construction. Staff recommends the approval of 15 additional calendar days on the change order. It Is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment In full (both lime and money) for all costs arising out of, or incidental to, the above Change rder. - �ackson Constrllc on, W. Carmen Estep % 3/4/2021 ,f](rfclg�(Vlt aleDBpt ; .->-.''DBt�_PlislrilGODIi:SfjbOF�%4r;(TRW DepU_ S Mar22 2021 3/8/2021 ` �'Q /�is�.. Mar22,2021 DanaBi�rgHe Mar22,2021 Codricll M&C Number I N/A I M&C Dale Approved I NIA FA)- Wc� R-F 14 City of Fort Worth Change Order Additions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Pad 1 City Sec No.: 154210 Project No.(s): 5600210600430IC01780-56002/07004301C01780- I DOE No.' N/A I City Proj. No.: 2383 Project Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Description Weslcliff Road South N Contractor Jackson Conshuclion; Ltd. I Change Order:® Dale:' 31312021 _ City Project Mgr. ' Scott Taylor I City Inspector I Ramon Chavez ADDITIONS I hM UtSCHIN I IUN i DEPT Q Unit Unit Cost Total 63 24" Steel Casing Pipe (BOTC) Water 95.00 LF $1,025.00 $97,375.00 64 12" DIP Carrier Pipe Water 95.00 LF $245.00 $23,275.00 J 43 Imported Back811 Material Sewer 1,000.00 CY $32.00 $32,000.00 j 44 Removal and Replacement of manhole bottom ' Sewer 1.00 LS $2,689.29 $2,689.29 + Paige 1 of 1 I I I I I I I 1 I I I I I I I I 1 i I I I I I I I I Water $120,660.00 Sewer $34,589.29 TPW Additions Sub Total $155,239.29 1 c�Rr Wc)0x-IF 1-1 City of Fort Worth 9 . — -- Change Order Deletions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Pad 1 City Sec No.: 54210 ProjectNo.(s): I JVVVLIVVVVfJV/VV,IVV-VVVVL/V/VVYJVIVVIIVV' DOE No, N/A irn')A un City Pro). No.: 2383 Water, Sewer Replacement and Pavement Rehabilitation on Bellalre Circle, Ranch View Road, South Hills Circle Project Description and Westclili Road South Contractor Jackson Construction, Ltd. Change Order ® Date 3/3/2021 City Project Mgr. Scott Taylor City Inspector I Ramon Chavez DELETIONS . ITEM DESCRIPTION DEPT City Unit Unit Cost Total 3 12" DIP with CLSM Backfill at Hulen Street iWaler 95.00 LF $1.126.00 $106,875.00 50 Permanent Pavement Repair (311 HMAC over 2:27) at Hulen St. lWater 144.00 SY $100.00 $14,400.00 42 Sewer Construction Allowance jSewer 0.58 LS $60,000.00 $34,800.00 Page 1 of 1 Water $121,275.00 Sewer $34,800.00 TPW Deletions Sub Total $156,075.00 11 MWWBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO _ I Total I $0.00 Previous Change Orders Co # DATE AMOUNT Total Page 1 of 1 $0.00 Contract Cotnnliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Signature Ia\I11tov-- Name of Employee Title ATTEST; Mary J. Kayser City Secretary CSC No. 54210-CO5 F(>1Z'1' WO�lR'1' HH City of Fort Worth Change Order Request Project Name:1 Water and Sanitary Sewer Replacement Contract 2014 WSM•B, Pod 1 Clly Sec No.: 1 64210 Project No.(a):II DOE No. I N/A Clly Pro), No.: 1 2383 Project Dascripflon: Water, Sower Replacement and Pavement Rehabllllallon on Bellaire Circle, Rench View Road, South Hills Circle and WesIcIIN Road South Conlreclor,1 Jackson Conalrucllon, Ltd. Change Orderfl ® Dale: 313112021 City Projact Mgr:( Scott Taylor I Clly Inspector: I Ramon Chavez Phone Number.1 817.392.7240 Phone Number] 817.392.0306 Dept, Water Sower TPW Totals ContraclTime Celendardeye) Original Conlrecl Amount $3,01' 69�00 $1,002,698.00 $1,238,6 6,00 $6,614,912.00 6 0 Exlras to Dale q , b, 0 $0.00 0, $69162 ,0Q 0100 Credits to Dale 11 1M.30 $210.71 10.00 $16;083,01 Pending Change Orders (In M&C Process) Contract Cost to Dole $3.628,351.70 $1,802,387.29 $1,230 616,00 $6,6 9,353,99 840 Amount of Pro oesd Change Order �I I . 11 ,� 3'0,00 Revlud Conlrac�Amounl jit'7 8,J61ilU I $164, 6� ,dd7,2g $1,2 '(Zit UU . $tl,tl .,dtl'¢,b9 840 Original Funds Available for Change Orders 1211AO I 78.00 0,����pppppp $101,289,00 Remaining Funds Available for this CO 52,6681 64,288,71 $0.00 $106,847.01 Addlllonal Funding (If necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0:82°Ib': MAXALLOWABLE CONTRACTAMOUNr (ORIGINAL CONTRACT COST+ 25%) �$8,200,040.00 Change Order No, 5 provides for pay Item quantity for unclassified excavation to remove excess pavement material. II Is understood end agreed that the acceptance of this Change Order by the contractor conslllules an accord and sallsfacllm and represents payment In full (both time and money) for all coals arising oul of, or Incidental to, the above Change Order. trio, -;- �j/���f 04/01/2021 14 IApr8,2ozi 4/6/2021 • Ap, B.2021 Aoi 9. 2021 1".� ;i1PdTdaNMIl0.7ifimlf&d);,:. M&C Number NIA ' M&C Dale Approved I N/A I City of Fort Worth Change Order Additions Projeol Name I Water and Sanitary Sewer Replacement Contract 2014 WSM•B, Pert 1 ! CitySec No.: 1 54210 Projeol No.(s); I 58002108004301C01780.580D2107004301C01780- J DOE No. N/A City Pro), No,: 1 2383 Project Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and . Description Westcillf Road South Contractor 1 Jaokson Construction, Ltd, Change Order: © Dale: 3/31/2021 City Project Mgr. Scott Taylor , City Inspector I Ramon Chavez ADDITIONS ritm utacnrklIUN DEPT Cost _ .Total 3J lrnclaesllled Mayellon ITPW 1UU.UU Callon 2 .76 $5,950,00 I 1 I A Page 9 of 2 • � I I I I I I Water Sewer TPW $6,950.00 Additions Sub Total '$5,950.00 City of Fort Worth Change Order Deletions Project Name I Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 I City Sec No,: 1 54210 Project No.(s): I VVVV<IVVVVYJVIVV I IVV•VVVVLIvI VVYVVIVV II VV' DOE No, N/A City Proj, No,: 1 2383 ontnnr nnnnaer nneon Project Description Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Weslcliff Road South Contractor Jackson Construction, Ltd. Change Order: © Date 3/31/2021 City Project Mgr, I Scott Taylor City Inspector: I Ramon Chavez I 29 Paving Construction Allowance I DELETIONS • �:;�-D6RT'�•:�:?.- ::::'sty.-;'=, Ui�li�;-� Unit'Cost•;. ,', Jbfalt;...-•• : . TPW 0.108 LS , $55,000.00 $5,940.00 1 I 1 l I I I_ I I I 1 I I I• I I I I I I I I I I I I � I i I I I I Water Sewer TPW 1$5,940.00 $6,940.00 Page 1 of 3 Deletions Sub Total MMBE Breakdown for this Change Order M Wa E;S U 'T f.,$dM6 Total $0.00 Previous Change Orders -7f Total Page 1 of 4 $0A Contract Compliance Manager By signing I acImowledge that I am the person responsible for the monitoring and administration of this contract, including ensuiting all performance and reporting requlrements, Signature ' ji Name of Bmployea ' Title yAyTTEySpT. ; MaryJ, Kayser City Secretary CSC No. 54210-CO6 FORT WORTH City of Fort Worth Change Order Request Project Name:1 Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Pad 1 ! Clty Sec No.: 1 64210 Project No,(s):l IM020A00130'C017E03600W70043000170P30100MWC43IM480 I DOE No. I N/A City Proj, No,:l 2383 Project Description: Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Wesloliff Road South Contractor:I Jackson Construction, Ltd. Change Order N © Dale: 8/31/2021 City Project Mgr,1 Scott Taylor City Inspector: I Ramon Chavez Phone Number:1 817-392-7240 Phone Number: 817.392-8306 Dept. Water Sewer TPW Totals Contract Time (Colander days) Original Contract Amount $3,673,699.00 $1,802,698.00 $1,238,616.00 $6,614,912.00 540 Extras to Dale �69,525.00 $0.00 $10.00 $69,635.00 0100 Credits to Dale 14,872.30 $210.71 $0.00 $16,083,01 Pending Change Orders (in M&C Process) Contract Cost to Date $3 628351.70 $1,802,387,29 $1,238,625.00 $6,669,363.99 640 `Amount of Proposed Change Order 0/ X;76 $0.00 $0.00 901261,76 015 J evISedContract Amount $ ,R;,613.46 $1,802,387.29 $1.,238,626.00 1 .1 9,8826.74 655 Original Funds Available for Change Orders $107,211.00 $54,078.00 $0.00 $161,289.00 Remaining Funds Available for this CO $62,658,30 , $54;288.71 $0.00 $108,847.01 Additional Funding (if necessary) $37,703.46 $37,703.46 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 2.19%, MAXAL LOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 259Q $8,268,640,00 Change Order No. 6 will provide Increased quantities of 8-Inch PVC water main and allow for the looping of the water system by connecting the newly replaced water main on Westcliff Road South to the existing dead end water main on Hilltop Road. Staff recommends the addition of 15 calendar days for the change order. II Is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full (both time and money) for all costs arising out of, or Incidental to, the above Change Order. Jackson Construction, Ltd, Carmen Estop 1".-W,,//.'liyC�/yI Y _ - ion - � I e�1,7i'dl' t�1i(('A!Ili,il11��N) hl (t> �1n'1,;,� r%Irk! o : �1, _ loFjC "�� -� L�. irf Sep 7, 2021 Aad-y- ;pp 7- in91 M&C Number 1 21-0621 1 M&C Dale Approved 1 812412021 1 FORT "�7V0 TH City of Fort Worth Change Order Additions Project Name I Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 City Sec No,: 154210 Project No.(s): I 5600210600430/CO1760-5600210700430/001780- M DOE No.1 N/A City Pro], No.: 2383 Project Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Description Westcllff Road South I Contractor I Jackson Construction, Ltd. Change Order:© Date:1 8/31/2021 City Project Mgr, I Scott Taylor City Inspector I Ramon Chavez ADDITIONS 5 6" PVC Water Pipe Water 11 Connection to Existing 4" to 12" Water Main Water 13 1" Water Service Water 14 1" Water Service, Meter Reconnecllon Water 17 6" Gate Valve Water 18 8" Gate Valve Water 20 Ductile Iron Fittings lWater 21 Salvage Fire Hydrant Water 22 Fire Hydrant Water 23 Trench Safety Water 6B 8" Ductile Iron Water Pipe lWater Page 2 of 4 RMId1 MIWB1Mitl>r i ��lll�l 227.00 LF $118.00 $26, 13.00 LF $76.00 $976.00 2.00 EA $6,000.00 $12,000.00 4.00 EA $1,600.00 $6,000.00 4.00 EA $300,00 $1,200.00 1.00 EA $925.00 $925.00 3.00 EA $1,400.00 $4,200.00 0.50 TN $11,000.00 $5,600.00 1.00 EA $500.00 $500.00 1.00 EA $5,000.00 $5,000.00 407.00 LF $0.25 1$101.75 167.00ILF 1 1 1 1 1 $222.00 1 1 1 1 1$37,074.00 1 1 1 1 1 I I 1 1 I I I I I I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I I I � I I I I I I I I I I I I I I I I I I I I Water $100,261.76 Sewer TPW Additions Sub Total $100,261.76 TORT'VVO TH City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 City Sec No.; 1 64210 uvvvcwuvvrvv,vv„ uvvvvvuv'vvyuwvv 11 uv- Project No.(s); �n�nn�nonne��traoenn DOE No, N/A City Pro]. No.; 1 2383 Project Description Water, Sewer Replacement and Pavement Rehabilitation on Bellaire Circle, Ranch View Road, South Hills Circle and Westcliff Road South Contractor Jackson Construction, Ltd. Change Order; © Date 8/31/2021 City Project Mgr. Scott Taylor City Inspector; I Ramon Chavez DELETIONS 65 Water Construction Allowance Water 0.100 LS $100,000.00 $10,000.00 (Water $10,000.00 (sewer JPW Page 3 of 4 iDeietions Sub Total $10,000.00 n MWWBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO 00 # Previous Change Orders DATE Total Total AMOUNT $0.00 Pi $0.00 Page 4 of 4 Contract Comlillance Manager By signing acknowledge that lam the poison rosponsible for the monitoring and administration of this contraot, inoluding onsuring all perfoimance and reporting requirements, V Signature f Scx1A- I a`I eat Name of Employee ,' Title ATTEST: A,,P Ronald Gonzales Acting City Secretary City of Fort Worth, Texas Mayor and Council Communication DATE: 08124/21 M&C FILE NUMBER: M&C 21-0621 LOG NAME: 602014AWSMBP1006-JACI(SON SU C (CD 3) Authorize Execution of Change Order No, 6 In the Amounl of $90,281,76 and the Addition of 16 Calendar Days to a Contract with Jackson Construction, Ltd,, for Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Pad 1 Project, for a Revised Contact Amount of $6,769,626.74 and Adopt Attached Appropriation Ordinance It Is recommended that the City Council: 1. Authorize execution of Change Order No, 6 in the amount of $90,261.76 and the addition of 16 calendar days to City Secretary Contract No. 64210 with Jackson Construction, Ltd„ for Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 project for a revised contract amount of $6,769,626.74: and 2. Adopt the attached appropriation ordinance Increasing estimated recelpts and appropriations in the Water and Sewer Capital Projects Fund In the amount of $90,262.00, transferred from available funds within the Water and Sewer Fund, for the purpose of funding the Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 project (City Project No. 002383), DISCUSSION: On June 2, 2020, Mayor and Council Communication (M&C) 20.0377, the City Council authorized a contract with Jackson Construction, Ltd., In the amount of 16,614,912,00 for the Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 project. The contract was subsequently revised by Change Order No.1 with a net total amount of $47,176.00 administratively authorized October 161 2020 that provided for the Installation of 1 '/a -Inch water meters and service relocations on the project Instead of 1-Inch meter that was Initially called for; Change Order No, 2 with a net total amount of $22,360.00 administratively authorized November 4, 2020 provided for the Installation of additional 1 '% and 2-Inch water and service relocations on the project; Change Order No, 3 with a credit of $14,247.30 administratively authorized January 27, 2021 provided for the Inslallallon of a 42-Inch x 12-Inch lapping sleeve and valve Instead of a 42-Inch x 12-Inch lee to minimize closure time at the Ranch View Drive/Overton Park Drive West Intersection; Change Order No. 4 with a credit of $835.71 administratively authorized March 22, 2021 provided for by other than open cut Installation Instead of open cut Installation In order to minimize traffic disruption at the Ranch View RoadlSoulh Hulen Street Intersection and Change Order No, 6 with a net total amount of $10.00 that provided for the removal of excess pavement material on the project. This M&C Is to authorize execution of Change Order No. 6 In the amount of $90,261.76 and the addition of 15 calendar days to City Secretary Contract No. 64210 with Jackson Construction, Ltd., for Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Pert 1 project for a revised contract amount of $6,769,626,74. Change Order No. 6 will provide Increased quantities of 8-Inch PVC water main that are necessary on the project and allow for the looping of the water system by connecting the newly replaced water main on Westcliff Road South to the existing dead end water main on Hilltop Road, Due to Insufficient funds remaining In the Water Pay -As -You Go location for Fiscal Year 2021, Sewer funding Is being used to fund the Water construction cost required In this M&C, Appropriations for the 2014 Water Line & Sanitary Sewer Replacement WSM-B, Part 1 project are as depicted below: Fund I EXlsling Additional Project Total" Appropriations Appropriations Water Capllal Fund $206,719.00 T$0.00 $206,719.00 59601 Sewer Capital Legacy $139,147.00 $0.00I $139,147.00 Fund 69607 Water & Sewer Capital $610861940.00 $90,262,001$6,176,211,00 Projects Fund 56002 General Capllal Projects Fund 30100 1$1,312,932,00 $0.00 $1,312,932,00 Project Tolal $7,744,747.00 $90,262.001$7,835,009,00 'Numbers rounded for presentation purposes. Business Equity: Jackson Construction, Ltd, Is In compliance wllh the City's BDE Ordinance by committing to three percent MBE particlpallon an documenling good faith effort, Jackon Construction, Ltd. Identified several subcontracting and supplier opportunities. However, the firm contacted In the areas Identified did not respond or did not submit the lowest bids, The Clty's MBE goal on this project Is seven percent. This project Is located In COUNCIL DISTRICT 3. C The Director of Finance cerlliles that funds are currently available within the Water & Sewer Fund and upon approval of the above recommendations and adoption of the attached appropriation ordinance, funds will be available In the W&S Capital Projects Fund for the W&S Repl. Cl. 2014WSM•B project to support the approval of the above recommendations and execution of the change order to ilia contract. Prior to any expenditure being Incurred, the Water Department has the responsibility of verifying the availability of funds. 's Office bv: Dana Burghdoff 8018 OrIalnating Business Unit Head: Chris Harder 6020 Additional Information Contact,; ScollTaylor 7240 6C20149VW3NIBPIC06JAC WNFIDTable L JOYVL v��vtJ� 2 56002 0600430 s :c 20u $90,26200 2 56001 0709020 5956001 $902o 00 Funds are coming trom sewer 2 56002 0600430 4956001 CO2383 C01730 9999 ($90,262.00) 2 56002 06D 430 4956001 CD2383 C01780 1 56002 0600430 5740010 CO2383 CM780 9999 $90,261.75 9999 59Q263-75 CSC No. 54210-CO7 FORT Wn RT H City of Fort Worth Change Order Request Project Name:1 Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Pad 1 City Sec No,: 1 64210 Project No.(s):l ! DOE No. I N/A City Prof . No.:1 2383 Project Doscripilon:1 Water and Sanitary Sewer and Pavement Rehabilitation on Rench View Road, Hills Circle and Weslclllf Road South Contractor:) Jackson Construction, Ltd, Chango Order Ii 7 Dale: 111212022 City Project Mgr.1 Scott Taylor City Inspector: Ramon Chavez Phone Number: 817-392-7240 Phone Number l 897.392.0306 Dept, Water Sewer TPW Totals Contract Time ' cCalender days) Original Contract Amount $3,673 699.00 $1,802,698.00 $1,238,616.00 $6,614,912.00 410 Extras to Date $169100636 $0,00 $10.00 .$169,796.76 0116 Credits to Date $14, 2.30 $210.71 $0.00 $16,083.01 Pending Change Orders (In M&C Process) $0,00 $0.00 $0.00 Contract Cost to Date $3``7.1811613.45 $11802 387.29 $1,23011625.00 $ 7¢7�6 6;J4 655 6U �59.00 14 y 0 Amount of Proposed Change Order $138 369,60 $3,86�,982,95 $311147,60 , $2,0A,846.29 $1,64�,772,60 M423.;K74 655 Revised Contract Amount Original Funds Available for Change Orders $107,211.00 $54,070.00 $0.00 $161,289.00 Remaining Funds Available for this CO $0,00 $64,28831 $0,00 $54,288.71 Addillonal Funding fir necessary) $130,369,60 $138,369.60 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 12,23% MAXALLOWABLECONTRACTAMOUNT (ORIGINAL CONTRACT COST+25%) 1$8,268,640.00 Change Order No. 7 will provide additional pay Item quantities for cutting/ plugging the outlets on a 42-Inch water main that were Inadvertently omitted at the time the project was advertised for bid, Pay Item quantities are also needed to Install a subdrain at the Ranch View Road/Echo Drive Intersection to eliminate ground water penetration and Installation of pavement markings on both sides of Ranch View Road as requested by residents. The Change order will also provide Increased pay item quantities of curb/gutter, pavement pulverization and asphalt pavement due to actual field conditions that were encountered during construction. it Is understood and agreed thatthe acceptance of this Change Order by the contractor consIllules an accord and satisfaction and represents payment In full (both time and money) for all costs arising out of, or Incidental to, the above Change Omer. 11WOW 1 .�r-� l N ZZ lznrhoFhnr Narder }5 �a�ta,zozz l� // / 1/14/22 _ tli�;I,Y41d10 Y'il Jan 21, 2022 n'!iv 8«l °ems, Jan 22,2022 M&C Number 22.0036 M&C Date Approved j 111112022 1 FORT WORTH City of Fort Worth Change Order Additions Project Name I Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Peril Clly Seo No.: 64210 Project No.(s): j 66002106004301CO1780.66002107004301C01780- DOE No,j N/A City Proj, No.: 23(83 Project I Water and Sanitary Sewer and Pavement Rehabilitation on Ranch Vlew Road, Hills Circle and Description Wasicliff Road South I j 1 Contractor j Jackson Construction, Ltd, Change Order: Dale:1 1/1212022 City Project Mgr. j Scott Taylor City Inspector I Ramon Chavez ADDITIONS utaurtiN i wro DEPT Qt Unit 'Unit Cost Total 36 Remove Curb and Gutter Water 30.00 LF $10.00 $4,200.00 37 7" Curb and Gutter Water 420.00 LF $76.00 $31.600.00 38 Remove Concrete Driveway Water 267.00 SF $2.00 $514,00 39 6" Concrete Driveway Water 267.00 SF $12.60 '$3,212.60 41 2" Asphalt Pavement Type D Water 590.00 BY $14.00 $8,280.00 48 10" Pavement Pulverization Water 690.00 SY $9.00 $5,310.00 67 Cut & Plug 20" outlets on 42" maln Water 1.00 LS $66,794.0C.66,794.00 68 1 W Concrete Water Line Connection Water 1.00 LS $13,205.00 $13,206.00 I 69 SWPPP > I Acre Water 1.00 LS $1,864.00'$1,864.00 70 Cement Modifloallon, 26Lbs,/SY Water 18,00 TN $195.OG'$3,610.00 27 Remove Curb and Gutter Sewer 420,00 LF $10.00 $4,200.00 28 7" Curb and Gutter Sewer 420.00 LF $76.00•$31,600.00 29 Remove Concrete Driveway Sewer 2,680.00 SF $2.0N6,160.00 30 6" Concrete Driveway Sewer 268.00, SF 12.6C-$3,226.00 32 3" Asphalt Pavement, Type D Sewer 6,600.00 SY 120,OU4110,000.00 I 39 11 " Pavement Pulverization Sewer 5,500.00 SY $10.00I$56,000.00 43 Cement Modification, 26Lbs,1SY Sewer 18.00 TN $195.0Cr$3,610.00 i 44 SWPPP > .1 Acre Sewer 1.00 LS $1,864.OG$1,864.00 6 Remove Curb and Gutter TPW 840.00 LF $10.0G$8,400.00 6 7" Curb and Gutter TPW 840.00 LF $76.O0463,000.00 7 Remove Concrete Driveway TPW 408.00- SF $2.00'$816.00 8 6" Concrete Driveway TPW 616,00' SF $12,6C:$6,437.60 I 10 W Asphalt Pavement, Type D TPW 6,600.00 SY $20.0C%J10,000.00 17 11" Pavement Pulverization TPW 6,600.00 SY $10.00$66,000.00 18 Cement Modification, 26LbsdSY TPW 36.001 TN $195.00-$7,020.00 34 Pavement Markings TPW 1,700.00- LF $20.00 '$34,000.00 32 SWPPP > I Acre TPW 1.00 LS $3,728.00 I$3,728.00 33 6" Sub-Draln TPW 408.00 LF $55.76 1$22,746.00 j Water $138,369,50 Sewer $214,459.00 TPW $311,147.60 Page 2 of 4 Addlllons Sub Total $663,976.00 FORT WORTH City of Fort Worth Change Order Deletions Project Name Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 City Sec No.: 64210 Project No.(s) I DOE No. N/A City Proj, No.: 2383 �1411Monnea4 Jrnneon Project Description ( Water and Sanitary Sewer and Pavement Rehabilitation on Ranch View Road, Hills Circle and Westeliff Road South Contractor I Jackson Construction, Ltd, Change Order: a Date I 1/1212022 City Project Mgr, Scott Taylor I City Inspector: I Ramon Chavez DELETIONS ITEM DESCRIPTION DEPT Qty Unit 'Unit Cost 'Total Page 3 of 4 Water Sewer TPW Deletions Sub Total MIWBE Breakdown for this Change Order MWBE Sub Type .of Service Amount for this CO Total $0.00 Previous Change Orders Coll DATE AMOUNT Total $0.00 Page 4 of 4 .Contract Compllance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, Including ensuring all performance and reporting requirements. ,Q_.����• Pry Signature Scott Taylor, P.R. Name of Employee Project Manager Title ATTEST: Sannehfe S. Gaadall Jannette s Goodall (Jan 24. 202207.37 CST( Jannette Goodall City Secretary City of Fort Worth, Texas Mayor and Council Communication DATE: Tuesday, January 11, 2022 REFERENCE NO.: **M&C 22-0036 LOG NAME: 602014AWSMBP1CO7-JACKSON SUBJECT: (CD 3) Authorize Execution of Change Order No. 7 In the Amount of $663,976.00 to a Contract with Jackson Construction, Ltd., for Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 Project, for a Revised Contract Amount of $7,423,601.74 and Adopt Attached Appropriation Ordinances RECOMMENDATION: It Is recommended that the City Council: 1. Authorize execution of Change Order No. 7 In the amount of $663,976,00 to City Secretary Contract No. 54210 with Jackson Construction, Ltd., for Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 project for a revised contract amount of $7,423,601.74; 2. Adopt the attached appropriation ordinance Increasing estimated receipts and appropriations In the Water and Sewer Capital Projects Fund In the amount of $352,829.00 transferred from available funds within the Water and Sewer Fund for the purpose of funding the Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 project (City Project No. CO2383); and 3. Adopt the attached appropriation ordinance to adjusting estimated receipts appropriations In the General Capital Projects Fund by decreasing the estimated receipts and appropriations In the Contract Street Maintenance Programmable Project (City Project No. P00020) in the amount of $311,148.00 and Increasing the estimated receipts and appropriations In the Water and Sanitary Sewer Replacement WSM-B Part 1 project (City Project No. CO2383) by the same amount. DISCUSSION: On June 2, 2020, Mayor and Council Communication (M&C) 20-0377 the City Council authorized a contract with Jackson Construction, Ltd., in the amount of $6,614,912.00 for the Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 Project, The contract was subsequently revised by Change Order No. 1 with a net total amount of $47,176.00 administratively authorized October 16, 2020 that provided for the Installation of 1 '/Z-Inch water meters and service relocations on the project Instead of 1-Inch meter that was initially called for; Change Order No. 2 with a net total amount of $22,360.00 administratively authorized November 4, 2020 provided for the Installation of additional 1 '/z and 2-Inch water and service relocations on the project; Change Order No. 3 with a credit of $14,247.30 administratively authorized January 27, 2021 provided for the Installation of a 42-inch x 12-Inch tapping sleeve and valve Instead of a 42-Inch x 12-Inch tee to minimize closure time at the Ranch View Drive/Overton Park Drive West intersection; Change Order No. 4 with a credit of $835.71 administratively authorized March 22, 2021 provided for by other than open cut Installation Instead of open cut Installation In order to minimize traffic disruption at the Ranch View t Road/South Hulen Street Intersection Change Order No. 5 with a net total amount of $10.00 administratively authorized April 9, 2021 that provided for the removal of excess pavement material on the project and on August 24, 2021, M&C 21-0621, the City Council authorized Change Order No. 6 with a net total amount of $90,261.76 that provided for Increased quantities of 8-Inch PVC on the project and for the looping the water system by connecting a newly Installed water main on Westcliff Road South to the existing dead end water main on Hilltop Road, This M&C Is to authorize execution of Change Order No, 7 In the amount of $663,976,00 to City Secretary Contract No. 64210 with Jackson Construction, Ltd., for Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1 project for a revised contract amount $7,423,601.74. Change Order No. 7 will provide additional pay Item quantities for cutting/plugging the outlets on a 42-Inch water main that were Inadvertently omitted at the time the project was advertised for bid. Pay Item quantities are also needed to Install a subdrain at the Ranch View Road/Echo Drive Intersection to eliminate ground water penetration and Installation of pavement markings on both sides of Ranch View Road as requested by residents. The change order will also provide Increased pay Item quantities of curb/gutter, pavement pulverization and asphalt pavement due to actual field conditions that were encountered during construction. Appropriations for the 2014 Water Line & Sanitary Sewer Replacement WSM-B, Part 1 project are as depicted below: Existing Additional j Fund Appropriations Appropriations Protect Total* l Water Capital Fund 59601 $206,719.00 $0.00 $206,719.001 Sewer Capital Legacy $139,147.00 $0.00 $139,147.00 Fund 59607 Water & Sewer Capital Projects Fund $6,176,211.00 $362,829.00 $6,629,040.00 56002 General Capital $1 312,932.00 $311,148.00 $1,624,080.00 Projects Fund 30100 ' Project Total $7,835,009.00 $663,977.001 $8,498,986.001 *Numbers rounded for presentation purposes. Business Equity: Jackson Construction, Ltd. agrees to maintain Its Initial MBE commitment of three percent that It made on the original contract and extend and maintain that same MBE commitment of three percent to all prior change orders up to and Inclusive of this Change Order No. 7. Therefore Jackson Construction, Ltd. remains In compliance with the City's BDE Ordinance and attests to It commitment by Its signature on the Acceptance of Previous MBE Commitment form executed by an authorized representative of Its company. This project Is located In COUNCIL DISTRICT 3. FISCAL INFORMATION 1 CERTIFICATION: The Director of Finance certifies that funds are available In the current operating budget In the Water & Sewer Fund, and upon approval of the above recommendations and adoption of the attached appropriation ordinances, funds will be available In the W&S Capital Projects and General Capital Projects Funds for the W&S Repl. Ct. 2014WSM-B project to support the approval of the above recommendation and execution of the change order to the contract. Prior to any expenditure being Incurred, the Water and Transportation and Public Works Departments have the responsibility of verifying the availability of funds. FUND IDENTIFIERS IFIDs): TO Department �Accountl Project Budget Reference # �Amountl IFund l IProgram�Activityl ID II ID II Year I (Chartfield 2) i FROM ccountl Project Program�Activityl Budget I Reference # rmountl i �Fund lDepartment r ID ID I II Year (Chartfield 2) CERTIFICATIONS: Submitted for City Manager's Office by, Dana Burghdoff (8018) Ori Inatin Department Head: g g.—p Chris Harder (5020) Additional Information Contact: Scott Taylor (7240) ATTACHMENTS 1.602014AWSMBP1C07-JACKSON docx (CFW Internal) 2. 602014AWSMBP CO7-JACKSOI� 1295,pdf (CFW Internal) 3. 602014AWSMBPICO7-JACKSON FID Table Draft (CA ) 11.18.21.xlsx (CFW Internal) 4. 602014AWSMBP1CO7-JACKSON SAM,pdf (CFW Internal) 5.02014AWSMBP�CO7-JACKSON 30100 AO22(r3) .doc (Public) 6.602014AWSMBP CO7-JACKSON 56002 AO22(r2)r.docx (Public) 7, 602014WSMBP1C07-JACKSON APC-TS.odf (CFW Internal) 8. 602014WSMBP1C07-JACKSON Mampdf (Public) i 602014WSMBP1CO7-JACKSONFID Table 2 56002 0600430 CO2383 2022 $338,370.00 2 56002 0600430 14956001 00" 2D22 $338,370.00 2 56002 I 0700430 4951001 CO2393 I 2022 $214,459.00 2 56002 I 0700430 I CO2383 2022 $U4,459.00 3 30100 I 0200431 4910100 P00020 2022 (5311,148.00)I 3 1 30100 0200431 14910100 CO2383 2022 I I $311,14&001 13 I 30100 I 0200431 I P00020 2022 I I ($311,148.00)I I 3 30100 I 0200433. ' CO2383 2022 I I $3U a4&001 2 56001 0609020 5956001 I $239,370.00 2 56002 0600430 4956001 CO2383 9999 I ($138,370.00) 2 56001 0709020 5956001 I ( I $214,459.00 E 2 I 56002 0700430 14956001 I CO23W 9999 I I ($214,459.00)I 3 I 30100 I 020043.1 I I 14910100 I I I P00020 PGMABL I I I 9999 I I I I $311,148.00I I 3 130100 I 0200431 14910100 CO2393 CO2480 I 999.9 ' I I ($311,148.00)1 — 'A Fund Dept # Account L3 fr6je&—IVAct',vit'--- �Y �Pr`cgrA 71 Amount 1 56002 0600430 5740010 CO2383 C01780 ar 9999 $138,36950 1 56002 0700430 574003.0 CO2383 C01780 9999 I $n4,459.00 ` 1 130100 I 0200431 I 15740010 1 1 I CO2383 I CO2480 I I I 9999 I I I $311,14750 The following entries will be executed by the Water Capital Finance Team as soon as the M&C is approved. Fc3RT WORT City of Fort Worth = Change Order Request Project Namo:1 Project No,(s):[ Project Descriplian:l Contractor[ City Project Mgr,1 Phone Number:[ CSC No. 54210-CO8 Water Sanitari Sevier Replacement Contract 2014, WSM-8, Part 1 Clly Sec No.: J 54210 CU2303 ! DOE No, I N/A Cily Proi. No.:l 02383. Walor and Sanitary Sower and Pavement Rehabilitation on Ranch View Road, South lillis Circle, and Westclifl Road South Jackson Construction Ltd. Scott Taylor 817.392.2740 Dept, Original Contract Amount Extras to Dale Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Dale (Amotmt of Proposed Change Order ovIsod Conlract Amount Original Funds Available for Change Orders Romaining Funds Available (or this CO Additional Funding (11 necessary) Change Order tI I 8 J Date: 9/29/2022 j City Inspector Mallhew Wilson Phone Numbers (682) 215.9539 Water Unit I Sower Unit 2 TPW Unit 3 Totals Contract Time (Calendar days) $3,673,699.00 $1,802,598.00 $1,238,616.00 $6,614,912.00 640 $298,166,26 $2.14,459,00 $311,157,50 k823,772.75 0115 $14,872.30 $210,71 $0.00 $16,083.01 $3,866,982.95 $2,016,846.29 $1,649,772.60 $7,423,601.74 655 $116,941,25 263,952.00 $656,576,09 180 J275,682,64 $ ,132,665.59 $2,133,787.64 $1,813,724.50 38,000,177.63 835 $107,211.00 $64,078.00 $0.00 $161,289.00 $0.00 $0.00 $0.00 $0.00 $275,682.64 $-116,941.25 $263,952.00 $656,675.89 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 2215% MAXALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25516) 10,268,610,00 JUSTIFICATION (REASONS) FOR CHANGE ORDER Change Order No. 8 will provide increased pay Item quantitles of curb/gutter removal, curb/gutter Installation, and unclassified street excavation that are necessary to complete paving hnprovements on the project streets. The change order will also provide sturdier temporary paving on Ranch View Drive, Staff recommends that the contract time be extended by 180 calendar clays. It is understood and agreed that the acceptance of this Chango Order by the contractor constitutes an accord and satisfaction and represents payment in (till (both time and money) for all costs arising out of, or Incidental to, the above Chango Order. Contractor's Company Namn Contractor Name I /,/ Contractor Slgnal ifV, dale j Jackson Construction Ltd. I Carmen Eslep Inspector Matthew Wilson Dale Project Manager 9/30/22 soot " ` ayl or PC Date 9/30/22 Director (Water Depl) Date Co nr Ion Superviso TPW Dept) Dee VXU& a ` a' T' S. Oct 25, 2022t I Senior Assistant City Attorney Date Assistant City Manager Date a Oct 27, 2022a Nov 2, 2022 Council Action (If Required) M&C Number 1 22.0763 1 M&C Date Approved I :1r t izuzz j City of Fort Worth Chsnge Order Additions Project Namo I Water Sanitary Sower Replacement Contract 2014, WSM-D, Part 1 Cily Sec No.: 1 54210 Project No.(s): 1 CO2303 I DOE No.1 N/A City Pro]. No.: 1 02383 Project I Water and Sanilary Sower and Pavement Rehabilitation on Ranch View Road, South Hills Circle, and Wostcllll Road Dessriplion Soullt Contractor Jackson Consimclron Ltd, , Change order,® Dale:1 9129/2022 City Project Mgr. 1 Scott Taylor City Inspector Mallhow Wilson ADDITIONS I I tM ' UtSCKIF I IUN DEPT I Qt}Y'Unit 'Unit Cost Total 1.36 Remove Curb and Gutter Water Unit 1 2,3&00 LF $10.00 $23,420.00 1.37 7" Curb and Guller Water Unit 1 2,341.00 LF $75.00 $176,675.00 1.71 2" Asphall Pavement Type D Water Unit 1 3,202.00 SY $12.32 $39,440.64 1.72 Wedge Milling Water Unit 1 1'800.00 SY $6.21 $11,178.00 1.73 Unclassified Excavation Water Unit 1 876.00 CY $20.76 $26,061.00 11.27 Remove Curb and Gullor Sewer Unit 2 _ 2,341.00 LF $10.00 $23,410.00 11.28 7" Curb and Guller Sewer Unit 2 900.00 LF $76.00 $67,600.00 11.46 Unclassified Excavalion Sewer Unit 2 876.00 CY $29.76 $26,031.25 111.5 Remove Curb and Gutter TPW Unit 3 4,683.00 LF $10.00 $46,830.00 111.6 7" Curb and Gullnr TPW Unit 3 2,200.00 LF $75.00 $165,000.00 111.30 Unclassified Excavation TPW Unit 3 1,752.00 CY $29.75 $52,122.00 Water Unit 1 $275.682.64 Sower Unit 2 $116,041.26 TPW Unit 3 $?-63,952,00 Page 2 of 4 Additions Sub Total $656,575.89 t City of rota Worth Change Order Deletions Project Name Water Sanilary Sewer Replacement Conirncl 2014, WSMd3, Part 1 ( City Sec No.: 54210 Project No,(s): CO2383 I DOE No. N/A City Pro], No.: 02383 Projecl Description I Water and Sanitary Sewer and Pavement Rehabllilallon on Ranch View Road, South Hills Circlo, and Weslcliff Road South Contractor Jackson Conslydcllon Ltd. Change Order: F-6-1 Dalu 9/29/2022 City Project MOr, Scoll Taylor City Inspector; I Matthew Wilson DELETIONS ITEM DESCRIPTION DEPT Qly Unit Unit Cost Total Water Unit I Sewer Unil 2 1'PW Unit 3 Page 3 o(Ll Delotions Sub Total MNVBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO Total $0.00 Prevlous Change Orders co li DATE AMOUNT Total $0.00 Page 4 of 4 9/29/2022 Water Sanitaey Sewer Replacement Contract 201.4, WSM-13, Part• 1 CPN 02383 Change Order B Notes Staff lies revirwrd the requested prices and considers them to be fair and reasonable, .Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements. Signature Scott Taylor, P.E. Name of Employee Project Manager Title ATTEST: 9Q�cneth S. jrrr dA& Jannette S. Goodall (Nov 2, 2022 11:34 CDT) Jannette Goodall City Secretary City of Form Worth, Texas Mayor and Co uinc H C®mmiuin�c afion DATE: Tuesday, September 27, 2022 REFERENCE NO.: w"M&C 22-076a LOG NAME; 602014AWSMBP1C08-JACKSON SUBJECT: (CD 3) Authorize Execution of Change Order No, 8 in the Amount of $656,575,89 and the Addition of 100 Calendar Days to a Contract with Jackson Conslrucllon, Ltd., for Walor and Sanitary Sewer Replacement Contract 20,14 WSM-B Project, for a Revised Contact Amount of $8,080,177.63 and Adopt Appropriation Ordinance to Effect a Portion of Water's Contribution to the Fiscal Years 2022-2026 Capital Improvement Program RECOMMENDATION: II is recommended that Ilia Oily Council: 1, Authorize execution of Change Order No. 8 In the amount of $656,576.89 to City Secretary Contract No, 54210 Willi Jackson Construction, Ltd., for Water and Sanitary Sewer Replacement Contract 2014 WSM-B project for a revised contract amount of $8,080,177.63; 2. Adopt the allaclied appropriation ordinance Increasing appropriations in Ilia Water and Sewer Capital Projects Fund in the amount of $392,625.00 transferred from available funds within the Water and Sewer Fund for Ilia purpose of funding the Water and Sanitary Sewer Replacement Contract 2014 WSM-B project (City Project No, CO2363) to effect a portion of Water's contribution to the Fiscal Years 2022-2026 Capital Improvement Program; 3. Adopt the allachod appropriation ordinance adjusting ostimaled receipts and appropriations in the General Capital Projects Fund by Increasing receipts and appropriations in the Water and Sanllary Sewer Replacement Contract 20,14 WSM-B project (City Project No. CO2383) in the amount of $21i3,9.52,00, and decreasing receipts and appropriations in Ilia Contract Street Maintenance programmable project (City Project No. P00020) by the same amount; and 4. Amond TPW's Contribution to the Fiscal Years 2022-2026 Capital Improvement Program, DISCUSSION: On June 2, 2020, Mayor and Council Communication (M&C) 20-0377 Ilia City Council authorized a contract Willi Jackson Construction, Ltd„ in the amount of $6,614,912.00 for the Water and Sanitary Sewer Rnptacninenl Contract 2014 WSM-B project. The contract was subsequently revised by Change Order No. 'I Willi a not total amount of $47,176,00 administratively authorized October 16, 2020 that provided for the installation of 1 %-inch water meter and service relocalions on Ilia project instead of 1-1110 mr:Ier that was Initially galled for; Change Order No, 2 Willi a not total amount of $22,350.00 administratively authorized November 4, 2020 provided for the Installation of additional 1 �/2 and 2-Inch water and service relocations on ilia project; Change Order No, 3 Willi a credit of $14,247.30 adminislraliveiy authorized January 27, 2021 provided for the Installation of a 42- Inch x 12-Inch lapping sleeve and valve instead of a 42-inch x 12-Inch too to minimize closure time at the Ranch View DrlvelOverton Park Drive West Intersection; Change Order No, 4 with a credit of $835.71 admiiiislralively authorized March 22, 2021 provided by other than open cut Installation In order to minimize traffic disruption at the Ranch View Road/South Hulen Street intersection; Change Order No, 5 with a not total amount of $10.00 administratively authorized April 9, 2021 that provided for Ilia removal of excess pavement material on the project; on August 24, 2021, M&C 21-0621, the City COUncll authorized Change Order No. 6 Willi a net total amount of $90,261,75 that provided for Increased quantities of 6-inch PVC on the project and for the looping the water system by connecting n newly installed water main on Westclilf Road South to Ilia existing dead end water main on Hilltop Road; and on January '11, 2022, M&C 22-0036, Ilia Oily Council authorized Change Order No, 7 In the amount of $663,976.00 lhiii primarily provided for cutting/plugging the outlets on a 42-Inch water main, the Installation of a subdrain at the Ranch View Road/Echo Drive Intersection to ellminate ground water penetration Into Ilia pavement subgrade Find additional paving pay Item quantities, This M&C is to authorize execution of Change Order No. 8 In the aniuunl of $656,675,89 to City Saoro(ary Contract No. 54210 will) Jackson Construction, Ltd„ for Waler and Sanilnry Sower Roplacement Contract 2014 WSM-B project for a revised contract nmount $8,080,177.63. Change Order No. 8 will provide Increased pay item qunnliltus of curb/gutter removal, curb/gutter Installation, and unclassified street excavation that are necessary to complete paving Improvements on the project streets. The change order will also provide sturdier temporary paving on Ranch View Drive. The staff has reviowod and vorified lho quantities for Ilia additional work under this Change Order No. 8, Additionally, to cornplele this work, staff recommends that the contract time be extended by 180 calendar days. Tho action In this M&C will arnend TPW's contribution to the Fiscal Years 2022-2026 Capital Improvement Program as approved In connecllon with Ordinance 25073-09-2021, Section 6. Capital Improvements, page 23, as follows: capital--- — - — - � Fund Project FY2022 CIP Authority Budget Adjustment Revised FY2022 ' Name Name I Appropriations Budget 30'100- General P00020- Capital Contract ! Projects Street Fund Maintenance 'I $ 20,441,000,001M_&_C21-0827 $ (1,05_0,034.00) $ '19,390,966.00 -- -IM&C 22-0036 $ (311,148.00) $ 19,079,8'IB.00 I M&C 22-0127 $ _- (603,254.00) $ 18,4 76,564.00 M&C 22-0323 $ (1,403,324,00) $ 17,073,240.00 M&C 2.2-0541 $ (1,000,000,00) $ 16,073,240.00 This M&C $ (263,952.00) $ 16,809,28B.00 It IS the practice of the Water Department to nppropriata its CIP plan throughout the fiscal year, instead of within the annual budget ordinance, as projects commence, additional funding needs are identified, and to comply with bond covonanls, The acllons In the M&C will appropriate funds In support of tho Water's portion of the City of Fort Worth'-. Fiscal Years 2022-2026 Capital Improvement Program, as follows: 802014WSMBP1C08-JACKSON Capital r Project Fund F-Y2022 CIP Authorityl Budget Change Revised FY2022 Name Name Appropriations ! (Increase/Decrease) Budget W&S W&S Capital Projects Replc. Cl $352,829.00;'This M&C $392,625.00 $745,464.001 Z014WS — FundM- 56002 B I --- - — - --- General Capital Projects $311,148.00 This M&C $263,962.00 $575,100.00 — Fund 30'100 Funding Is budgeted In the Iontract Street Maintenance programmable project within the General Capital Projects Fund and In the Transfer to Water/Sower account of the Water and Sewer operating budget for the purpose of funding the Walor & Sewer Replacement WSM-B project within the Water & Sewer Capital Projects Fund. Appropriations for the 2014 Water & Sanitary Sower Replacement WSM-B project are as depicted below: Fund Existing Additional project Total' Appropriations Appropriations _ baler Capital Fiord $206,719.00 $0.00 $206,719.00 5960.1 Sewer Capital Legacy Fund 59607 Water & Sewer Capital Projects Fund 56002 General Capital Projects Fund I30100 Project'rolal $139,147.00 $0.00 $139,147.00 $6,529,040.00 $392,625.00 $6,921,666.00 $1,624,080.00 $263,952.00 $1,888,032,00 $8,498,986,00 $656,577.00 $9,155,563,00 'Numbers rounded for presentation purposes. Business Eqully: Jackson Construction, Lld, agrees to maintain Its Initial M/WBE commitment of three percent that It made on tho original contract and extend and maintain that same M/WBE commitmont of three percent to all prior change orders up to and inclusive of this Change Order No. 8, Therefore, Jackson Construction, Ltd. remains In compliance with the City's Business Equity Ordinance and attests to Its commitment by Its signature on the Acceptance of Previous MIWBE Commitment form executed by an authorized representative of its company. This projocl is located in COUNCIL DISTRICT 3. FISCAL INFORMATION / CERTIFICATION: The Director of Finance certifies that funds are available in the current operating budget In the Water & Sewer Fund and in the Contract Street Maintenance programmable project within the General capital Projects Fund, and upon approval of the above recommendations and adoption of the attached appropriation ordinances, funds will be available in Ilia W&S Capital Projects and General Capital Projects Funds for the W&S Repl. 01. 2014WSM-13 project to support the approval of Ilse above recommendations and execution of the change order to the contract. Prior to any expenditure being incurred, the Water and Transportation and Public Works Departments have the responsibility of verifying the availability of funds. FUND IDENTIFIERS (FIDs): TO _ Fun(i Department ccount Project Activity Budget Reference# Amount I I ID 1_ 1D IP-ro'gram _ I _ I Year I (Chartfield 2) _ _ FROM ifAmo_ __ IFundy Department ccount Project: ProgramsP ctivity Budget Reference un4 I ID I_ Ip I I Year I (Chartfield 2)_ CERTIFICATIONS: Submitte(t for City Manager's Offlco by; Dana Burghdoff (8018) Originatir g Department I�leacl: Chris Harder (5020) Additional Information Contact: Scott Taylor (7240) ATTACHMENTS. -1. (iU20'I4AWSMBP'IC08,JAC:ICSON_ FlD l'ahln (WC_l- 0B.09.22).xlsx (CFW Inlefnel) 2, i 020_111AWSIy1BP IC011 JACKS N fun& -ivdiInblllty,101. ((;PW Internal) 3. GOPO 111MM I' I CO(1-JACKSON_I2n5,p(If (CFW Inhunal) 4. GO2014WSMBPICOB-JAC:KSON AI?C-Foff- ul f (CFW Inlornal) 5.6020'111V1r5ME3PiCgti-J!\C�SON NLI�p<If (Public) 5, G020:14WSIVIL�P'ICOf)-.IAC{<SON S�M,1?rlf (CFW Intumal) 7.bRD,AI?P,G0201�IA\N[Ifv1EiP'ICOf3-JACItSOI�I_'10'100_A02'2_(rJ,).docx (Public) a. C)I'�I)AI'I GU'1.f11AA\6W;Iv1BPICQLL_1\II< QN ;i(i(lll'1._n022(W)-d0C ( (Public) 0. I'LiS (;Phi CQ?.;lfi3.in_If (CFW Internal) 602014WS1,5P1C08 ACKSOXFL0TabLe Purpose 2 56002 0500430 4956001 CO2383 I 2022 I 5275,683.00 J 2 56002 I G600430 J CO2393 I 2072 J 5275,6E3.00� 2 560C2 I 0700430 4956001 CO2383 I I 202_� I I I 5116 942_COI 2 560C2 I 0700430 I CO2383 I 2022 I I I 5116,94200J J 3 30100 J 0200431 14910100 P00O20 I I 2022 13 30100 I 020043i 1=910100 CO2393 I I 2022 I I $263,952.001 3 301CO I 0200431 J P00020 2OZ2 I I --- -= „I 13 301G0 J 0200431 I CO2383 I 2022 J J I 5263,952_COI I 7 56001 I O609020 1 5956001 I ( I 5275,683G0� I+ 2 56002 I 0600430 14956001 COL=83 C01780 ( 9999 �2 ; 56001 I 0709020 5956002 I I I 5116 94? GO` 2 56002 0700430 4956001 CO2383 I C01730 J 9999 I I 3 30100 I 0200431 1491010C P00020 I PC-,MABL 9999 I I I 5263,952.001, J 3 I 30100 I 0200431 I 4-91010C CO2383 II CO2480 I 9999 6 7 YIY •1 )1,IiYil'�I =-11 .I Ylii 1'•� :I IIY i.11 .I11 - - - +!r_ II O6OO431 _-rnn,n rm3g3 C01790 9959 I 5275,E&2.6= 1 I 560C2 I 0700430 57=O010 CO2383 :.01780 I 9999 I I 5116,94125 1 30100 0200431 i 5740710 CO2283 J CO_4SO I 9999 I I S263,952.00 J' CSC No. 54210-009 FORT WORTH City of Fort Worth Change Order Request Project Name:1 Water Sanitary Sewer Replacement Contract 2014, WSM-B, Part 1 City Sec No.: 54210 Project No.(s):l CO2303 I DOE No. I N/A City Pro]. No.: 02383 Project Description: Water and Sanitary Sewer and Pavement Rehabilitation on Ranch View Road, South Hills Circle, and Weslcliff Road South Contractor: Jackson Construction Ltd. Change Order# 9 Date: 3/1/2023 City Project Mgr. Scott Taylor City Inspector: Fabian Diaz-Agulnaga Phone Number: 817-392-2740 Phone Number: (682) 215-9539 Dept. Water Unit I Sewer Unit 2 TPW Unit 3 Totals Contract Time (Calendar days) Original Contract Amount $3,673,699.00 $1,802,698.00 $1,238,615.00 $6,614,912.00 540 Extras to Date $673,838.89 $331,400.25 $576,109.60 $1,480,348.64 0295 Credits to Dale $14,872.30 $210.71 $0.00 $15,083.01 Pending Change Orders (In M&C Process) Contract Cost to Date $4,132,665.69 $2,133,787.54 $1,813,724.60 $8,080,177.63 835 Amount of Proposed Change Order $0;00 $0.00 $0.00 $0.00 080 Revised Contract Amount $4,132,665.59 $2,133,787.64 $1,813,724.50 $8,080,177.63 915 Original Funds Available for Change Orders $107,211.00 $54,078.00 $0.00 $161,289.00 Remaining Funds Available for this CO $0.00 $0.00 $0,00 $0.00 Additional Funding (If necessary) CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 22.15% MAX ALLOWABLE CONTRACTAMOUNT (ORIGINAL CONTRACT COST+ 25%) $8,268,640.00 - -_ w I g Ib `( �Sd 5 O C ORbBR Change Order No. 9 will provide an additional 80 calendar days on the project for the delay resulting from not being able to connect a project water main (as directed by Water Production) to an existing 42-inch waterline due to high water demand. It is understood and agreed that the acceptance of this Change OrJerby l&ie contractor constitutes an accord and satisfaction and represents payment In full (both time and money) for all costs arising out of, or incidental to, the above Change Order. Jackson Construction Ltd. I Carmen Fabian Diaz 03/06/2023 S , Mar 10, 2023 Mar 11, 2023 03/02/2023 Scott Ta for PE 03/06/2023 03/06/2023 girl �ma 8 Mar20,2023 .m 51111nn -f n�jrn mean •nrnn t4�tlPfiillfAiiCi(IftRtllPlj. ..,Yi, M&C Number N/A M&C Dale Approved N/A FORT WORTH City of Fort Worth Change Order Additions Project Name Water Sanitary Sewer Replacement Contract 2014, WSM•B, Part 1 Clly Sec No.: j 54210 Project No.(s): j CO2383 I DOE No.1 N/A City Proj. No.: 1 02383 Project I Water and Sanitary Sewer and Pavement Rehabilitation on Ranch View Road, South Hills Circle, and Weslcliff Road Description South Contractor Jackson Construction Ltd. ! Change Order: 09 Date: j 3/1/2023 City Project Mgr, I Scott Taylor City Inspector I Fablan Diaz-Aguinaga ADDITIONS 1I hM , UI:80KII' 11UN DEPT Qty Unit Unit Cost Total lWaler Unit I Sewer Unit 2 ITPW Unit 3 Page 2 of 4 jAddilions Sub Total FORT WORTH City of Fort Worth & Change Order Deletions Project Name Water Sanitary Sewer Replacement Contract 2014, WSM-B, Part 1 City Sec No.: 64210 Project No.(s): CO2383 DOE No. I N/A City Pro]. No.: 02383 Project Description Water and Sanitary Sewer and Pavement Rehabilitation on Ranch View Road, South Hills Circle, and Westcliff Road South Contractor Jackson Consiructlon Ltd. Change Order: F9 � Dale 3/1/2023 City Project Mgr. Scott Taylor City Inspector: I Fabian Diaz-Agulnaga DELETIONS ITEM DESCRIPTION DEPT City Unit Unit Cost Total Water Unit I Sewer Unit 2 TPW Unit 3 Page 3 of 4 Deletions Sub Total MWWBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO CO # Previous Change Orders DATE Total Total AMOUNT $0.00 Pi $0.00 Page 4 of 4 3/1/2023 Water Sanitary Sewer Replacement Contract 2014, WSM-B, Part 1 CSC: 54210 CPN:02383 Change Order 9 Notes Staff has reviewed the requested days and considers them to be fair and reasonable, .Contract Compliance Manager By signing I acknowledge that I am the person responsible for the monitoring and administration of this contract, Including ensuring all performance and reporting requirements. J l Signature Scott Taylor, P.E. Name of Employee Project Manager Title ATTEST, C ,b -&x,5 Jannette Goodall City Secretary FORTWORTH TRANSPORTATION AND PUBLIC WORKS PIPE REPORT FOR: PROJECT NAME: Water and Sanitary Sewer Replacement Contract 2014, WSM-B Part 1 CITY PROJECT NUMBER: 2383 WATER PIPE LAID SIZE TYPE OF PIPE LF 12" PVC 8" PVC 3,947 12" DIP 12" DIP 448 8" PVC 8" PVC 7,104 6" PVC 6" PVC 386 30' Steel Encasement Pipe 30" Stell Encasement Pipe 80 FIRE HYDRANTS: 8 VALVES (16" OR LARGER) PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: All Densities Passed NEW SERVICES: 1" Copper 1340LF 2" Copper 50LF SEWER PIPE LAID SIZE TYPE OF PIPE LF 8" PVC 8" PVC 4,333 30" Fiberglass Pipe 30" Fiberglass 82 PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: All Densities Passed NEW SERVICES: 4" sewer 4" PVC 40OLF TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth • 1000 Throckmorton Street • Fort Worth, TX 76012-6311 FORTWORTH. TRANSPORTATION AND PUBLIC WORKS March 16, 2023 Jackson Construction, Ltd 5112 Sun Valley Dr Fort Worth, TX, 76119 RE: Acceptance Letter Project Name: Water and Sewer Replacement Contract 2014 WSM-B Part 1 Project Type: Water and Sewer Replacement City Project No.: 02383 To Whom It May Concern: On March 16, 2023 a final inspection was made on the subject project. There were punch list items identified at that time. The punch list items were completed on June 5, 2023. The final inspection and the corrected punch list items indicate that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on June 5, 2023, which is the date of the punch list completion and will extend of two (2) years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at 817- 392-7240. Sincerely, Mary Hanna, Project Manager Cc: Fabian Diaz, Inspector Donald Watson, Inspection Supervisor Oscar Aguillon, Senior Inspector Tony Sholola, Program Manager APM & Associates, Inc, Consultant Jackson Construction, Ltd, Contractor CFW Water Department, Developer File E-Mail: TPW_Acceptance@fortworthtexas.gov Rev. 8/20/19 CONSENT OF SURETY TO FINAL PAYMENT AIA Doc=ennt G707 Bond No. 1068076 TO OWNEL rNarne surd uddresr•) City of Fort Worth 200 Texas Street Fort Worth, TX 76102 PROJECT`: (1l -IF and ad&-.10 07JNFR CONTRACTOR SURT k'Y OTHER ARCHITECT'S PROJECT NO.: CONTRACC FOR: CONTRACT DATEDz June 18, 2020 Water and Sanitary Sewer Replacement Contract 2014 WSM-B, Part 1, City Project No. 02383 In accoudance with the provisican5 of tl c Contract bemn--en the Owner and the Contractor as indicated above, the flnsr�! rxanr aird aelditsx of.S�r+�h J The Hanover Insurance Company 440 Lincoln Street Worcester, MA 01653 SURETY, on bcod of flnwrr more ant! addrva [(Cmzrraa,,r) Jackson Construction, Ltd. 5112 Sun Valley Drive Fort Worth, TX 76119 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Sure of any of irs obligations to Crnwn nanreandaddmrafOuner) City of Fort Worth 200 Texas Street Fort Worth, TX 76102 +''r ` g as set forth in said Surety's bona. IN WITNESS WRl3RROR, the Surety Iw hereunto set its hand on this elate: June 20, 2023 (Ifl,wrl hz kvVi g (be nwntbfallauwd kt� lbe rnurrcrk datrand rear ) ow"w oo. The Hanover Insurance Company (SWIutunr ofarrlbar�IzrAirprasrrrruriiE) Aftt}jt. Holly Clevenger Attorney -in -Fact (Afrared parr+e awl I&&) G707---1994 THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA POWER OF ATTORNEY THIS Power of Attorney limits the acts of those named herein, and they have no authority to bind the Company except in the manner and to the extent herein stated. KNOW ALL PERSONS BY THESE PRESENTS: That THE HANOVER INSURANCE COMPANY and MASSACHUSETTS BAY INSURANCE COMPANY, both being corporations organized and existing underthe laws of the State of New Hampshire, and CITIZENS INSURANCE COMPANY OF AMERICA, a corporation organized and existing under the laws of the State of Michigan, (hereinafter individually and collectively the "Company") does hereby constitute and appoint, Jack M. Crowley, Laurie Pflug and/or Holly Clevenger Of Willis Towers Watson Insurance Services West, Inc of Dallas, TX each individually, if there be more than one named, as its true and lawful attomey(s)-in-fact to sign, execute, seal, acknowledge and deliver for, and on its behalf, and as its act and deed any place within the United States, any and all surety bonds, recognizances, undertakings, or other surety obligations. The execution of such surety bonds, recognizances, undertakings or surety obligations, in pursuance of these presents, shall be as binding upon the Company as if they had been duly signed by the president and attested by the secretary of the Company, in their own proper persons. Provided however, that this power of attorney limits the acts of those named herein; and they have no authority to bind the Company except in the manner stated and to the extent of any limitation stated below: Any such obligations in the United States, not to exceed Thirty Five Million and No/100 ($35,000,000) in any single instance Thatthis power is made and executed pursuant to the authority ofthe following Resolutions passed by the Board of Directors ofsaid Company, and said Resolutions remain in full force and effect: RESOLVED: That the President or any Vice President, in conjunction with any Vice President, be and they hereby are authorized and empowered to appoint Attorneys -in -fact of the Company, in its name and as it acts, to execute and acknowledge for and on its behalf as surety, any and all bonds, recognizances, contracts of indemnity, waivers of citation and all other writings obligatory in the nature thereof, with powerto attach thereto the seal ofthe Company. Any such writings so executed by such Attorneys -in -fact shall be binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company in their own proper persons. RESOLVED: That any and all Powers of Attorney and Certified Copies of such Powers of Attorney and certification in respect thereto, granted and executed by the President or Vice President in conjunction with any Vice President of the Company, shall be binding on the Company to the same extent as if all signatures therein were manually affixed, even though one or more of any such signatures thereon may be facsimile. (Adopted October7, 1981 — The Hanover Insurance Company; Adopted April 14, 1982 — Massachusetts Bay Insurance Company; Adopted September 7, 2001—Citizens Insurance Company of America and affirmed by each Company on March 24, 2014) IN WITNESS WHEREOF, THE HANOVER INSURANCE COMPANY, MASSACHUSETTS BAY INSURANCE COMPANY and CITIZENS INSURANCE COMPANY OF AMERICA have caused these presents to be sealed with their respective corporate seals, duly attested by two Vice Presidents, this 23'd day of August, 2022. THE HANOVER INSU E COMPANY MASSACHUSETTS PRY HOURANCE COMPANY CITIZENS INSURA E COMPANY OF AMERICA Vice President sent AAA E THE COMMONWEALTH OF MASSACHUSETTS ) COUNTY OF WORCESTER ) ss. THE HANOVER INSURANCE COMPANY MASSACHUSETTS BAY INSURANCE COMPANY CITIZENS INSURANCE COMPANY OF AMERICA On this 231 day of August, 2022 before me came the above named Executive Vice President and Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company ofAmerica, to me personally known to be the individuals and officers described herein, and acknowledged that the seals affixed to the preceding instrument are the corporate seals of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, respectively, and that the said corporate seals and their signatures as officers were duly affixed and subscribed to said instrument by the authority and direction of said Corporations. ak ARLEEN V. SIMONS • Notary Public �1 jpCOMMONWMTHOFMASSACHUSMS Arleen V Simons, otaryP/bkc'A �\�®��/f My Commission 15, 2 Expires M Commission Expires June 15, 2023 June 15, 2023 y p I, the undersigned Vice President of The Hanover Insurance Company, Massachusetts Bay Insurance Company and Citizens Insurance Company of America, hereby certify thatthe above and foregoing is a full, true and correct copy of the Original Power of Attorney issued by said Companies, and do hereby further certify that the said Powers of Attorney are still in force and effect. GIVEN under my hand and the seals of said Companies, at Worcester, Massachusetts, this 20th day of June, 2023 CERTIFIED COPY THE HANOVER INSURANCE COMPANY M HUSETTS BAY INSURANCE COMPANY I 3 GE CO�PANV OF AMERICA �ji ohn A_ R—edder, Vice President §JACKSON CONSTRUCTION LTD. 5112 SUN VALLEY DRIVE FORT WORTH, TX 76119 TEL: 817-572-3303 FAX: 817-478-0443 AFFIDAVIT STATE OF TEXAS COUNTY OF TARRANT Before me, the undersigned authority, a notary public in the state and county aforesaid, on this day personally appeared Troy L. Jackson, President Of Jackson Construction, Ltd, known to me to be a credible person, who being by me duly sworn, upon his oath deposed and said; That all persons, firms, associations, corporations, or other organizations furnishing labor and/or materials have been paid in full; That the wage scale established by the City Council in the City of Fort Worth has been paid in full; That there are no claims pending for personal injury and/or property damages; On Contract described as; Contract 2014 WSM-B, Part 1 BY Troy . ackson, President Subscribed and sworn before me on this date 20th of June, 2023. IN Notary •� Tarrant, Texas CARMEN L. ESTEP Notary Public, State of Texas • °�= Comm. Expires 04-06-2024 Notary ID 2910611 OF ��