HomeMy WebLinkAboutContract 40234-CO2FORT WORTH .
CITY SECRETARY
CONTRACT NO. 4D234-G02.
~
City of Fort Worth
Change Order Request
Project Name! HMAC Surface Over1ay Contract 2009-19
Client Project #(s)! C293-541200-203620138583
City Sec # 40234
Proj
Description :::::=====================------=====----====±= Contractor._! _J_LB_Con_tracti __ ·ng ________ ___. ChangeOrder# 2 Date 10/5/2tl11
~MAC Surface Overlay Contract at Various Locations DOE 6372
City Project Mgr .... I _K_ris_ti_an_S_ug"""n-·m ________ ___. City Inspector Ali Motamed
Original Contract Amount
Extras to Date
Credits to Date
Dept
Pending Change Orders (in M&C Process)
Contract Cost to Date
Revised t
Original Funds Availa>le for Change Orders
TPW Water Sewer
Remaining Funds Availa>le for this CO .00
Additional Funding (if necessary)
CHANGE ORDERS to DA TE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT
lfAX ALLOWABLE CONTRACT AIIOUNT (ORIGINAL CONTRACT COST+ 25%)
complete work on Chapin Road .
Contract Time
CD
240
I ao
I 320
I 9
,130.01 329
$0.00
It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents
payment in fuU (both time and money) for al costs arising out of, or incidental to, the above Change Order.
10-25-11 P0 1 :41 1 ,
Project Name
Client Project #
City of Fort Worth
Change Order Additions
HMAC Surface Overlay Contract 2009-19 City Sec # 40234
:=;:c:;:29::::3-:::::54=12==00-=20===36=20=13858===::::3 ===================================--.:._--====:1
Project Description HMAC Surface Overlay Contract at Various Locations DOE 6372
Contractor JLB Contracting Change Order # 2 Date 10/5/2011
City Project Mgr. .__Kri_·s_tian_Su_.g..._rim _________ ____, City Inspector L...;..;Al;.;...;i M.;.;.;o;.;;;;ta;.;...;m.;.;ed;...._ ______ ......
ADDITIONS
ITEM ..,'IIUN Ut:t"I UlV Unff Unif c.;ost Total
l;aiander Days I l"'YY 9.UI.I CD $0 .Ul
TIW
--Water
Sewer
tilJD Total Additions
Change Order Additions Page 1 of 1
:>U .Ul
$0 .0CJ
$0.00
$0 .00
$0.UIJ
City of Fort Worth
Change Order Deletions
Project Name HMAC Surface Overlay Contract 2009-19
Client Project# C293-541200-203620138583
City Sec# 40234
Project Description HMAC Surface Overlay Contract at Various Locations DOE 6372
llt.M
Contractor JLB Contracting
City Project Mgr. ...._Kri_·s_tian_Su_g._n_·m _________ ____.
DELETIONS
!J!:~l_:"'(lt" I IUN
-
Change Order # ---===----=====:::: City Inspector ... I _Al_i _Mo_ta_m_ed _______ __,
2 Date 10/5/2011
Ut.t"I YlY unit Unit 1.,0St
11W
--Water
Sewer
l:>UD 1 OtaJ ueieuons
Change Order Deletions Page 1 of 1
IOtal
~u .uu
$0.00
$0 .00
M/WBE Breakdown for this Change Order
MWBESulL Type of Service · Amount for this CO f
Total
Previous Change Orders
DATE '
PROJECT NAME:
BuySpeed No (r/PW):
BuySpeed No (Water):
City Project No :
Contract No:
D.0.E. No:
Attachment to Change Order No :
Today's Date :
Original Contract Amount:
Extras to Date:
Credits to Date:
PROJECT SUMMARY SHEET
(Change Order Attachment)
HMAC 2009-19 Surface Overlay 50/50
CSC0-10-00060691
NIA
01385
CS38299
6372
2
10/11/11
TOTAL
$ 1,775,710.00
$ 381,420.01
$
$
$
$
~ P253 P258
887,855.00 $ 532 ,713.00 $ 355,142 .00
190,710.00 $ 114 ,426.02 $ 76,283.99
$ $
Contract Amount to Date: $ 2,157,130.01 $ 1,078,565.00 $ 647,139.02 $ 431,425 .99
Amount of Proposed Change Order:
Revised Contract Amount:
Contingency Funds Avail. for Admin . Change Orders:
Remaining Funcjs Available for Change Orders:
Additional Funding (if necessary):
TIME ONLY $ $ $
$ 2,157,130.01 $ 1,078,565.00 $ 647 ,139.02 $ 431,425 .99
$
$
$
$
$
$
$
$
$
$
$
$
Prepared By : Christy Ezernack T/PW Construction Services