HomeMy WebLinkAboutContract 41296-CO1fORTWORTH. City of Fort Worth
Change Order Request
CITY SECRETARY
CONTRACT NO. '4 lrQ9(q-CQ,l ..
~
Project Name! Concrete Restoration (2010-11) At Eighteen Locations City Sec# 41296
Client Project #(s~ C293-541200-202330159383 DOE Number: 6545 City Project Number: 01593
Project Descriptio1 Concrete panel replacement at various locations
Contractor! Westhill Construction , Inc. Change Order #
City Inspector
Date 9/10/2011
City Project Mgr.! Tariqul Islam (817) 392-2486 Candace Klenk (817) 319-6452
Enter Department(s) to the Right and TPW Cohtract Time
Contract Day Type Totals I CD
Original Contract Amount a-------+---._!""!!"r ..... -----1--1"!!'9,"!!'984!!"!"'!!.90_. ........... i..... ... 1-50--1
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
Original Funds Available for Change Orders
Remaining Funds Ava ilable for this CO
Additional Funding (if necessary)
$0.00
$9,200.00
CHANGE ORDERS to DATE (INCLUDING THIS ONE} AS% OF ORIGINAL CONTRACT
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%)
It , . ' . . ·. . . ,
~ . . . . .
150
5
155
This change order is requested to increase and add new line item quantities. Due to the shifting of the ground and pavement which caused an;
impassable trip hazard, it was necessary to remove and replace an inlet top, some sidewalk and a handicapped ramp to reso '1ffl
1
the issue . Also
request that 5 additional calendar days be approved for the work performed .
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
FORT WORTH -----.---City of Fort Worth
Change Order Additions
Project Name Concrete Restoration (2010-11) At Eighteen Locations
Client Project# C293-541200-202330159383 DOE Number: 6545
Project Description Concrete panel replacement at various locations
Westhill Construction, Inc.
City Sec#
City Project Number: 01593
Change Order # 1 Date 9/10/2011 Contractor
City Project Mgr. Tariqul Islam (817) 392-2486 City Inspector Candace Klenk (817) 319-6452
ADDITIONS
11 t:M Ut:.:,l,t(lt' I IUN Ut:I"' I Qty Unit Unit cost
l:I (lnC) Kemoo111zat1on ll"'W 1.UU t:A ~:,uu .uu
1U(New) Kemove ana Kep1ace 1u-t-oot Inlet 1 op ll"'W 1.00 EA $1,l:l:>U .w
11(New) Remove and Replace 4-lncn l;Oncrete ;:,1aewa1K I l"'VV :,uu.ou .:it" ~:,.uu
1:l(New) Kemove t:x1st1ng vvnee1cnair Ramp ana Install stanaara 4-lncn ADA wnee1 I l"'VV 1.00 EA $1,f:>U.UU
1J(New) Remove ana Replace Existing Aspnalt Pavement fPW :,uu .uu ::;,-~0 .Ul.
TPW
::;uo I otal Aaamons
Change Order Additions Page 1 of 1
41296
IOtal
~:,VU .UV
~l,l:!OV.UV
,>.£,OW .W
~l, /00 .UU
~:l,:>UU .UU
$9,200 .00
~l:1 ,LW.U\.
FORT WORTH ---..,.....-City of Fort Worth
Change Order Deletions
Project Name Concrete Restoration (2010-11) At Eighteen Locations
Client Project# C293-541200-202330159383 DOE Number : 6545
Project Description Concrete panel replacement at various locations
City Sec# 41296
City Project Number: 01593
Contractor
City Project Mgr.
Westhill Construction, Inc .
Tariqul Islam (817) 392-2486
Change Ord~e_r #~==1==~-D_a_te~==9=/1=0/=20=1=1 ::::::
City Inspector Candace Klenk (817) 319-6452
DELETIONS
lfEM L---'" IIUN Ut:t"' I Qty Unil Unit (.;OSt 1ota1
TPW
Sub 1 otal Deletions
Change Order Deletions Page 1 of 1
$0 .00
M/WBE Breakdown for this Change Order
--" MWBESub ' Type of Service Amount for this ,CO ' 'k " ,F ,. ··-· ._,
Total 1,.. -i"Cf: :}i . " '.$000 ;fjf!·,,. • ~r~ f _ :i ,·
·~· '-<S -·., .. :l':: ~~ .. ~ _.; •
Total
PROJECT NAME:
BuySpeed No Cf/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 :
Contract Amount to Date:
PROJECT SUMMARY SHEET
(Change Order Attachment)
Concrete Restoration 2010-11 (I Various Locations
P0-11-00064159
NIA
01593
CS41296
6545
1 C-24594 approved 11 -16-10
9/12/11
TOTAL
$ 519,984.90
s s
$ 519,984.90
Amount of Proposed Change Order: $ 9,200.00
Revised Contract Amount:
Contingency Funds Avail. for Admin . Change Orders:
Remaining Funds Available for Change Orders:
Additional Funding (if necessary):
$ 529,184.90
s s
$ (9,200.00)
Prepared By: Christy Ezernack T/PW Construction Services
• l
' .
PROJECT SUMMARY SHEET
(Change Order Attachment)
PROJECT NAME: Concrete Restoration 2010-11@ Various Locations
BuySpeed No: P0-11-00064159
Contract No: CS41296
D.O .E. No: 6545
Attachment to Change Order No: 1 ------Today's Date: 10/5/11 ------
Original Contract Amount:
Extras to Date:
Credits to Date:
Contract Amount to Date:
Amount of Proposed Change Order:
Revised Contract Amount:
Contingency Funds Avail. for Admin. Change Orders:
Remaining Funds Available for Change Orders:
Additional Funding (if necessary):
l',f & C C-24594 Approved 11-16-10
TOTAL
$ 519,984.90
$
$
$ 519,984.90
$ 9,200.00
$ 529,184.90
$
$
$ (9,200.00)
Prepared By: Karen Striker T/PW Business Support