HomeMy WebLinkAboutContract 41658-CO4FORT WORTH ..
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City of Fort Worth
Change Order Request
City Sec # 41658 ~-----~ Project Name! Concrete Restoration 2010-8 At Various Locations
Cl ient Project #(s)! GG01-537110 -0202002 DOE Number: 6667
Project Description Concrete Pavement Repair @ Various Locations throughout the City
Contractor! Jet Underground Utilities , Inc . Change Order# 4 Date 3/27/2012
City Project Mgr.I Tariqul Islam (817) 392-2486 City Inspector Gary Deyon (817) 223-2257 '-----"-""-----.....;.___:_ ___ ___.
Enter Department(s) to the Right and TPW Contract Day Type
Original Contract Amount $495,405 .70
Extras to Date $22 ,298.25
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $517 ,703 .95
!Amount of Proposed Change Order $0.00
Revised Contract Amount $517,703 .95
Original Funds Available for Change Orders
Remain ing Funds Available for this CO $0 .00
Additional Fund ing (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%)
JUSTIFICATION (REASONS) FOR CHANGE ORDER
Totals Select Day Type
$495,405.70 150
$22 ,298.25 40
$517 ,703.95 190
26
$517 ,703 .95 216
$0 .00
4.50%
$619 ,257 .13
This change order is to request that 26 Calendar Days (CD) be added to cover the construction time for an additional street that was added to ,
this contract. Whittenberg Dr. (Camelot Rd . -Crowley Rd.).
It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents paymen t
in full (both time and money) for all costs aris ing out of , or incidental to , the above Change Order .
M&C Number I Nik
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FORT WORTH ..
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City of Fort Worth
Change Order Request
City Sec # 41658 ..__ _____ ____. Project Name! Concrete Restoration 2010-8 At Various Locations
Client Project #(s)! GG01 -537110-0202002 DOE Number : 6667
Project Description Concrete Pavement Repair @ Various Locations throughout the City
Contractor! Jet Underground Utilities , Inc . Change Order # 4 Date 3/27/2012
City Project Mgr.! Tariqul Islam (817) 392-2486 City Inspector Gary Deyon (817) 223-2257 ,.__ ____________ --'---'-------'
Enter Department(s) to the Right and TPW Contract Day Type
Orig inal Contract Amount $495,405 .70
Extras to Date $22 ,298 .25
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $517 ,703 .95
!Amount of Proposed Change Order $0.00
Revised Contract Amount $517 ,703 .95
Original Funds Available for Change Orders
Remaining Funds Available for this CO $0 .00
Additional Funding (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%)
JUSTIFICATION (REASONS) FOR CHANGE ORDER
Totals Select Day Type
$495,405 .70 150
$22 ,298 .25 40
$517,703.95 190
26
$517 ,703 .95 216
$0 .00
4.50%
$619 ,257 .13
This change order is to request that 26 Calendar Days (CD) be added to cover the construction time for an additional street that was added to
this contract. Whittenberg Dr. (Camelot Rd . -Crowley Rd.).
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 time and money) for all costs arising out of , or incidental to, the above Change Order .
M&C Number
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City of Fort Worth
Change Order Request
City Sec# 41658 Project Name! Concrete Restoration 2010-8 At Various Locations
Client Project #(s)j GG01-537110-0202002 DOE Number: 6667
Project Description Concrete Pavement Repair @ Various Locations throughout the City
Contractor! Jet Underground Utilities , Inc . Change Order# 4 Date 3/27/2012
City Project Mgr .! Tariqul Islam (817) 392-2486 City Inspector Gary Deyon (817) 223-2257 .__---''---'-------'---'-------'
Enter Department(s) to the Right and TPW Select Day Type Contract Day Type Totals
Original Contract Amount $495,405 .70 $495,405.70 150
Extras to Date $22 ,298.25 $22 ,298.25 40
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $517 ,703 .95 $517,703 .95 190
!Amount of Proposed Change Order $0.00 26
Revised Contract Amount $517 ,703 .95 $517,703 .95 216
Original Funds Available for Change Orders $0 .00
Remaining Funds Available for this CO $0 .00
Additional Funding (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 4.50%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $619,257.13
JUSTIFICATION (REASONS) FOR CHANGE ORDER
This change order is to request that 26 Calendar Days (CD) be added to cover the construction time for an additional street that was added to
this contract. Whittenberg Dr. (Camelot Rd. -Crowley Rd.).
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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 time and money) for all costs arising out of, or incidental to , the above Change Order.
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M&C Number M&C Date Approved
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FORT WORTH .
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City of Fort Worth
Change Order Request
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Project Name! Concrete Resto ration 2010 -8 At Various Locations
Client Project #(s)! GG01-537110 -0202002
City Sec # 41658 ~--------'
DOE Number : 6667
Projec t Description Concrete Pavement Repair @ Various Locations throughout the City
Contractor! Jet Underground Utilities , Inc . Change Order#
City Inspector
4 Date 3/27/2012
City Project Mgr.! Tariqul Islam (817) 392-2486 Gary Deyon
Enter Department(s) to the Right and TPW Contract Day Type
Original Contract Amount $495,405 .70
Extras to Date $22 ,298 .25
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $517 ,703.95
IAmount of Proposed Change Order $0.00
Revised Contract Amount $517 ,703 .95
Original Funds Available for Change Orders
Remaining Funds Ava ilable for this CO $0 .00
Additional Funding (if necessary)
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS% OF ORIGINAL CONTRACT
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%)
JUSTIFICATION (REASONS) FOR CHANGE ORDER
Totals
$495,405 . 70
$22 ,298 .25
$517 ,703 .95
$517 ,703 .95
$0 .00
4.50%
$619 ,257 .13
(817) 223-2257
Select Day Type
150
40
190
26
216
This change order is to request that 26 Calendar Days (CD) be added to cover the construction time for an additional street that was added to
this contract. Whittenberg Dr. (Camelot Rd . -Crowley Rd .).
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 time and money) for all costs arising out of, or incidental to , the above Change Order .
Contractor's Compan Name Contractor Name Contract Si nature Date
Jet Under round Utilities , Inc . 1 /
Inspector/Inspection Supervisor Date Project Manager/Program Manager Date
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Assistant Director (Dept) Date Director , ContractinQ Department (Dept) Date
Assistant City Attorney Date Assistant City Manager Date ,,.. ,
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Council Action if required)
M&C Number I fl!< I M&C Date Approved I I
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FORT WORTH ---..,----City of Fort Worth
Change Order Additions
Project Name Concrete Restoration 2010-8 At Various Locations
Client Project# GG01-537110-0202002 DOE Number : 6667
Project Description Concrete Pavement Repair @ Various Locations throughout the City
Contractor Jet Underground Utilities, Inc . Change Order #
City Sec# 41658
4 Date 3/27/2012
City Project Mgr . Tariqul Islam (817) 392-2486 City Inspector ,__G_a ...... ry_D_e,_yo_n ___ _,_(8_1_,7)'-2_2_3-_22_5_7 ___.
ADDITIONS
11 t:M !..>!:tiL~lt"' I IUN Ut:1-' I Uty Unit Unit GOS! total
Time Only 11-'W ib.UU uay :j>U .UL
Change Order Additions Page 1 of 2
;i,u.uu
TPW $0 .00
Sub Total Additions :i;u.oc
Change Order Additions Page 2 of 2
FORT WORTH ----.---City of Fort Worth
Change Order Deletions
Project Name Concrete Restoration 2010-8 At Various Locations
Client Project# GG01-537110 -0202002 DOE Number : 6667
Project Description Concrete Pavement Repair @ Various Locations throughout the City
Contractor Jet Underground Utilities , Inc . Change Order #
City Sec# 41658
4 Date 3/27/2012
City Project Mgr . .__T_ar_iq._u_l ls_la_m _______ ( __ 81_7 ..... ) 3_9_2-_2_48_6 __ __, City Inspector ,__G_a_ry_D_e_yo_n ____ (8_1_7) __ 2_2_3-_22_5_7 __,
DELETIONS
11 t:M LJ1::.:,c..;Klr' I ION Ut:r' I u.iy Unit unit c..;ost 1ota1
Change Order Deletions Page 1 of 2
TPW $0 .00
~ub Iota ue1et1ons
Change Order Deletions Page 2 of 2
M/WBE 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
PROJECT NAME:
BuySpeed No (T/PW):
BuySpeed No (Water):
City Project No:
Contract No :
D.O .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 2010-8 @ Six Locations
P0-11-00065783
N/A
N/A
CS41658
6667
4
3/27/12
TOTAL
$ 495,405. 70
$ 22,298.25
$
$ 517,703.95
Amount of Proposed Change Order: Additions
Revised Contract Amount:
TIME ONLY
$ 517,703.95
Contingency Funds Avail. for Admin . Change Orders:
Remaining Funds Available for Change Orders:
Additional Funding (if necessary):
$
$
$
Prepared By : Christy Ezernack T/PW Construction Services