HomeMy WebLinkAboutContract 41968-CO1; I,.. •
FORT WORTH .
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City of Fort Worth
Change Order Request
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Project Namel HMAC Surface Overlay (2011-7) At Various Locations CitySec# I 41968 ~--------'
Client Project #(s)I C293-541200-203620171683 City Project No: 01716 DOE : 6655
Project Description HMAC Surface Overlay Throughout The City
Contractor! JLB Contracting , LLC
City Project Mgr. I Kristian Sugrim
Change Order# Date 5/29/2012
(817) 392-8902 City Inspector David W. Bowers (817) 350-3522
Enter Department(s) to the Right and TPW Contract Day Type
Original Contract Amount $777 ,943.65
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $777,943 .65
!Amount of Proposed Change Order $0.00 $0 .00
Revised Contract Amount $777 ,943 .65
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 Contract Time
(CD)
$777 ,943 .65 120
$777 ,943 .65 120
128
$777 ,943 .65 248
$0 .00
0.00%
$972,429 .56
This change order is to request that 128 Calendar Days (CD) be added to this contract due to Atmos franchise utility work on Marys Lane and
Sanguine! Dr.
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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
06 -'14 -1 2 A09:34 IN
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FORT WORTH ..
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City of Fort Worth
Change Order Request L/ V!llo fO I
Project Name! HMAC Surface Overlay (2011-7) At Var ious Locations City Sec # 41968
Clien t Project #(s)! C293-541200-203620171683 City Project No : 01716 DOE : 6655
Project Descrip ti on HMAC Surface Over lay Throughou t The City
Contractor! JLB Contracting , LLC
City Project Mgr. I Kr istian Sugr im
Change Order # Date 5/29/2012
(817) 392-8902 City Inspector David W. Bowers (817) 350-3522
Enter Department(s) to the Right and TPW Contract Day Type
Original Contract Amount $777 ,943 .65
Extras to Date
Credits to Date ,. )
Pending Change Orders (in M&C Process) 1--I l "-Contract Cost to Date ..... JII\ ·-$777 ,943 .65
!Amount of Proposed Change Order $0.00 $0.00
Revised Contract Amount $777 ,943 .65
Original Funds Available for Change Orders
~
Remaining Funds Available for this CO $0 .00 -Additional Funding (if necessary) , I
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 Contract Time
(CD)
$777 ,943.65 120
'
$777 ,943 .65 120
128
$777 ,943 .65 248
$0 .00
0.00%
$972,429 .56
This change order is t9 request that 128 Calendar Days (CD) be added to this contract due to Atmos franchise utility work on Marys Lane and
.. r Sanguine! Dr . ,.,
It is understood and agreed that the acceptance of this Change Order by the contractor cons ti tutes 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.
Date
C,. /,
M&C Number M&C Date Approved
•
..
Co 011. o F ~ .
FORT WORTH .
~
City of Fort Worth
Change Order Request LJ /' !(11 (u J
Project Name! HMAC Surface Overlay (2011-7) At Various Locations City Sec# 41968
Client Project #(s)! C293-541200-203620171683 City Project No: 01716 DOE: 6655
Project Description HMAC Surface Overlay Throughout The City
Contractor! JLB Contracting , LLC
City Project Mgr.! Kristian Sugrim
Change Order # Date 5/29/2012
(817) 392-8902 City Inspector David W. Bowers (817) 350 -3522
Enter Department(s) to the Right and TPW Totals Contract Time
Contract Day Type (CD)
Original Contract Amount $777 ,943 .65 $777 ,943 .65 120
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process) (
Contract Cost to Date ... I " $777 ,943 .65 $777 ,943 .65 120
!Amount of Proposed Change Order $0.00 $0.00 128
Revised Contract Amount $777 ,943 .65 $777 ,943 .65 248
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 0.00%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $972 ,429 .56
JUSTIFICATION (REASONS) FOR CHANGE ORDER
This change order is to request that 128 Calendar Days (CD) be added to this contract due to Atmos franchise utility work on Marys Lane and
Sanguine! Dr.
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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 j ¥4
FORT WORTH .,
~
City of Fort Worth
Change Order Request
1..-C (>-/ J_ o
Project Name! HMAC Surface Overlay (2011-7) At Various Locations City Sec # 41968
Client Project #(s)j C293-541200-203620171683 City Project No : 01716 DOE : 6655
Project Description HMAC Surface Overlay Throughout The City
Contractor! JLB Contracting , LLC Change Order # Date
City Project Mgr .! Kristian Sugrim (817) 392-8902 City Inspector David W. Bowers
Enter Department(s) to the Right and TPW Contract Day Type
Original Contract Amount $777 ,943 .65
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date $777 ,943 .65
!Amount of Proposed Change Order $0.00 $0.00
Revised Contract Amount $777 ,943 .65
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
$777 ,943.65
$777 ,943 .65
$777 ,943 .65
$0 .00
0.00%
$972 ,429.56
5/29/2012
(817) 350-3522
Contract Time
(CD)
120
120
128
248
This change order is to request that 128 Calendar Days (CD) be added to this contract due to Atmos franchise utility work on Marys Lane and
Sanguine! Dr .
( J I : (.. -
It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfact ion 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 Contract Si nature Date
JLB Contractin , LLC .,. -I -
Inspector/Inspection Supervisor Date Project Manager/Program Manager Date
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Assistant Director (Dept) Date Director, Contracting Department (Dept) Date ..
Assistant City Attorney Date Assistant City Manager Date
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Council Action if required)
M&C Number I Ii.-I M&C Date Approved I I
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FORT WORTH ---,..---
Project Name
Client Project #
City of Fort Worth
Change Order Additions
:=::H::;::M::::A::C:;:::S::urt:::::;a::::::ce:;::O:::::;v:::::e::::rla::::y:::(2::0::::11::-::::::7)::A::tV::a::ri::ou::s::L::oc::a::tio::n::::;s::::::::::::::::::::::::::::::::::::::::::::::::::::::::::......~C~ity:...S~e~c~#--=::::::4::;1968
C293-541200-203620171683 City Project No : 01716 DOE : 6655
Project Description HMAC Surtace Overlay Throughout The City
IIEM
NA
Contractor
City Project Mgr.
lime Only
JLB Contracting , LLC
Kristian Sugrim
ut:;t.;RIP rlON
Change Order# 1 Date 5/29/2012
(817) 392-8902 City Inspector David W. Bowers (817) 350-3522
ADDITIONS
Utt-'I Uty Unit Unit t.;OSt 1ota1
11-'W 1 ltl.UU uays ~u .uu
Change Order Additions Page 1 of 2
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TPW $0 .00
$0 .00
Sub Tota l Add1bons :i;u .uu
Change Order Additions Page 2 of 2
FORT WORTH ---......--
Project Name
Client Project#
City of Fort Worth
Change Order Deletions
HMAC Surface Overlay (2011-7) At Various Locations
C293-541200-203620171683 City Project No: 01716 DOE: 6655
Project Description HMAC Surface Overlay Throughout The City
11 t:M
Contractor
City Project Mgr.
JLB Contracting, LLC
Kristian Sugrim
Ut:~L;KII" I ION
Change Order #
(817) 392-8902 City Inspector David W. Bowers
DELETIONS
Ut:I" I l..lty Unit
Change Order Deletions Page 1 of 2
City Sec# 41968
Date 5/29/2012
(817) 350-3522
Unit cost lotal
TPW $0 .00
$0 .00
Sub Total Deletions
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 SUMMARY SHEET
(Change Order Attachment)
PROJECT NAME:
BuySpeed No (T/PW):
HMAC 2011-7 Surface Overlay@ various locations
P0-11-00067164
BuySpeed No (Water): NIA
City Project No : 01716
Contract No : CS41968
D.O .E. No : 6655
Attachment to Change Order No : 1
Today's Date : 5/31/12
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):
Additional Time Requested: 128 days
Original M & C, C-24957, approved 06-14-11
TOTAL
$ 777,943.65
$
$
$ 777,943.65
TIME ONLY
$ 777,943.65
$
$
$
Prepared By : Christy Ezernack T/PW Construction Services