HomeMy WebLinkAboutContract 43299-CO1fORTWORTH ® ....... ,.....,.
.. Arr SE CRETARY
CONTRACT NO. ~ 31-CJ~ -CO \
Change Order No . Date
City of Fort Worth
Change Order Request
TPW Project No. Funding (FAG )
One (1) 8/20/12 Brennan Drainage R101-539410-020212009000
Repair : ENV 12-09 BSC
Facility and Project Description
Repair of French Drain for De-watering the Northern Slope , East of Improved Drainage Channel
ORIGINAL CONTRACT AMOUNT ............................................................... .
EXTRAS TO DATE .................................................................... .
CREDITS TO DATE ................................................................... .
City Secretary Contract No .
43299
$
$
$
4,850.00
0.00
0.00
CONTRACT COST TO DATE.................................................................................................. $
AMOUNT OF PROPOSED CHANGE ORDER ............................................. (ADD)....................... $
BALANCE CONTRACT REMAINING....................................................................................... $
REVISED CONTRACT AMOUNT............................................................................................. $
IN ACCORDANCE WITH THIS CHANGE ORDER , THE CONTRACTOR SHALL:
• Provide two additional cleanouts along replaced drainage ;
• Cap line from east of collection sump ;
4,833.00
1,212.50
1,229.50
6,062.50
• Provide a bentonite barrier at capped location within the gravel pack surrounding the installed French Drain ; and
• Provide an inlet seal into sump and increase the size of the discharge line from 2"0D to 4"0D.
All work to be performed in accordance with the Proposal specifications.
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 Name
Effective Environmental, Inc (WWW.EFF-ENV.COM)
Original Contract Time Addi tional Approved Ti me To Date Approved Contract Time To Date Addit ional Time For Th is Change Order
NA NA NA NA
Date
8'-JD -/').
Date
JO ·lf .J
Date
10/t /1 i..
Environmental Supervi -
Roger Grantham
Assistant Director/ TPW -
Michael A . Gange
Assistant City Attorne
Art N. Bashor ~
Council Action (If Required)
D Approved D Disapproved N/A
D Othe
Date
/O•J.-1z.
Date Jlr!tt--
.:;.z~~~~~~-----;-OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX