HomeMy WebLinkAboutContract 59712-CO1CSC No. 59712-COI
FUli�l, WUR-1 I E City of Fort Worth
Change Order Request
Project Name 2023 Concrete Pavement Joint Seal Contract I City Sec # l 59712
Client Project #(s)l 104618
Project Description Cleaning and fillling of concrete pavement joints with silicone sealant.
Contractorl Straight Line Sawing & Sealing Inc. I Change Order#1 1 I Date' 1/10/2024
City Project Mgr.l Iretomiwa Otuyelu l City Inspectorl Byron McDonald
Dept.
TPW
Original Contract Amount
$484,000.00
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to DateG14�EEE!E�
lGo to ADD & DEL Tabs to Enter CO Backup
! $0.00
Revised Contract Amount
$484,000.00
Original Funds Available for Change Orders
$20,000.00
Remaining Funds Available for this CO
$20,000.
Additional Funding (if necessary)
Contract Time
Totals (CD�
$484,000.00 20
$484,000.00
$484,000.00
$20,000.00
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT o
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $605,000.00
120
30
150
This Change Order is to add locations to the original scope of work for the concrete joint seal at Randol Mill Rd from Bridgewood Drive to East Loop 820 and John T White Rd
from Randol Mill Rd to Sylvan Dr. This is a $0 change order due to the availability of funds in the current contract under the existing bid item quantities.
Staff also recommends the addition of 30 days to complete this additional scope of work.
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. The Project/Program Manager signing below acknowledges that
he/she is the person responsible for the monitoring and administration of this contract, including ensuring all performance and reporting requirements.
ontractor's C...a—,v ffContractor Nam ntract Si natur
Straight Line Sawing and Sealing, Inc. Eric Johnson 41—,,,,,,', „,„
Date
I Jan 17, 2024
Inspector/Inspection Supervisor
Date
Project and Contract Compliance Manager Ill
Date
brr
Jan 17, 2024r
Jan 17, 2024
Program Manager
Date
Jan 17, 2024
Senior Capital Project Officer
Date
✓
Jan 17, 2024
Assistant Director (Dept)
Date
Director, Contracting Department (Dept)
Date
Jan 18, 2024
Jan 18, 2024
Assistant City Attorney
Date
Assistant City Manager
Date
Jan 18, 2024
Jan 18, 2024
Council Action if required)
M&C Number I M&C Date Approved
ATTEST: a Or°0000000 (�va�
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Jannette Goodall, City Secretary 0t1g o=0
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OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
I I tM
T: N �Wide rri City of Fort Worth
Change Order Additions
Project Name 1 2023 Concrete Pavement Joint Seal Contract City Sec # I 59712
Client Project # I 104618 1
Contractorl Straight Line Sawing & Sealing Inc. I PMI Iretomiwa Otuyelu Inspectorl Byron McDonald I
Change Order Submittal # O1 Date 1 1/10/2024 1
ADDITIONS
UtSCKIPIIUN UtPI Uty Unit Unit Cost total
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TFW $0.001
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Sub Total Additions $0.001
Change Order Additions Page 2 of 4
11 tM
T t� x;'r City of Fort Worth
T Change Order Deletions
Project Name 1 2023 Concrete Pavement Joint Seal Contract City Sec # 1 59712
Client Project# 1 104618 1
Contractorl Straight Line Sawing & Sealing Inc. I PMI Iretomiwa Otuyelu I Inspectorl Byron McDonald I
Change Order Submittal # O1 Date 1 1/10/2024 1
DELETIONS
ULbUNINl IUN ULF'1 Lny Unit unit host total 1
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TOW $o.00l
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Sub Total Deletions
Change Order Deletions Page 3 of 4
M/SBE for this Change Order
M/SBE Sub Type of Service Amount for this CO
Total $0.00
Previous Change Orders
CO # DATE I AMOUNT
Total I $0.00 1
FORT WORTH
Routing and Transmittal Slip
Transportation and Public Works
Department
DOCUMENT TITLE: 2023 CONCRETE PAVEMENT JOINT SEAL CONTRACT — C01
M&C; 23-0426
Date:
To:
CPN: 104618 CSO # 59712 DOC# 1
Name
1
Ann Estes
2
Eric Johnson
3
Byron McDonald
4
Iretomiwa Otuyelu
5
Mary Hanna
6
Patricia Wadsack
7
Lauren Prieur
8
Doug Black
9
Jesica McEachern
10
Jannette Goodall
11
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Date Out
Jan 17, 2024
Jan 17, 2024
Jan 17, 2024
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Jan 18, 2024
Jan 18, 2024
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Jan 19, 2024
CC: Program Manager, Sr. CPO, TPW BSAP Recon Team, TPW Records Room, TPW Contracts
-Bus Sppt: Ann Estes; -Prg Mgr: Mary Hanna: -Sr. CPO: Mary Hanna
DOCUMENTS FOR CITY MANAGER'S SIGNTURE: All documents received from any and all City
Departments requesting City Manager's signature for approval MUST BE ROUTED TO THE
APPROPRIATE ACM for approval first. Once the ACM has signed the routing slip, David will review
and take the next steps.
NEEDS TO BE NOTARIZED: ❑ Yes X No
RUSH: ❑ Yes X No SAME DAY: ❑ Yes X No NEXT DAY: ❑ Yes X No
ROUTING TO CSO: ❑ Yes ❑ No
Action Rea it :
❑ As Requested
❑ For Your Information
X Signature/Routing and or Recording
❑ Comment
❑ File
❑ Attach Signature, Initial and Notary Tabs
Return to: Please notify TPWContracts(dfortworthtexas.gov for pickup when complete. Call ext. 7233 or
ext. 8363. Thank you!