HomeMy WebLinkAboutContract 39379-CO1wwm-raa
CMUR,f- aowTRuc.foft BERV U
POK-FROACT MUVAUM
OOln6atflO. CORiRACTOR
CITY OF FORT WORTH CITY SECRETARY
CHANGE ORDER REQUEST CONTRACT NO, 3 3rj ' _ l
ORUER ISM DATE F'FtWtL i lu
ICHANGE
1 0511712010 IC293-209620135183
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PAVIW IMPROVEMENTS FOR SOUTH ADAMS ST. BETWEEN MAGNOLIA AND W. ROSEDALE
WATER
SEWER
ORIGINAL CONTRACT AMOUNT ............... ............. ............. ..................... ..�.
EXTRAS TO DATE .... -.... ....................................... ......... ...
$
CREDITS TO DATE .............. ........................ ......
$ - $
- $
CONTRACT COST TO DATE .....» ......... ......... _............... ....... ............. ...........
$ - $
- $
AMOUNT OF PROPOSED CHANGE ORDER .......»..........._ ................._.._
$
REVISED CONTRACT AMOUNT —
$
ORIGINAL FUNDS AVAILABLE FOR CHANGE ORDERS ...............................
$ - $
- $
REMAINING FUNDS AVAILABLE FOR THIS CHANGE ORDER .....................
$ - $
- $
ADDITIONAL FUNDING (IF NECESSARY).......................................................
$ - $
- $
CHANGE ORDERS TO DATE (INCLUDING THIS ONE,► AS % OF ORIGINAL CONTRACT COST
MAIL ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25V
ITES r(3fiWrFlWlllpff#*PLUG
Q TMENT
I PW26.DD.) ABANDON WATER SERVICES & REMOVE BOXES IT / PW I
ITEM r7.(�ffRM*A
F4ETR SERVICE
8.I(DEC.TE METER BOX
D ENT
IT
T / PW
U.q.E. No
5230
CITY SEC N!
39379
T/PW TOTALS
125,697.00
$ 125.697.00
b -
125,697.00
$ 125,697.00
5,650.00
$ 5,650.00
131,347.00
$ 131,347.00
6,284.85
6,284.85
TY UNIT UP(IT C(ZgT
1.00 LS 3 `6w$
9.00 EA 300.00
WATER
SENDER $
T/PW $
SUBTOTAL A $
TY UNIT UNIT
580.�6 �f�g�
1.00 EA $ a
1.00 EA $ 150.00 $
WATER $
SEWER $
T►PWl
SUBTOTAL BI
TOTAL (SUB -TOTAL A - SUB -TOTAL B)' $ 5,650.001
IN ACCORDANCE WITH THIS CHANGE ORDER THE CONTRACTOR SHALL:
R tt wWWA od aid apaad OW fM .000ptwm of tft Cf wW ORfr by aw mnusaw wmftkn an aocfad wd tatlefadim aid opow wMa. Paymwa to Ar"Wo wd =_) for r mb aftN ar of, or brJdafdr W an abara Cttwp
ONar.
CONTRACTORS NAME CONTRACTOR(PRINT]: , L h.1j' DATE
AVEMCAN SAFETY CASUALTY INSURANCE CO.: . { Q p )1 A �qI rl s L=
OIDONAL CONTRACT TINE ADDL �p�p fE A'C�w
112 CD co `112 CD
% 4.M
$ 157,121.29
TOTAL
3,600,00
2,700.00
6,300.00
6,300.00
TOTAL
500.00
150.00
650.00
650.DO
COUNCIL ACTION IW R
APPROVED
DATE
DATE
IDA
OTHER
OFFICIAL RECORD
CITY SECRETARY
I
WORTH, TX
MANAGER
"T
A 8* -
DA
�vf� 7HE OR 7}NG O.
CD
DATE
DATE
INO M&C REQUIRED I
06-17-10 P02:18 IN
DATE: 05 / 17 / 2010
TRANSPORTATION AND PUBLIC WORKS
CHANGE ORDER JUSTIFICATION RECORD AND PROJECT SUMMARY SHEET
PROJECT NAME: PAVING IMPROVEMENTS FOR SOUTH ADAMS ST. BETWEEN MAGNOLIA AND W. ROSEDALE
CHANGE ORDER 10: 1 D.O.E. NO: 5238 CLIENT PROJECT 10: C293-ZG§620135183
INSPECTOR: LESLIE BAGBY PHONE NO: (817) 392-8306 CITY SECRETARY NO: 39379
PROJECT MANAGER: DEBBIE WILLHELM PHONE NO: (817) 392-2481
COMBINED
WATER
SEWER
T / PW
ORIGINAL CONTRACT AMOUNT
$
125,697.00
$ -
$ -
$
125,697.00
EXTRAS TO DATE
$
-
$ -
$ -
$
-
CREDITS TO DATE
$
-
$ -
$ -
$
-
ORIGINAL AMOUNT TO DATE
$
125,697.00
$ -
$ -
$
125,697.00
AMOUNT OF PROPOSED CHANGE ORDER
$
5,650.00
$ -
$ -
$
5,650.00
REVISED CONTRACT AMOUNT
$
131,347.00
$ -
$ -
$
131,347.00
ORIG. CONTINGENCY FUNDS AVAILABLE
FOR CHANGE ORDERS $ 6,284.85 $ - $ - $ 6,284.85
REMAINING FUNDS AVAILABLE
FOR THIS CHANGE ORDER $ 6,284.85 $ - $ - $ 6,284.85
ADDITIONAL FUNDING (IF NECESSARY) $ - $ - $ - $ -
REASON(S) FOR CHANGE ORDER:
This project is being Constructed under a takeover agreement between American Casualty Insurance Company and the City
of Fort Worth.
During Excavation, the completion contractor noted that various Public Improvements within Adams St. ROW for adjacent
development had not been performed as planned. So as to not delay the paving construction, the work for fireline installation
and water service abandonments were added to the scope of this project.
y (f tw-/D
Ins or Date
As< Dir. - Infrastructure Design & Const Date
Director of Con ding Dept.',,-' Date
OFFICIAL RECORD
CITY SECRETARY
F7: WORTH, TX
06-17-10 P02:78 IN
s-/zq,
` Date J
Date /
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