HomeMy WebLinkAboutContract 62257-CO1CSC No. 62257-COI
FORT WORTH,: City of Fort Worth
Change Order Request
Project Name Pavement Leveling Service Unit Price Contract City Sec # I 62257
Client Project #(s)l
Project Description Leveling uneven concrete pavement slab, soil densification and joint grinding
Contractorl Nortex Concrete Lift and Stabilization, Inc I Change Order #1 1 I Date 3/17/2025
City Project Mgr.I Tariqul Islam
Dept.
Original Contract Amount
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
Amount of Proposed Change Order
Revised Contract Amount
Original Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
TPW
$1,000,000.00
City Inspector Eddie Walker
Contract Time
Totals (CD)
$1,000,000.00
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.00%
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) $1,250,000.00
JUSTIFICATION (REASONS) FOR CHANGE ORDER
This change order adds new bid items to the original unit price contract. These new items are for performing sinkholes, storm drains, sidewalks, and other repairs at various
locations.
•tems 14 and 15 are to be used for foam applications in different sizes of Reinforced Concrete Pipe or Galvanized pipe joint
-Rem 16 to be used for foam liner applications in different sizes Reinforced Concrete Pipe or Galvanized pipe
-Rem 17 to be used for foam applications in different sizes Reinforced Concrete Pipe or Galvanized pipe sleeve
-Rem 18 to be used for foam application in Box Culvert joints
-Rem 19 to be used for foam sealing and lining applications in Inlet Box
•tems 20, 21, and 22 are to be used to perform sidewalk repairs at various locations.
This is a zero -change order and will not increase the contract price. The staff has compared the prices of the new items with the current North Texas Council of
Government contract prices and found the prices reasonable.
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.
Contractor's Corn an Nam Contractor Name Lentract Signature
Date
Nortex Concrete Lift and Stabilization, Inc
David Simpson ,.
Mar 24, 2025
Inspector/Inspection Supervisor
ate
Project and Contract Compliance Manager
Date
Mar 18, 2025
Mar 18, 2025
Program Manager
Date
Senior Capital Project Officer
Date
Ze(&(ePJ Aa�a
Mar 25,2025
Mar26,2025
Assistant Director Dept
Date
Director, Contracting Department Dept
Date
➢a-mlcia I wadcaok
Mar 27, 2025
Mar 27, 2025
ssistant Ci Attorne
D
i Manager
Date
1111FOuncil
Mar 31, 2025 Q -
Action (if required)
M&C Number I I M&C Date Approved
Apr 6, 2025
I I
ATTEST: won
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Jannette Goodall, CitySecretary il.", z;
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OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
FORT W/�R_ TH City of Fort Worth
`' Change Order Additions
Project Name I Pavement Leveling Service Unit Price Contract City Sec # 62257
Client Project #
Contractorl Nortex Concrete Lift and Stabilization, Inc I PMI Tadqul Islam I Inspectorl Eddie Walker l
Change Order Submittal # 0 Date 1 3/17/2025 1
ADDITIONS
ITEM
DESCRIPTION
DEPT
Qty
Unit
Unit Cost
Total
New 14
9999.0006 RCP or Galy. Pipe Inject/Joint 12 inch - 30 inch Pipe
TPW
0.00000000
LB
$9.50
$0.001
New 15
9999.0007 RCP or Galy. Pipe InjectlJoinl32 inch Pipe and above
TPW
0.00000000
LB
$9.00
$0.001
New 16
9999.0008 RCP or Galy. Pipe Polyurethane Liner 36 inch Pipe and above
TPW
0.00000000
LB
$9.00
$0.001
New 17
9999.0009 RCP or Galy. Polyurethane Pipe Sleeving
TPW
0.00000000
LB
$8.00
$0.001
New 18
9999.0010 Box Culvert Injection per Joint (Any Size)
TPW
0.00000000
LB
$8.00
$0.001
New 19
9999.0011 Inlet Box Sealing and Lifting
TPW
0.00000000
LB
$7.00
$0.001
New 20
9999.0012 Sidewalk Lifting and Undersealing (1-320 SIFT)
TPW
0.00000000
LB
$8.00
$0.001
New 21
9999.0013 Sidewalk Lifting and Undersealing (321-960 SIFT)
TPW
0.00000000
LB
$7.00
$0.001
New 22
9999.0014 Sidewalk Lifting and Undersealing (961 SIFT and above)
TPW
0.00000000
LB
$6.00
$0.001
TPW s0.00 1
Sub Total Additions $0.001
Change Order Additions Page 2 of 5
I I EM
Foxe City of Fort Worth
Change Order Deletions
Project Name I Pavement Leveling Service Unit Price Contrail City Sec # 1 62257
Client Project # I I
Contrailorl Nortex Concrete Lift and Stabilization, Inc I PMI Tariqul Islam I Inspeilorl Eddie Walker I
Change Order Submittal # = Date 1 3/17/2025 1
DELETIONS
DESOKIPI ION DEPI Oty Unit Unit Cost total
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1
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1
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1
1
1
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1
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1
1
1
1
1
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TPW s0.001
Sub Total Deletions s0.00 1
Change Order Deletions Page 3 of 5
MISBE for this Change Order
M/SBE Sub Type of Service Amount for this CO
Not Applicable Not Applicable Not Applicable
Total $0.00
Previous Change Orders
Co # DATE I AMOUNT
Not Applicable
Not Applicable
Total I $0.00 1
FORT WORTH.
Routing and Transmittal Slip
Transportation & Public Works
Department
DOCUMENT TITLE' PAVEMENT LEVELING SERVICE UNIT PRICE CONTRACT
M&C: 24- 0902 CPN:
Date:
To:
1
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Name
Crystal Greene
Nortex Concrete Lift and Stab.
Eddie Walker
Tariqul Islam
Zelalem Arega
Mary Hanna
Patricia Wadsack
Lauren Prieur
Doug Black
Jesica McEachem
Jannette Goodall
TPW Contracts
CSO: 62257
Department
Initials
Bus-Sppt
Vendor
ps L
TPW - Inspector
EddiWa,ke,
TPW
'd
TPW°
TPW'
TPW AD
�L
TPW Director
�a f�
Legal
i
o -glas Black
CMO
cv-
Jeaica McEachem
CSO
�
TPW
DOC#:
Date Out
M a r 25, 2025
Mar 24, 2025
Mar 18, 2025
Mar 18, 2025
Mar 25, 2025
M a r 26, 2025
M a r 27, 2025
M a r 27, 2025
Mar 31, 2025
Apr6,2025
Apr 7, 2025
CC: Program Manager, Sr. CPO, TPW BSPAP Recon Team, TPW Records Room, TPW Contracts
ALSO List: - Bus Sppt: Crystal Greene; Prg Mgr.: Zelalem &re a; Sr CPO — Mary Hanna
DOCUMENTS FOR CITY MANAGER'S SIGNATURE: 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, Jay will review
and take the next steps.
NEEDS TO BE NOTARIZED: ❑YES ®No
RUSH: ❑YES ®No SAME DAY: ❑YES ❑No NEXT DAY: ❑YES ❑No
ROUTING TO CSO: ®YES ❑No
Action Required:
❑ As Requested
❑ For Your Information
® Signature/Routing and or Recording
❑ Comment
❑ File
❑ Attach Signature, Initial and Notary Tabs
Return To: Please notify TPWContractsnn,fortworthtexas.Lrov for pickup when complete. Call ext. 7233 or ext.
8363 with questions. Thank you!