HomeMy WebLinkAbout063563-CO1 - Construction-Related - Contract - Interstate Sealant & Concrete, Inc.Contract Time
(CD)
0
Date
Date
Date
Date
Date
ATTEST:
____________________________________________
, City Secretary
City of Fort Worth
Contractor
63563
Client Project #(s)104463 & 106257
Date 10/21/2025
City Project Mgr.
Change Order Request
1
Project Name
Remaining Funds Available for this CO
Pending Change Orders (in M&C Process)
MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%)
$0.00
Contract Cost to Date
$0.00
Amount of Proposed Change Order
$1,301,001.70
Revised Contract Amount $1,311,085.40
$10,083.70$10,083.70
City Sec #AFW Joint Reseal & Pavement Repair - Phase I Construction
AviationDept.Totals
Project Description Construction of Phase I of the Joint Reseal & Pavement Repair project at Perot Field Fort Worth Alliance Airport. Project consists of resealing joints,
miscellaneous pavement repairs and application of new pavement markings on Runway 16L-34R.
Change Order #Interstate Sealant & Concrete, Inc.
Tyler Dale N/ACity Inspector
$1,290,918.00
Original Funds Available for Change Orders
$1,311,085.40
Extras to Date $33,952.00
$1,290,918.00
Credits to Date $23,868.30
1.56%
$1,613,647.50
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT
Additional Funding (if necessary)$10,083.70
JUSTIFICATION (REASONS) FOR CHANGE ORDER
$10,083.70
DateAssistant City Attorney
Repair of unforeseen field conditions required to be made prior to reopening the runway:
1. Electrical saw kerf deterioration near runway centerline
2. Pavement section around several flush mounted light cans near runway centerline
These conditions and the corresponding methods for repair differ from the current project scope and therefore require new Bid Items as defined by DCN-04 and RFI-0003.
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.
Council Action (if required)
M&C Number
Inspector/Inspection Supervisor Date Project and Contract Compliance Manager
$1,301,001.70
$33,952.00
$23,868.30
Original Contract Amount
M&C Date Approved
Contractor's Company Name
Interstate Sealant & Concrete, Inc.
Contractor (Name)
Gregory A. Sment
Contract Signature
Senior Capital Project Officer
Director, Contracting Department (Dept)
DateProgram Manager
DateAssistant Director (Dept)
Assistant City Manager
10/22/2025
$5,502.00
$21,450.00
$1,572.00
$2,145.00
P-606 5.1 - Saw Kerf Repair, Complete
P-606 5.2 - Pavement Section Repair in and Around Light Base Tops, Complete
3.50
10.00
SF
EA
City of Fort Worth
Change Order Additions
Project Name AFW Joint Reseal & Pavement Repair - Phase I Construction City Sec # 63563
LS
N/A
Date
ADDITIONS
TotalUnit CostUnitQty
1.00
DEPTITEMDESCRIPTION
AviationCG-145 5.1 - Temp Fencing, Barricades, & Facilities2a
11
12
Client Project # 104463 & 106257
1 10/21/2025
Tyler Dale InspectorContractor
Change Order Submittal #
Interstate Sealant & Concrete, Inc.PM
$7,000.00$7,000.00
Aviation
Aviation
$33,952.00
$33,952.00
Sub Total Additions
Aviation
Change Order Additions Page 2 of 3
$23,868.30
$23,868.30
Sub Total Deletions
Date
Aviation
Client Project # 104463 & 106257
1 10/21/2025Change Order Submittal #
Contractor
City of Fort Worth
Change Order Deletions
Project Name AFW Joint Reseal & Pavement Repair - Phase I Construction City Sec # 63563
DELETIONS
Unit Cost
$45.00
Unit
P-101 5.2 - Spall Repair
P-605 5.1 - Joint Sealing Filler
$8,325.00
Total
LF
Qty
185.00000000
DEPTITEMDESCRIPTION
AviationP-101 5.1 - Crack Repair3
4
6
Aviation
Aviation
110.07000000
484.00000000
$14,309.10
$1,234.20
$130.00
$2.55
SF
LF
Interstate Sealant & Concrete, Inc. PM Tyler Dale Inspector N/A
Change Order Deletions Page 3 of 3
Routing and Transmittal Slip
___________________________________
Department
DOCUMENT TITLE: __________________________________________
M&C______________ CPN______________ CSO #______________ DOC#______________
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 No
RUSH:Yes No SAME DAY:Yes No NEXT DAY:Yes No
ROUTING TO CSO: Yes No
Action Required:
d
our Information
Signature/Routing and or Recording
Return to:Please call _____________________at ext._____ for pick up when completed. Thank you.
DATE: 10/22/2025 INITIALS DATE OUT
TO:
1. Roger Venables
2. Candace Pagliara
3. Valerie Washington
4. Janette Goodall
5.
6.
t Repair - Phase I Construction Change Order 1
Aviation
Tyler Dale 541
X
X
X
10 63563
City Secretarys Office
Contract Routing & Transmittal Slip
*Indicates the information is required and if the information is not provided, the contract will be
returned to the department.
Contractors Name:
Subject of the Agreement:
M&C Approved by the Council? * Yes No
If so, the M&C must be attached to the contract.
Is this an Amendment to an Existing contract? Yes No
If so, provide the original contract number and the amendment number.
Is the Contract Permanent? *Yes No
If unsure, see back page for permanent contract listing.
Is this entire contract Confidential?*Yes No If only specific information is
Confidential, please list what information is Confidential and the page it is located.
Effective Date: Expiration Date:
If different from the approval date. If applicable.
Is a 1295 Form required?* Yes No
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If applicable.
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes No
Contracts need to be routed for CSO processing in the following order:
(Approver)
Jannette S. Goodall (Signer)
Allison Tidwell (Form Filler)
Interstate Sealant & Concrete, Inc.
Change Order I for Phase I of the Joint Reseal & Pavement Repair construction
project at Perot Field Fort Worth Alliance Airport. This change order consisted of unforeseen, but necessary, field
condition repairs that were needed in order to re-open the runway.
CSC 63563 Change Order 1
Approval Date N/A
104463 & 106257