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Home My WebLink About063488-CO1 - Construction-Related - Contract - C. Green Scaping, L.P.CSC No. 63488-COl FORT x, Project Namel SH 121 Public Art and Landscaping Client Project#(s)l CSJ 0363-03-056 ; CPN C01639 City of Fort Worth Change Order Request City Sec # l 63488 l l Project Description This project includes installation of large Fort Worth letters to create a sign which will be implanted with a mixture of native flowers and grasses. Contractor C. Green Scaping, L.P. Change Order#1 1 l Datel 1/30/2026 City Project Mgr.l Fanta Kaba City Inspectorl Toliver Lipka l Dept. Original Contract Amount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date lGo to ADD & DEL Tabs to Enter CO Backup Revised Contract Amount Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) TPW $571,578.40 Contract Time Totals (CD� $571,578.40 50 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 0.00% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST+ 25%) $714,473.00 JUSTIFICATION (REASONS) FOR CHANGE ORDER 150 150 The Contractor for this project has submitted RFI #1 for the C01639: SH 121 Public Art and Landscaping project, which requests to modify the dimensions of the plynth for the footers of the letters in order to accommodate the rebar. This change order does not propose changes to the bid items, quantities, or schedule. As there are State Funds, CFW will need to process a CO to accompany the TxDOT change order request. 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 Company Name Contractor (Name) Contract Signature Date C.Green Scaping,LPICarson Green I on( s,en (Feb 4, 2026 11'29 54 CST) 02/04/2026 Inspector/Inspection Supervisor Date Project and Contract Compliance Manager Date 02/04/2026 02/04/2026 anager rog:!rector Date Senior Capital Project Officer Date 02/13/2026 = : - 02/24/2026 (Dept) Date Director, Contracting Department (Dept) Date Patricia L. WatlsacR (Feb 27, 202612a9:16 CST) 02/27/2026 ,?� 03/01/2026 Assistant City Attorney Date Assistant City Manager Date 03/02/2026 03/10/2026 Council Action (if required) M&C Number ATTEST: Font7. as a -�d— P�o OoS=0 Jannette Goodall, City Secretary opt ao *� gaga nnaasa4 M&C Date Approved I I OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX FOW.IWIRTH City of Fort Worth ■ Change Order Additions Project Name I SH 121 Public Art and Landscaping City Sec # j 63488 Client Project # I CSJ 0363-03-056 ; CPN C01639 Contractorl C. Green Scalping, L.P. I PMI Fanta Kaba I Inspectorl Toliver Lipka Change Order Submittal # 0 Date j 1130/2026 ADDITIONS UEbUKIN I IUN UEP I Uty Unit Unit lost I otal I I I TPW $0.001 Sub Total Additions $0.001 Change Order Additions Page 2 of 3 HEM tM FORT WORTH City of Fort Worth Change Order Deletions Project Name I SH 121 Public Art and Landscaping City Sec # 1 63488 1 Client Project # I CSJ 0363-03-056 ; CPN 001639 1 Contractorl C. Green Scaping, L.P. I PMI Fame Kaba Inspectorl Toliver Lipka Change Order Submittal # 0 Date 1 1/30/2026 1 DELETIONS UM;RIPI ION DEPI Oty Unit Unit(;ost total 1 I 1 I 1 I 1 I I 1 I 1 I 1 I 1 I I 1 I I I I I I I I I I 1 1 I I 1 I I I 1 I I I I 1 I I I I I I I I 1 1 I 1 I I I I I I I I I I I 1 I I I I TOW $0.001 I I I Sub Total Deletions $0.001 Change Order Deletions Page 3 of 3 Change Order #, TxDOT Review 1. Contract Information LG Contract No: CSC 63488 CCSJ: 0363-03-056 Project No: None Contractor: C. Green Scaping, LP 2. Change Order Details LGP Guide 9.3.2 Date Received: 01/21/2026 County: Tarrant District: Fort Worth Highway: SH 121 Did the LG provide an adequate narrative describing the change(s) and the reason for the CO? E]Yes ❑No ❑N/A Did the LG provide adequate documentation to support the elements of the CO? - New/revised plan sheets for design changes? DYes ❑No ❑N/A - Cost analysis for any new contract items? ❑Yes ❑No EIN/A Total amount of Change Order: $ $ 0.00 - Time impact analysis for additional contract days? ❑Yes ❑No ❑N/A Additional days included in this change order: 0 3. Participation Determination* Are the costs associated with this CO eligible for participation? ❑Yes ❑No ❑N/A Note: Eligibility of costs does not guarantee availability of federal or state funds; refer to AFA for responsibility of cost overruns. Actual participation will be determined by the final project cost reconciliation. Current Contract Value: $ 571,578.40 Amount added by this Change Order: $ 0.00 Total Amount of Revised Contract Value: $ 571,578.40 Is the time extension associated with this CO eligible for participation? ❑Yes ❑No ❑N/A Current number of contract days: 150 Number of eligible days added by this CO: 0 Total number of approved contract days: 150 *Comments: Work appears necessary for completion of the project at no additional cost or time added to the project. Reviewed by: Kevin Spohrer Signature/Ti e Date: 1 /26/2026 Form 2146-LG TxDOT Review Please Note: This form is not a part of the CO or contract documents, but may be used by TxDOT for the (Rev 08/2024) completion of required activities as outlined by the Local Government Project Management Guide. Form (Rev. 0/1111))` CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: 01 Page 1 of 1 1. CONTRACTOR: C. Green Scaping, LP CCSJ: 036303056 2. Change Order Work Limits: Sta. 0+00.00 to Sta. 5+10.11 SH 121 Public Art Project: 3. Type of Change (on federal -aid non-exempt projects): Minor (MajorlMinor) Highway: SH 121 4. Describe the change and the reason for the change order. When necessary, include County: Tarrant exceptions to this agreement. District: Increasing the width of the plynths for the footers. They are interfering with the Contract rebar as the size in the plans. This is a minor no cost change order. Number: CSC 63488 5. New or revised plan sheet(s) are attached and numbered: Attached on Page 6 Each signatory hereby warrants that each has the authority to execute this Change Order. By signing this change order, the contractor agrees to waive any and all The following information must be provided claims for additional compensation due to any and all other expenses; additional changes fortime, overhead and profit or loss of compensation as a result of this change. Further, the contractor agrees that this agreement Time Ext. #: 0 Days added on this C.O.: 0 — is made in accordance with hem 4 and the Contract. Exceptions should be noted in the responsefor#5 above. Amt. added by this change order: $0.00 For TxDOT use only: THE CONTRACTOR Date 1/14/2026 Days participating: By. --- . _. Amount participating: Typed/Printed Name Carson Green Typed/Printed Title Project Manager RECOMMENDED FOR EXECUTION: Name/Title Date Name/Title Date NamefT'itle Date Will Herbert / President 1/21/2026 Name/Title Date Engineer's Seal: • ; 1 • WILL .A HERBERT•. I 92824 ' Signature Date Name/Title Name/Title Date APPROVED REQUEST APPROVAL Namefl-itle Date APPROVED ❑ REQUEST APPROVAL Name/Title Date ❑ APPROVED REQUEST APPROVAL Name[Title Date APPROVED TABLE A: Force Account Work and Materials Placed into Stock LABOR Faustino Salazar Eduardo Salazar Bartolo Gomez Alfredo Jimenez Gonzales Jhenry Remirez Perez CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: 01 Estimated Cost: MO CCSJ: 0363-03-056 Paid by Invoice? ([j Yes ❑ No ) EQUIPMENT HOURLY RATE HOURLY RATE 20.50 N/A 15.50 15.00 16.50 15.00 TABLES; Contract Items ORIGINAL + PREVIOUSLY NEW REVISED ITEM DESCRIPTION UNIT UNIT PRICE QUANTITY ITEM COST QUANTITY ITEM COST 17 Public Art (Letters) EA 35,485.00 9.00 319,365.00 9.00 319,365.00 TOTALS TXDOT Form 2146-L TAB (Rev. 10/11) Page 1 of 2 319,365.00 319,365.04 OVERRUN/ UNDERRUN 0.00 0.01 CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: TABLE B: Contract Items (Continued) ITEM DESCRIPTION UNIT UNIT PRICE The "Totals" from Table B of the previous work sheet: TOTALS TXDOT Form 2146-L TAB (Rev.10/11) Page 2 of 2 ORIGINAL+ PREVIOUSLY REV SED QUANTITY ITEM COST 319,365.Ocl 319,365.01 CCSJ: NEW QUANTITY ITEM COST 319365.0 319:365.O1 OVERRUN/ UNDERRUN 0.0(j 0.0c> DBE # HFDB75797N0322, MBE # HFMB37092N0323, WBE # HFWB06201NO323 GREEN SCAPING REQUEST FOR INFORMATION SH121 Public Art and Landscabing The Plynth detail shows it being 1'-6"SQ, this will interfere with the rebar due to the base plates being 1'-6" as well. We are requesting to make the plynth larger to be 2' Sq for the letters "F" and "T" and the other letters to be 2' width instead of 1'-6". Plan Page 39: 5" 5' 1 3/4" THICK BASE PLATE QO w/ (4) 3/4"0 ANCHOR BOLTS (1'-4" MIN EMBEDMENT) • -0 / d V PLAN VIEW O- TYP 39 CTYPICAL COL BASE PLATE DETAIL 1 112 = V-0" 2401 Handley Ederville Rd. • Fort Worth • Texas • 76118 Tel: 817.577.9299 • Fax: 817.577.9331 • Web: www.greenscaping.com 2" m 4'-ON SQUARE CLE77ER "T" FOUNDATION 3/4' = 1'-0" 1'-6" SQ PLYNTH REINF w/ (8) #5 VERT w/ 10- HOOK @ EA END & (3) #3 TIES b r FINAL GRADE 1I- I,III� i REINF FTG w/ M (4) #5 EA WAY n n 1 u n n IIIIIIIIIIII Is"- II 11 N II -III-I IIII II II , II II II II I II II -I ♦ 11 _)_ �_ 1 �-� 11 U CLETTER "W" FOUNDATION 3/4" = V-0" 61 I0N SQUARE m s 5'xl'-6" PLYNTH REINF w/ (14) #5 VERT w/ 10" HOOK @ EA END & (3) #3 TIES b FINAL GRADE z. =III III III=1 1=1 I 1=1 I REINF FTG wl (6) #5 EA WAY 2401 Handley Ederville Rd. • Fort Worth • Texas • 76118 Tel: 817.577.9299 • Fax: 817.577.9331 • Web: www.greenscaping.com Y�0' SO PLYNTH REINF w/ Y_4-� 5'x2'-0'PLYNTH (8)#"HOOK@REINFw/(14)#5 T VERT./10"HOOK@ EA ENEA END B(3)#3 TIES ', FINAL GRADE 2'CL — b YCLR b TCLR F FINAL GRADE r FINAL GRADE 1 II{r III I 11 IIII I61 6 a l 1I I I— 16" I �l �A�,. I 6' bl III= = I � I I I I I I IIII I 11 I I �I I III I� III III= ' ��III III1" ilI !I _ 1 �IL 1 1 y II R n - 4 � REINF FTG w/ 6 95 EA WAY Z$ REINF FTG REINF FTG w/ w/ () #5 EA WAY 6'-0' 8 #5 EA WAY SQUARE t SQUARE SQUARE C LETTER ' "FOUNDATION C LEETTER' "FOUNDATION ^ jE/4 ER-0R" FOUNDATION 5'x2'-0' PLYNTH �i Si PLYNTH 2'-0"SQ PLYNTH REINF w/(14)R5 REINFw/(14)7R5 REINF w/ (8) #5 VERT VERT w/ 10" HOOK @ VERT w/ 10' HOOK @ /10'HOOK @EA EA END&(3)#3 TIES I EA END &(3)#3 TIES it END & (3) #3 TIES 2'CLR rFINAL GRADE 2"CLR it f rFINAL GRADE YCLR 11 o rFINAL GRADE p11� 111 1 I6 III - I -s� II �I IIII��IIIIIIIII 1 1III11 III —III= IIIIIIIIIIIIY I 11�IIIII�ii,l :rt i i �J REINF FTG w/ REINF FTG w/ REINF FTG w/ 8-p - 4 #5 EA WAY 6 #5 EA WAY 6 95 EA WAY m m SQUARE SQUARE 4 SQUARE C LE/TTER "0T/ ' FOUNDATION 3'ETTER" FOUNDATION 34TTER "H" FOUNDATION 3 1.2 5" 5' 3/4" THICK BASE PLATE O 0 W (4) 314.0 ANCHOR BOLTS W-4' MIN C• EMBEDMENT) F 0 I a PLAN VIEW CTYPICAL COL BASE PLATE DETAIL 1 1'..= 1'-0" HEAVY HEX NUT & 114' HEAVY DUTY WASHER COL BEARING a pp ELEV — NOTE: ALL ANCHOR HEAVYHEX NUT AND BOLTS TOBEF1554 SDARDWASHER GR360R TAN OR HEAVY HEX BOLT y A36 THREADED ROD HEAD AND STANDARD WASHER 8 TYPICAL ANCHOR ROD DETAIL O NTS Revised Plan Revisions FINAL SUBMITTAL 05/24/2024 ZE F Tf ��1 / WILL ..11ERBERT / /i q, 92824 � LI(�'OAF </CENS6�.6��4ii 1.73. 24 . VAN 1, j� MAPPED AREA FORT WORTH HoH - ENGINEERING, INC 1055pmes Dhve Fon Wo0h, TX 76126 TBPE Firm No. F13825 (817) 7134977 Texas Department of Transportation SH 121 PUBLIC ART AND LANSCAPING SIGN FOUNDATION DETAILS STA. -0 + 90 TO STA. 7 + 00 I E.°N F,a�ER"� .xE IlvtZxlx.) Q aEnsloRxoornaarec TEXAS FTW TARRANT I I�1 0oL 3o 056 39 C01639-CNCO-SH 121 Public Art and Landscaping Project — Construction CO #1 Request Interim Agreement Report Created: 2026-02-04 By: Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) Status: Out for Signature Transaction ID: CBJCHBCAABAAiv15yUGQKyUOmZYIHswl5x_nEPmpC9-z Agreement History 2026-02-12 Agreement history is the list of the events that have impacted the status of the agreement prior to the final signature. A final audit report will be generated when the agreement is complete. "C01639-CNCO-SH 121 Public Art and Landscaping Project — C onstruction CO #1 Request" History Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) 2026-02-04 - 1:54:24 AM GMT- IP address: 204.10.90.100 Document emailed to Alexandra Ripley(aexandra.ripley@fortworthtexas.gov) for filling 2026-02-04 - 4:11:57 PM GMT Document emailed to carson@greenscaping.com for signature 2026-02-04 - 4:11:57 PM GMT Document emailed to Toliver Lipka (Toliver.Lipka@fortworthtexas.gov) for signature 2026-02-04 - 4:11:58 PM GMT Document emailed to Fanta Kaba (fanta.kaba@fortworthtexas.gov) for signature 2026-02-04 - 4:11:58 PM GMT Email viewed by Toliver Lipka (Toliver.Lipka@fortworthtexas.gov) 2026-02-04 - 4:14:06 PM GMT- IP address: 172.58.111.217 Document e-signed by Toliver Lipka (Toliver.Lipka@fortworthtexas.gov) Signature Date: 2026-02-04 - 4:15:44 PM GMT - Time Source: server- IP address: 172.58.111.217 FORTWORTH, Powered by Adobe Acrobat Sign Email viewed by carson@greenscaping.com 2026-02-04 - 5:28:24 PM GMT- IP address: 137.27.173.66 6, Signer carson@greenscaping.com entered name at signing as Carson Green 2026-02-04 - 5:29:52 PM GMT- IP address: 137.27.173.66 Document e-signed by Carson Green (carson@greenscaping.com) Signature Date: 2026-02-04 - 5:29:54 PM GMT - Time Source: server- IP address: 137.27.173.66 Document e-signed by Fanta Kaba (fanta.kaba@fortworthtexas.gov) Signature Date: 2026-02-04 - 9:45:00 PM GMT - Time Source: server- IP address: 208.184.124.181 Email viewed by Alexandra Ripley (alexandra.ripley@fortworthtexas.gov) 2026-02-09 - 9:54:35 PM GMT- IP address: 104.47.65.254 Form filled by Alexandra Ripley (alexandra.ripley@fortworthtexas.gov) Form filling Date: 2026-02-09 - 9:57:49 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Chad Allen (Chad.Allen@fortworthtexas.gov) for signature 2026-02-09 - 9:57:52 PM GMT FORT WORTH. Powered by Adobe Acrobat Sign C01639-CNCO-SH 121 Public Art and Landscaping Project - Construction CO #1 Request Final Audit Report 2026-03-12 Created: 2026-02-13 By: Andrea Munoz (Andrea. Mu noz@fortworthtexas.gov) Status: Signed Transaction ID: CBJCHBCAABAA9ZRSwzpUKUggSnfTxro6fNowpNAecp6B "C01639-CNCO-SH 121 Public Art and Landscaping Project - C onstruction CO #1 Request" History Document created by Andrea Munoz (Andrea.Munoz@fortworthtexas.gov) 2026-02-13 - 3:37:07 AM GMT- IP address: 204.10.90.100 Document emailed to Chad Allen (Chad.Allen@fortworthtexas.gov) for signature 2026-02-13 - 3:15:29 PM GMT L:o Document e-signed by Chad Allen (Chad.Allen@fortworthtexas.gov) Signature Date: 2026-02-13 - 9:06:04 PM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) for signature 2026-02-13 - 9:06:08 PM GMT L-4 Document e-signed by Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) Signature Date: 2026-02-24 - 3:03:17 PM GMT - Time Source: server- IP address: 204.10.90.100 Document emailed to Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) for signature 2026-02-24 - 3:03:22 PM GMT Signer Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) entered name at signing as Patricia L. Wadsack 2026-02-27 - 6:19:14 PM GMT- IP address: 208.184.124.181 Document e-signed by Patricia L. Wadsack (patricia.wadsack@fortworthtexas.gov) Signature Date: 2026-02-27 - 6:19:16 PM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to Lauren Prieur(Lauren.Prieur@fortworthtexas.gov) for signature 2026-02-27 - 6:19:20 PM GMT FORTWORTH. DO -e4by Adobe Acrobat Sign -= Document e-signed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) Signature Date: 2026-03-02 - 0:34:51 AM GMT - Time Source: server- IP address: 76.227.105.128 Document emailed to Lorita Lyles (Lorita.Lyles@fortworthtexas.gov) for approval 2026-03-02 - 0:34:54 AM GMT Email viewed by Lorita Lyles (Lorita.Lyles@fortworthtexas.gov) 2026-03-02 - 2:07:46 PM GMT- IP address: 104.47.64.254 Document approved by Lorita Lyles(Lorita.Lyles@fortworthtexas.gov) Approval Date: 2026-03-02 - 2:27:01 PM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to Douglas Black (Douglas.Black@fortworthtexas.gov) for signature 2026-03-02 - 2:27:04 PM GMT Document e-signed by Douglas Black (Douglas.Black@fortworthtexas.gov) Signature Date: 2026-03-03 - 0:20:50 AM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to Jesica McEachern Qesica.mceachern@fortworthtexas.gov) for signature 2026-03-03 - 0:20:54 AM GMT Document e-signed by Jesica McEachern Qesica.mceachern@fortworthtexas.gov) Signature Date: 2026-03-10 - 5:34:31 AM GMT - Time Source: server- IP address: 204.10.90.100 Document approval automatically delegated to Cristian Chavez (cristian.chavez@fortworthtexas.gov) by Katherine Cenicola (katherine.cenicola@fortworthtexas.gov) 2026-03-10 - 5:34:34 AM GMT Document emailed to Cristian Chavez (cristian.chavez@fortworthtexas.gov) for approval 2026-03-10 - 5:34:35 AM GMT Document emailed to Katherine Cenicola (katherine.cenicola@fortworthtexas.gov) for approval 2026-03-10 - 5:34:35 AM GMT 3 Document approved by Cristian Chavez (cristian.chavez@fortworthtexas.gov) Approval Date: 2026-03-11 - 2:15:57 PM GMT - Time Source: server- IP address: 208.184.124.181 Document emailed to Jannette Goodall Oannette.goodall@fortworthtexas.gov) for signature 2026-03-11 - 2:15:59 PM GMT Email viewed by Jannette Goodall Qannette.goodall@fortworthtexas.gov) 2026-03-11 - 7:09:53 PM GMT- IP address: 104.47.65.254 Document e-signed by Jannette Goodall 0annette.goodall@fortworthtexas.gov) Signature Date: 2026-03-11 - 7:10:18 PM GMT - Time Source: server- IP address: 208.184.124.181 FORTWORTH. "by Adobe Acrobat Sign Form filling automatically delegated to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) by Allison Tidwell (allison.tidwell@fortworthtexas.gov) 2026-03-11 - 7:10:21 PM GMT Document emailed to Allison Tidwell (allison.tidwell@fortworthtexas.gov) for filling 2026-03-11 - 7:10:21 PM GMT Document emailed to Elisa Winterrowd (Elisa.Winterrowd@fortworthtexas.gov) for filling 2026-03-11 - 7:10:22 PM GMT 0;� Form filled by Allison Tidwell (allison.tidwell@fortworthtexas.gov) Form filling Date: 2026-03-12 - 1:39:32 PM GMT - Time Source: server- IP address: 208.184.124.181 Q Agreement completed. 2026-03-12 - 1:39:32 PM GMT FORTWORTH. "by Adobe Acrobat Sign FORT WORTH.., Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: SH 121 Public Art and Landscaping Project — Construction CO #1 Request M&C: CPN: C01639 CSO: 63488 DOC#: 1 Date: To: Name Department Initials Date Out 1. Alexandra Ripley TPW 02/09/2026 2. Carson Green Vendor 02/04/2026 3. Toliver Lipka TPW TL 02/04/2026 4. Fanta Kaba TPW � 02/04/2026 5. Chad Allen TPW 02/13/2026 6. Lissette Acevedo TPW 02/24/2026 7. Patricia Wadsack TPW AD 02/27/2026 8. Lauren Prieur TPW Director 03/01/2026 9. Doug Black Legal 03/02/2026 10. Jesica McEachern CMO CA 03/10/2026 11 Jannette Goodall CSO e' ��ooda„ 03/11/2026 12 TPW Contracts TPW CC: Program Manager, Sr. CPO, TPW BSPAP Recon Team, TPW Records Room, TPW Contracts ALSO List: -Bus Sppt: Alex Ripley; Prg Mgr: Chad Allen; Sr CPO: Lissette Acevedo 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: DYES ®No RUSH: DYES ®No SAME DAY:DYES ❑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 TPWContracts(a fortworthtexas.Liov for pickup when complete. Call ext. 7233 or ext. 8363 with questions. Thank you! CONSTRUCTION CONTRACT ROUTING & TRANSMITTAL SLIP 1 Eff 06.21.23, mdhm FORT WORTH. City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: C. Green Scaping, L.P. Subject of the Agreement: Change Order No. 1 to CSC No.63488, a Contract for the Construction of SH 121 Public Art and Landscaping Project M&C Approved by the Council? * Yes ❑ No 8 If so, the M&C must be attached to the contract. Is this an Amendment to an Existing contract? Yes ❑ No 8 If so, provide the original contract number and the amendment number. Is the Contract "Permanent"? *Yes 8 No ❑ If unsure, see back page for permanent contract listing. Is this entire contract Confidential? *Yes ❑ No 8 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 8 *If so, please ensure it is attached to the approving M&C or attached to the contract. Project Number: If applicable. C01639 *Did you include a Text field on the contract to add the City Secretary Contract (CSC) number? Yes 8 No ❑ Contracts need to be routed for CSO processing in the following order: 1. Katherine Cenicola (Approver) 2. Jannette S. Goodall (Signer) 3. Allison Tidwell (Form Filler) *Indicates the information is required and if the information is not provided, the contract will be returned to the department.