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Attest: (1
lannette S. Goodall, City Secretary
Facility and
FORTWORTUR,
City Of Fort Worth
Change Order Request
Funding (FID) No.(s) 36001 0350420 5740010104467 CAPEX 9999
ContraGtor:J Mart Inc.
City Project Mgr. Jackson Jones
Phone Number: 817 269-6578
CSC No. 63104-COI
City Sec No. 63104
City Project No 104467
ChangeOrder# 0 Date: 5127/20206
City Inspector: lJohn Fowler
Phone Number: 682 201-1918
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.
Contractor's Company Name
Contractor Nam
Contrac
Mart, Inc.
Oscar Bustos
/-- YJ —
05/27/2026
Tim Proctor (May 27, 2026 15:38:18 CDT)
spector
05/28/2026
John Fowler (May 28, 2026 07:03:43 CDT)
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;06/05;
PMD Superinten
ector -Property Management Departm
05/28/2026
Jac on J nes (MMy 28, 2026 07:38:02 CDT)
roject Manager
Sr. Assistant City Attorney
- 05/28/2026
Jac on Jones (MMy 281 2026 07:38:02 CDT)
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Stephen Hines (Junes. 2026 13:45:21 CDT)
06/08/2026
ject Arc itect
IIIIIIIIIIIIIIIIIsistant City Mana
Ken Randall 05/28/2026
Ken Randall (May 28 2026 08:41:29 CDT
Va.-wAlt�
06/09/2026
Valerie Washington Jun 9, 2026 10:41:51 CDT
M&C Number M&C Date Approved
Contract Compliance Manager: OFFICIAL RECORD
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including CITY SECRETARY Nikita Watts
ensuring all performance and reporting requirements. I FT. WORTH, TX I Sr. Capital Projects Officer
Change Order
OWNER D
ARCHITECT D
CONTRACTOR D
FIELD D
OTHER D
PROJECT: City of Fort Worth CHANGE ORDER NUMBER: 01
Bob Bolen Generators DATE: 4/2112026
505 W Felix St Fort Worth TX 76115 ENGINEER'S PROJECT NO.: PMD2024-07111
TO CONTRACTOR: CONTRACT DATE: 5/1/2025
Mart, Inc CONTRACT FOR: General Construction
1503 Perry Road
Irving, Texas 75060
The Contract is changed as follows:
Deduct Cost for unused,owner contingency
additional days for generator delivery, RFI Resposes on electrical needs/Change order negotiation, assessing landscape needs, reworking
of gas lines, lead time of generator commissioning
Not valid until signed by the Owner, Engineer and Contractor.
The original Contract Sum was $ 2,263,196.00
Net change by previously authorized Change orders S
The Contract Sum prior to this Change order was $ 2,263,196.00
The Contract Sum will beincreased by this Change Order in the amount of S (11,984.51)
The new Contract Sum including this Change order will be $ 2,251,211.49
The Contract Time will beincreased by 32C
The date of Substantial Completion as of the date of this Change Order therefore is 4/14/2026
NOTE: This summary does not reflect changes in the Contract Sum, Contract Timeor Guaranteed Maximum Price which
have been authorized by Construction Change Directive.
Baird. Hampton a Brown Mart, Inc.
ENGINEER(Firm Name) -----
6300 Ridalea Place 11700 Fort Worth TX 7611503 Perry li 0
Address Address
BY (Signature) BY A
J.DC/"'o/Z.
(Typed Name) (Typed Name)
S-: Z7.2b
DATE DATE
City of Fort Worth
OWNER (Firm Name)
100 Fort Worth Trl Fort Worth TX 76102
Address
BY (Signature)
(Typed Name)
DATE
FORT WORTH.
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: Mart, Inc.
Subject of the Agreement: Change Order to reconcile the construction contract
M&C Approved by the Council? * Yes ❑ No M
If so, the M&C must be attached to the contract.
Is this an Amendment to an Existing contract? Yes 0 No ❑ 63104
If so, provide the original contract number and the amendment number.
Is the Contract "Permanent"? *Yes 0 No ❑
If unsure, see backpage for permanent contract listing.
Is this entire contract Confidential? *Yes ❑ No 0 If only specific information is
Confidential, please list what information is Confidential and the page it is located.
Effective Date:
If different from the approval date.
Expiration Date:
If applicable.
Is a 1295 Form required? * Yes ❑ No ED
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If applicable. 104467
*Did you include a Text field on the contract to add the City Secretary Contract (CSC)
number? Yes 0 No ❑
Contracts need to be routed for CSO processing in the followingorder:
rder:
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.