HomeMy WebLinkAbout064036-CO3 - Construction-Related - Contract - Jackson Construction, Ltd.CSC No. 64036-CO3
FORT WC7RTH
Change Order Request
Project Name I Sanitary Sewer Contract 127- Marys Creek 12-Inch Sanitary Sewer (M-259) Relocation City Sec No. 64036
Project No.(s) 560021070043015740010/001780 DOE No. N/A City Pro. No. 1104976
Project Sanitary Sewer Contract 127 - Replacement of—1,400LF of Marys Creek 12-Inch Sanitary Sewer (M-259)
Description
Contractorl Jackson Construction, Ltd. Change Order # 0 Date: 612612026
City Project Mgr. I Parvathi Sreekumaran Unnithan City Inspector Stephen Martinez
Phone Number: 817-392-7803 Phone Number: 817-392-6051
Dept.
Original Contract Amount
Extras to Date
Credits to Date
Pending Change Orders (in M&C Process)
Contract Cost to Date
JAmount of Proposed Change Order
Revised Contract Amount
Orig. Funds Available for Change Orders
Remaining Funds Available for this CO
Additional Funding (if necessary)
Water Unit 1
Sewer Unit 2
Paving Unit 3
Totals
Contract Time
(Calendar Days)
$2,150,260.00
$2,150,260.00
155
$262,860.00
$262,860.00
30
$206,306.40
1 $206,308.40
$2,619,428.40
$2,619,428.40
185
$0.00
$0.00
1
$2,619,428.40
$2,619,428.40
185
$107,513.00 1 $107,513.00
CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 21.82%
$2,687,825.00
I JUSTIFICATION (REASONS) FOR CHANGE ORDER
I Change Order No. 3 primarily provides for additional mill and overlay on a pavement segment located west of the
I bridge on Chapin Road as previously requested by the City of Benbrook and agreed by the City of Fort Worth
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
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.
Contractors Company Name
Contractor Name
Contractor Sic � :ture
Date
Jackson Construction, Ltd.
Carmen Estep
_
�i ��'jf��� &/)
06/26/2026
Inspector
Project Manager
Date
1
� ,
06/26/2026
Director
Cons ction a emsn �
Date
TS
A
_ r
Senior Assistant City Attorney
ssistant Cit ana er
Date
ouglas Buck jJW 14. 2026IS 11 18 CDT)
08/1 5/2026
Council Action if required)
M&C Number NIA M&C Date Approved
FORT WO RT H City of Fort Worth
Change Order Additions
Project Name Sanitary Sewer Contract 127 - Marys Creek 12-Inch Sanitary Sewer (M-259) Relocation City Sec No. 64036
Project No.(s) 56002/0700430/5740010/001780 DOE No. 1 N/A City Pro. No. 104976
Project
Description
Sanitary Sewer Contract 127 - Replacement of—1,400LF of Marys Creek 12-Inch Sanitary Sewer (M-259)
Contractor Jackson Construction, Ltd. Change Order # 1 3 Date: 6/2412026
City Project Mgr. Parvathi Sreekumaran Unnithan City Inspector Stephen Martinez
ADDITIONS
Page 1 of 1
FORT WORTH City of Fort Worth
Change Order Deletions
Project Name Sanitary Sewer Contract 127 - Marys Creek 12-Inch Sanitary Sewer (M-259) Relocation City Sec No. 64036
Project No.(s) 56002/0700430/5740010/001780 DOE No. N/A City Pro. No. 104976
Project Description Sanitary Sewer Contract 127 - Replacement of—1,400LF of Marys Creek 12-Inch Sanitary Sewer (M-259)
Contractor Jackson Construction, Ltd. Change Order #= Date 6/24/2026
CityProject Mgr. Parvathi Sreekumaran Unnithan City Inspector Stephen Martinez
DELETIONS
Page 1 of 1
Contract Compliance Manager
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Signature
Parvathi Sreekumaran Unnithan
Name of Employee
Project Manager
B�
Title aoFF°p*,�a,
A8 Vod
ATTEST:
�{�c#si °°an neza5o4
Jannette S. Goodall
City Secretary
OFFICIAL RECORD
CITY SECRETARY
FT. WORTH, TX
FORT WORTH.
City Secretary's Office
Contract Routing & Transmittal Slip
Contractor's Name: Jackson Construction, Ltd.
Subject of the Agreement: Sanitary Sewer Contract 127 Marys Creek 12-inch Sanitary Sewer (M-259)
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 ❑ 64036-CO3
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: 6/26/2026
If different from the approval date.
Expiration Date: N/A
If applicable.
Is a 1295 Form required? * Yes ❑ No 21
*If so, please ensure it is attached to the approving M&C or attached to the contract.
Project Number: If applicable. 104976
*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.