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Home My WebLink About057280-CO4 - Construction-Related - Contract - Circle C Construction CompanyCSC No. 57280-CO4 Fowl NVOin it City of Fort worth Change Order Request Project Name Westcliff Drainage Improvements Ph 1 and Contract 91 Pt 2 co Sec # 57280 Client Project #(s) C01669 & C01957 Project Description TPWand Water Department partnership constructing storm drain, water poe, and sanitary sewer improvements in the Westcliff neighborhood Contractor Circle C Construction Company Change Order # 4 1 Date 6/2512026 City Project Mgr. Berton Guidry City Inspector I Brian McGill Dept. Original Contract Amount Extras to Date Credits to Date Pending Change Orders (in M&C Process) Contract Cost to Date Original Funds Available for Change Orders Remaining Funds Available for this CO Additional Funding (if necessary) TPW I Water I Sewer Totals Contract Time (CD) 663,252.60 730 338,463.35 392 001, 715.95 1,122 i210,006.05 308 791, 709.90 1430 590.293.00 I 1 1 $29,747.57 1 1 $29,747.57 1 CHANGE ORDERS to DATE (INCLUDING THIS ONE) AS % OF ORIGINAL CONTRACT 1 21.34% MAX ALLOWABLE CONTRACT AMOUNT (ORIGINAL CONTRACT COST + 25%) 1 $18,329,065.75 FOR This change order is being provided to reconcile final construction quantities with the contract quantities. 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 Circle C Construction I Keegan Jonkers a 07/10/2026 Ins ector/Ins pection Su ervisor Date Project and Contract Compliance Manager Date 07/13/2026 07/09/2026 'Program Manager Date Senior Capital Project Officer Date 07/21/2026 - - 07/21/2026 Assistant Director (Dept) Date Director Contractlog Department (Dent) Date Pain"" L. WA') W-'r- Patricia L. VVad—k :Jul 28 2026 10:54:07 CDT; 07/28/2026 ' '�^ 3,,,oa„ �- 07/28/2026 Assistant City Attorney Date Assistant City er Date = 08/03/2026 , 111,. o,4-3azs„3r33C 08/14/2026 Council Action (if required) ATTEST y Jannette Goodall, City Secretary o�oaa�� M&C Number M&C 26-0517 c* FOR?pad pro °.10 Ov8 �=o Cain nEz o5dp M&C Date Approved 1 6/23/2026 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Fop %'AN-i H City of Fort Worth ""r- Change Order Additions Project Name Westcliff Drainage Improvements Ph 1 and Contract 91 Pt 2 City Sec # 57280 Client Project # C01669 & C01957 Contractor Circle C Construction Company PM Berton Guidry Inspector F Brian McGill Change Order Submittal # ® Date 6/25/2026 ADDITIONS Unit Unit Cost o a CONTRACT 91 UNIT 1: WATER IMPROVEMENTS (WATER) C91-11 3311.044112"Water Pipe Water 2111.00 LF $137.00 $289,207.00 C91-13 3311.02418"Water Pipe water 404.00 LF $80.00 $32,320.00 C91-14 3311.01416"Water Pipe water 1&00 LF $60.00 $1,080.00 C91-15 3311.02548"DIP Water Pipe w/CLSMBackfill Water 278.00 LF $185.00 $51,430.00 C91-18 3312.30026"Gate Valve Water 1.00 EA $1,500.00 $1,500.00 C91-1 22 0241.1300 Remove Existing Concrete Curb and Gutter (50150, 100% Water, Refer to Pavement Layout Sheet) Water 352.01 LF $5.00 $1, 760.05 C91-1 23 0241.1300 Remove Existing Concrete Curb and Gutter (25/25/50 Water/Sewer/Storm, Refer to Pavement Layout Water 96.05 LF $5.00 $480.25 C91-1 24 3216.0102Install New Concrete Curb and Gutter (match existing) (50150, 100% Water) Water 272.50 LF $35.00 $9, 537.50 C91-125 3216.0102Install New Concrete Curb and Gutter (match existing) (25/25/50 Weter/Sewer1Storm) Water 96.05 LF $35.00 $3,361.75 C91-1 26 0241.0401 Remove Existing 6-Inch Concrete Driveway (50150, 100% Water) Water 2897.04 SF $7.50 $21,727.80 C91-127 Remove Existing 6-Inch Concrete Driveway (2525/50Water /Sewer/Storm) Water 797.03 SF $7.50 $5,977.73 C91-128 3213.0401 Install New 6-Inch Concrete Driveway (50150, 100% Water) Water 3532.82 SF $22.00 $77,722.04 C91-129 3213.0401 Install New 6-Inch Concrete Driveway (25125150 Water/Sewer/Storm) Water 775.03 SF $22.00 $17,050.66 C91-130 0241.0100 Remove 4-Inch Concrete Sidewalk (50150,f00%Water) Water 1397.50 SF $5.00 $6,987.50 C91-131 3213.0301 Install New 4-Inch Concrete Sidewalk (50150, 100% Water) Water 1337.50 SF $22.00 $29,425.00 C91-135 0241.1700 11-Inch Pavement Pulverization (2525150Water/SewenStorm) Water 1205.33 SY $11.50 $13,861.30 C91-136 3211.33 8-Inch Chem -Lime Stabilization @ 32Lbs/SY (50150, 100% Water) Water 5.75 TN $325.00 $1, 868, 75 C91-137 3211.33 8-Inch Chem -Lime Stabilization @ 32Lbs/SY (25/25/50 Water/Sewerlstorm) Water 0.75 TN $325.00 $243.75 C91-140 3212.03033-Inch Surface Course Asphalt, Type"D" (2525/50 Water/Sewer/Storm) Water 505.33 SY $21.10 $10,662.46 C91-143 3305.0111 Water Valve Box Adjustment with Concrete Collar (50150, 100%Water) Water 0.50 EA $550.00 $275.00 C91-145 3305.0107 Manhole Adjustment With Concrete Collar (50150, 100% Water) Water 0.50 EA $1,500.00 $750.00 C91-150 3291.0100 Topsoil (25125150 Water/Sewer/Storm) Water 45.00 CY $35.00 $1,575.00 C91-151 3292.010061ockSodPlacement(50150,100%Water) Water 475.00 SY $10.00 $4,750.00 C91-156 3213.04516"Concrete Driveway, Exposed Aggregate Water 71.44 SF $65.00 $4,643.60 C91-162 3201.0400TemporaryAsphaftPavement Repair Water 2382.00 LF $22.00 $52,404.00 C91-164 3471.0001Traffic Control (Design -Install -Maintain -Remove) Water 7.00 MO $4,500.00 $31,500.00 SUBTOTAL: 672,101.14 CONTRACT 91 UNIT 2: SANITARY SEWER IMPROVEMENTS (WATER) C91-21 3331.41158"PVC Sanitary Sewer Pipe Sewer 185.00 LF $70.00 $12,950.00 C91-2 4 3331.1102 8" Sanitary Sewer By Pipe Enlargement Method Sewer 1105.00 LF $65.00 $71, 825.00 C91-25 3305.3002 8"Sewer Camer Pipe Sewer 90.00 LF $95.00 $8,550.00 C91-28 3305.110216"Steel Casing By Other Than Open Cut Sewer 96.00 LF $800.00 $76,800.00 C91-29 3331.1201 Service Reinstatement for Pipe Enlargement Sewer 8.00 EA $1,200.00 $9,600.00 C91-210 3331.3102 4"2-Way Cleanout Sewer 352.00 EA $250.00 $88,000,00 C91-211 3331.31014" Sanitary Sewer Service Sewer 11.00 EA $1,200.00 $13,200.00 C91-217 3339.1001 4'Diameter Sanitary Sewer Manhole Sewer 8.00 EA $6,500.00 $52,000,00 C91-218 3339.10024'DiameterSanHarySewerDropManhole Sewer 1.00 EA $7,500.00 $7,500.00 C91-219 3339.1003 Extra Depth for 4'Diameter Sanitary Sewer Manhole Sewer 11.00 VF $200.00 $2,200.00 C91-220 3339.0001 Epoxy Liner for Sanitary Sewer Manhole Sewer 40.05 VF $325.00 $13,016.25 C91-225 0241.2201 Remove Sanitary Sewer Manhole Sewer 10.00 EA $1,000.00 $10,000.00 C91-228 3110.0104 18"-24" Tree Removal Sewer 7.00 EA $1,850.00 $12,950.00 C91-231 3301.0001PreconstructionCCTVInspection ofSanitary Sewer Pipe Sewer 1100.00 LF $5.00 $5,500.00 C91-2 32 3301.0002 PostconsWction CCTV Inspection of Sanitary Sewer Pipe Sewer 979.00 LF $5, 00 $4,895.00 C91-233 3305.0109 Trench Safety for Excavations > 5'Depth Sewer 185.00 LF $1,00 $185.00 C91-234 3291.0100 Topsoil (50150, 100% Water) Sewer 40.00 CY $25,00 $1,000,00 C91-236 3292.010081ockSod Placement (50150,100%Water) Sewer 2099.80 SY $10,00 $20,998.00 C91-239 3305.0103Exploratory Excavation ofExistingUtilities Sewer 8.00 EA $1,500.00 $12,000,00 C91-2 40 3201.0112 T Wide Asphalt Pvmt Repair, Residential Sewer 65.00 LF $55.00 $3, 575.00 C91-241 3201.0201Asphalt PvmtRepairBeyondDefined Width, Residential Sewer 637.00 SY $35.00 $22,295.00 C91-2 43 0241.1300 Remove Existing Concrete Curb and Gutter (2525/50 Water/Sewer/Storm) Sewer 186.13 LF $5.00 $930.65 C91-2 45 3216.0102Install New Concrete Curb and Gutter (match existing) (25125150 Water/SewerlStorm) Sewer 186.13 LF $35.00 $6, 514.55 C91-246 0241.0401 Remove Existing 6-Inch Concrete Driveway (50/50, 100% Water) Sewer 3086.21 SF $5.00 $15,431.05 C91-2 47 0241.0401 Remove Existing 6-Inch Concrete Driveway (25125150 WaterlSewer/Storm) Sewer 875.47 SF $5.00 $4,377.35 C91-2 48 3213.0401 Install New 6-Inch Concrete Driveway (50150, 100% Water) Sewer 3536.89 SF $25.00 $88,422.25 C91-2 49 3213.0401 Install New 6-Inch Concrete Driveway (2525150 Water /SewerlStorm) Sewer 885.03 SF $25.00 $22,125.75 C91-2 50 0241.0100 Remove 4-Inch Concrete Sidewalk (50150, 100% Water) Sewer 74.50 SF $5.00 $372.50 C91-251 3213.0301 Install New 4-Inch Concrete Sidewalk (50150, 100% Water) Sewer 74.50 SF $25.00 $1,862.50 C91-253 3216.0302Install New 7"Concrete Valley Gutter (50150, 100% Water) Sewer 19.92 SY $5,500.00 $109,560.00 C91-255 0241.1700 11-Inch Pavement Pulverization (2525150Waterlsewen'storm) Sewer 1205.33 SY $11.50 $13,861.30 C91-2 56 3211.33 8-Inch Chem -Lime Stabilization @ 32Lbs/SY (50150, 100% Water) Sewer 5.75 TN $325.00 $1, 868.75 C91-2 57 3211.33 8-Inch Chem -Lime Stabilization @ 32Lbs/SY (25/25/50 Water/Sewer/Storm) Sewer 0.75 TN $325.00 $243.75 C91-260 321ZO3033-Inch Surface Course Asphalt, Type"D" (25/25/50 Water/Sewer/Storm) Sewer 505.33 SY $21.10 $10,662.46 C91-2 63 3305.0111 Water Valve Box Adjustment with Concrete Collar (50/50 100% Water) Sewer 0.50 EA $550.00 $275.00 C91-2 65 3305.0107 Manhole Adjustment With Concrete Collar (50150, 100% Water) Sewer 0.50 EA $1,500.00 $750.00 C91-2 69 0241.0500 Remove Fence Sewer 10.00 LF $5.00 $50.00 C91-272 3231.01448'SteelTube Fence Sewer 30.00 LF $65.00 $1,950.( C91-2 73 3231.04138'Fences, Wood Sewer 340.00 LF $25.00 $8,500.(10 Change Order Additions Page 1 of 2 Fop NIAM, H City of Fort Worth " - Change Order Additions Project Name Westcliff Drainage Improvements Ph and Contract 91 Pt 2 City Sec # 57280 Client Project # C01669 & C01957 Contractor Circle C Construction Company PM Berton Guidry Inspector F Brian McGill Change Order Submittal# ® Date 6/25/2026 ADDITIONS y unit UnitCost Iota] C91-2 76 3213.04516"Concrete Driveway. Exposed Aggregate Sewer 79.00 SF $70.00 $5,530.00 C91-2 77 3201.0400 Temporary Asphalt Pavement Repair Sewer 5478.00 LF $22.00 $120,516.00 C91-278 3231.0113 6'Chain Link Fence Sewer 270.00 LF $25.00 $6,750.00 C91-281 9999.0003 Temporary Fencing Sewer 5100.00 LF $10.00 $51,000.00 C91-2 86 3471.0001 Traffic Control (Install -Maintain -Remove) Sewer 11.00 MO $41500.00 $49,500.00 SUBTOTAL: 970,093.11 WESTCLIFF UNIT 1: WATER IMPROVEMENTS (TPW) WC-12 3311.02528"DIP Water, CSS Backfill TPW 12.00 LF $185.00 $2,220.00 WC-18 3304.0101 Temporary Water Service TPW 1.00 LS $3,500.00 $3,500.00 SUBTOTAL: $5,720.00 WESTCLIFF UNIT SANITARY SEWER IMPROVEMENTS (TPW) WC-2 2 3331.4119 8" DIP Sewer Pipe (Acceptable backfill) TPW 28.00 LF $185.00 $5,180.00 WC-2 3 3331.4116 8" DIP Sanitary Sewer, CSS backfill TPW 99.00 LF $205.00 $20, 295.00 WC-213 3305.0103 Exploratory Excavation of Existing Utilities TPW 1.00 EA $1,550.00 $1,500.00 UBT TAL: 26,975.00 WESTCLIFF UNIT 3: DRAINAGE IMPROVEMENTS (TPW) WC-34 0171.0101 Construction Staking TPW 0.20 LS $15,000.00 $3,000.00 WC-3 7 0241.1015 Remove 12"Water Line TPW 1555.00 LF $25.00 $38,875.00 WC-3 10 0241,3013 Remove 18" Storm Line TPW 32.00 LF $45.00 $1,440.00 WC-314 0241.4001 Remove l0'CurbInlet TPW 3.00 EA $1,500.00 $4,500.00 WC-3 16 0241,3001 Storm Line Grouting (60) TPW 325.00 CY $150.00 $48,750.00 WC-3 19 3341.0205 24"RCP, Class III TPW 37.00 LF $90.00 $3,330.00 WC-320 3341,0309 36" RCP, Class III TPW 25.00 LF $100.00 $2,500.00 WC-3 22 3341.0602 60" RCP, Class III TPW 14.00 LF $700.00 $9, 800.00 WC-325 3341,2004 10x7 Box Culvert TPW 2.00 LF $1.245.00 $2,490.00 WC-326 3341.200510x8Box Culvert TPW 8.00 LF $1,290.00 $10,320.00 WC-327 3349.5001lo'Curbinlet TPW 3.00 EA $6.500.00 $19,500.00 WC-331 3349.8003 20'Type 2 Inlet TPW 5.00 EA $15,000.00 $75,000.00 WC-3 38 3201.0400 Temporary Asphalt Paving Repair (2" HMAC on 6"Flex Base) TPW 1650.00 LF $40.00 $66,000.00 WC-3 45 3137.0104 Medium Stone Riprap, dry (placed, 18) TPW 10.00 SY $250.00 $2, 500.00 WC-351 9999.0004 Concrete Steps TPW 8.39 CY $15,000.00 $125,850.50 SUBTOTAL: 413,855.00 WESTCLIFF UNIT 4: PAVING IMPROVEMENTS (TPW) WC-41 0171.0101 Construction Staking TPW 0.50 LS $8,500.00 $4,250.00 WC-4 3 0241.0401 Remove Concrete Drive (100%Trail Lake, Manderly TPW 66.19 SF $5,00 $330.95 WC-4 4 0241.0401 Remove Concrete Drive (50%Anita, Suffolk) TPW 117.00 SF $5.00 $585.00 WC-4 7 0241.1300 Remove Conc Curb & Gutter (100% Trail Lake, Manderly) TPW 88.00 LF $7.50 $660.00 WC-4 8 0241.1300 Remove Conic Curb & Gutter (50%Anita, Suffolk) TPW 643.75 LF $7.50 $4,828.13 WC-411 0241.1700Pavement Pulverizatlon(11"pulverize,3"cut)(100%TradLake,Mannerly) TPW 1411.66 SY $11.50 $16,234.09 WC-413 3211.0600Cement (26lbs/sy)(100%Manderly) TPW 211.50 TON $335.00 $70,852.50 WC-4 15 32120303 3"Asphalt Pavement Type D (100% TrailLake, Manderly) TPW 1378.66 SY $21.10 $29,089.73 WC-417 3213.0104 9"ConcPvmt TPW 0.80 SY $125.00 $100.00 WC-4 22 3213.0401 6"Concrete Driveway (50%Anita. Suffolk) TPW 159.47 SF $20.00 $3,189.40 WC-423 3213.04516"Concrete Driveway, Exposed Aggregate (50% Anita, Suffolk) TPW 51.44 SF $25.00 $1,286.00 WC-4 24 3291.0100 6" Topsoil (100%Trail Lake. Manderly) TPW 303.75 CY $25.00 $7,593.75 WC-4 26 3292.0100 Block Sod Placement (100% TrailLake, Manderly) TPW 274.26 SY $10.00 $2, 742.60 WC-4 32 3305.0111 Valve Box Adjustment (w/Concrete Collar) (100%Trail Lake. Manderly) TPW 8.00 EA $550.00 $4,400.00 SUBTOTAL: 146,142.15 WESTCLIFF UNIT 5: LANDSCAPING (TPW) WC-515 3231.0133 6'Wroughttron Fence TPW 200.00 LF $145.00 $29,000.00 SUBTOTAL: $29,000.00 15 Water $672,101.14 Sewer $970,093.11 Su TotalAdditions 2 3, 86. 0 Change Order Additions Page 2 of 2 Fca 1�ia City of Fort Worth Change Order Deletions Project Name Westcliff Drainage Improvements Phl and Contract 91 Pt 2 City Sec # 57280 Client Project# C01669 & C01957 Contractor Circle C Construction Company PM I Berton Guidry Inspector FBrian McGill Change Order Submittal # ® Date 5/6/2026 DELETIONS y Unit UnitCost o a CONTRACT 91 UNIT 1: WATER IMPROVEMENTS (WATER) C91-12 3311.0464 12" PVC Water Pipe (Restrained Pipe) Water 125.00 LF $155.00 $19,375.00 C91-16 3305.2004 12" Water Carner Pipe Water 80.00 LF $185.00 $14,800.00 C91-1 7 3305,1103 20" Casing By Other Than Open Cut water 80.00 LF $600.00 $48, 000.00 C91-110 3312.300512"Gate Valve Water 2.00 EA $3,000.00 $6,000.00 C91-113 0241.12184"to12"Pipe Abandonment Plug water 3.00 EA $1,500.00 $4,500.00 C91-114 3312.0001Fire Hydrant Water 2.00 EA $4,200.00 $8,400.00 C91-115 0241.1510 Salvage Fire Hydrant Water 1.00 EA $1,000.00 $1,000.00 C91-116 3312.0117Connection toExisting 4"to12"Water Main Water 6.00 EA $1,500.00 $9,000.00 C91-117 3312.2003 1" Water Service Water 12.00 EA $1,500.00 $18,000.00 C91-1 18 3312.20011" Water Service, Meter Reconnection Water 12.00 EA $500.00 $6,000.00 C91-1 21 3201.0614 Concrete Pavement Repair, Residential Water 4.00 Sy $125.00 $500.00 C91-1 32 9999.0002 Install New 4-Inch ADA Wheelchair Ramp (w/ detectable warning dome -tile surface) (50150, 100% Wate Water 2.50 EA $3, 500.00 $8, 750.00 C91-133 3216.0302 Install New 7"Concrete Valley Gutter (50150, 100% Water) Water 6.75 Sy $85.00 $573.75 C91-134 0241.1700 11-Inch Pavement Pulverization (50150, 100% Water) Water 10,792.48 $11.50 $124,113.52 C91-138 3123.0101 Unclassified Street Excavation (25125150 Water/Sewer/Storm) Water 2.00 CY $35.00 $70.00 C91-139 3212.0303 3-Inch Surface Course Asphalt, Type"D" (50150, 100% Water) Water 14,684.28 SY $21.10 $309,838.31 C91-141 3217.0305 Stop Bars Pavement MarW'ngs (50150, 100% Water) Water 45.00 LF $35.00 $1,575.00 C91-142 3217.0305 Stop Bars Pavement Markings (2525150 WaterlSewerlStorm) Water 4.00 LF $35.00 $140.00 C91-146 3305,0107 Manhole Adjustment With Concrete Collar(251200 WaterlSewerlStorm) Water 1.00 EA $1,500.00 $1,500.00 C91-147 3217.5001 Painting Curb Addresses (50150, 100% Water) Water 28.00 EA $40.00 $1,120.00 C91-148 3217.5001 Painting Curb Addresses (2&25150WaterlSewerlStorm) Water 2.00 EA $40.00 $80.00 C91-149 3291.O1o0Topsoil (5015o,t00%water) Water 2.00 CY $35.00 $70.00 C91-152 3292.0100 Block Sod Placement (25125150WaterlSewerlStorm) Water 6.87 Sy $10.00 $68.70 C91-153 0135.0101 Railroad Coordination water 1.00 LS $15,000.00 $15,000.00 C91-154 0135.0102 Railroad Flagmen Water 7.00 WD $650.00 $4, 550.00 C91-155 3213.03514" Conc Sidewalk, Exposed Aggregate water 50.00 SF $55.00 $2,750.00 C91-1 59 3201.0201 Asphalt Pvmt Repair Beyond Trench Width, Residential Water 10.00 Sy $35.00 $350.00 C91-163 9999.0001 Construction Allowance Water 0.18 LS $120,000.00 $21,000.00 C91-166 8" DR 18 Water Pipe Water 1,067.00 LF $80.00 $85,360.00 C91-185 Misc. Concrete Water 300.00 TN $335.00 $100,500.00 SUBTOTAL: $812,984.28 CONTRACT 91 UNIT 2: SANITARY SEWER IMPROVEMENTS (WATER) C91-22 3331.4116 8" Sanitary Sewer Pipe, CSS Backfill Sewer 132.00 LF $185.00 $24,420.00 C91-2 12 3331.3105 4" Sanitary Sewer Service Relocation on Private Property (Including Property Restoration) Sewer 824.00 LF $52.00 $42, 848.00 C91-213 0241.21038"Plug forSanitary Sewer Abandonment Sewer 16.00 EA $1,000.00 $16,000.00 C91-214 0241.2001 Grouting ofAbandoned Sanitary Sewer Sewer 5.00 CY $250.00 $1,250.00 C91-215 3339,0003 Wastewater Access Chamber Sewer 1.00 EA $4,500.00 $4,500.00 C91-216 3339.1004 Shallow Sanitary Sewer Manhole Sewer 1.00 EA $5,500,00 $5,500.00 C91-2 22 3305.0113 Trench Water Stops (Clay Dam) Sewer 2.00 EA $500.00 $1,000.00 C91-2 24 0241.5001 Abandon Existing SSMH Sewer 20.00 E4 $800.00 $16,000.00 C91-2 26 3110.0102 6%12" Tree Removal Sewer 1.00 EA $750.00 $750.00 C91-227 3110.010312"-18"Tree Removal Sewer 1.00 EA $1,250.00 $1,250.00 C91-2 29 3110.0105 24" and Larger Tree Removal Sewer 2.00 EA $2, 250.00 $4,500.00 C91-230 3iiaw10 Replace6"Tree Sewer 4.00 EA $750.00 $3,000.00 C91-235 3291.0100Topsoil (252Y50WaterlSewerlStorm) Sewer 5.00 CY $25.00 $125.00 C91-2 37 3292.0100 Block Sod Placement (2525150 Water/SewedStorm) Sewer 6.87 Sy $10.00 $68.70 C91-2 42 0241.1300 Remove Existing Concrete Curb and Gutter (50150, 100% Water) Sewer 1,600.24 LF $5.00 $8, 001.20 C91-2 44 3216.0102 Install New Concrete Curb and Gutter (match existing) (50150, 100% Water) Sewer 1,618.50 LF $35.00 $56, 647.50 C91-2 52 9999.0002Install New 4-Inch ADA Wheelchair Ramp (wl detectable warning dome4ile surface) (5a50, 100% Wate Sewer 2.50 EA $2, 500.00 $6, 250.00 C91-254 0241.170011-Inch Pavement Pulverization (50150, 100% Water) Sewer 13,492.69 Sy $11.50 $155,165.94 C91-2 58 3123.0101 Unclassified Street Excavation (2525150 Wafer/Sewer/Storm) Sewer 2.00 CY $25.00 $50.00 C91-2 59 3212.0303 3-Inch Surface Course Asphalt, Type"D" (50150, 100% Water) Sewer 12,784.50 Sy $21.10 $269, 752.95 C91-2 61 3217.0305 Stop Bars Pavement Markings (50150, 100% Water) Sewer 45.00 LF $25.00 $1,125.00 C91-2 62 3217.0305 Stop Bars Pavement Markings (2&25150 Water/SewedStorm) Sewer 4.00 LF $25.00 $100.00 C91-2 64 3305.0111 Water Valve BoxAdjustment with Concrete Collar (25/25150 Water/SewedStorm) Sewer 1.00 EA $550.00 $550.00 C91-266 3305,0107 Manhole Adjustment With Concrete Collar(2525r50 Water/SewedStorm) Sewer 1.00 EA $1,500.00 $1,500.00 C91-270 3231,0114 8'Chain Link, Steel Sewer 950.00 LF $25.00 $23,750.00 C91-2 71 3231.0134 6' Wrought Iron Fence Sewer 30.00 LF $65.00 $1, 950.00 C91-2 74 3231.0213 Wire Mesh Fence, Metal Posts Sewer 30.00 LF $30.00 $900.00 C91-2 75 3213.03514" Conc Sidewalk, Exposed Aggregate Sewer 50.00 SF $65.00 $3,250.00 C91-283 9999.0005 Irrigation allowance Sewer 0.70 LS $25,000.00 $17,500.00 C91-284 9999,0006 Construction Allowance I Sewer 1 0,901 LS 1 $150,000.00 $135,000.00 Change Order Deletions Page 1 of 2 Fca t�id City of Fort Worth Change Order Deletions Project Name Westcliff Drainage Improvements Phl and Contract 91 Pt 2 City Sec # 57280 Client Project# C01669 & C01957 Contractor Circle C Construction Company PM I Berton Guidry Inspector FBran McGill Change Order Submittal # ® Date 5/6/2026 DELETIONS y Unit UnitCost o a C91-288 ConShield Manhole Additive (CO 1) Sewer 55.05 VF $325.00 $17,891.25 C91-2 92 Misc. Concrete (CO 2) Sewer 250.00 TN $335.00 $83, 750.00 C91-2 93 Remove Permanent Paving on W Seminary (CO 2) Sewer 400.00 LF $17.50 $7, 000.00 C91-2 98 4' Diameter Sanitary Sewer Manhole (CO 3) Sewer 4.00 EA $6,500.00 $26, 000.00 C91-2100 Remove Sanitary Sewer Manhole (Co 3) Sewer 3.00 EA $1,000.00 $3,000.00 SUBTOTAL: $940,345.54 WESTCLIFF UNIT 1: WATER IMPROVEMENTS (TPW) WC-1 10 3201.0400 Temporary Asphalt Paving Repair (2"HMAC on 6" Flex Base) TPW 230.00 LF $25.00 $5, 750.00 WC-1 13 3305.0202 Imported Embedment/Backfill, CSS TPW 25.00 Cy $150.00 $3,750.00 WC-1 14 33oaom Imported EmbedmentBackfill, CLSM TPW 25.00 Cy $250.00 $6,250.00 WC-115 3305.0207Imported EmbedmentBackfill,Select Fill TPW 25.00 Cy $25.00 $625.00 WC-1 17 9999.0001 Miscellaneous Utility Relocation (irrigation allowance) TPW 1.00 LS $600.00 $600.00 WC-118 9999.0002 Field OrderAllowance (by TPM TPW 20,000.00 EA $1.00 $20,000.00 SUBTOTAL: 36,975.00 WESTCLIFF UNIT 2: SANITARY SEWER IMPROVEMENTS (TPW) WC-25 3339.10014'Manhole TPW 2.00 EA $5,500.00 $11,000.00 WC-2 6 3339.1003 4' Extra Depth Manhole (vertical feet>6-ft depth) TPW 14.52 VF $200.00 $2, 904.00 WC-214 3305.0109 Trench Safety TPW 88.00 LF $1.00 $88.00 WC-215 3201.0400 Temporary Asphalt Paving Repair (2"HMAC on 6" Flex ease) TPW 815.00 LF $25.00 $20, 375.00 WC-218 3305.0202 Imported Embedment/Backfill, CBS TPW 25.00 Cy $150.00 $3,750.00 WC-219 33o5.o2m Imported EmbedmentlBackfill, CLSM TPW 25.00 Cy $225.00 $5,625.00 WC-2 20 3305.0207 Imported EmbedmenUBackfill, Select Fill TPW 25.00 Cy $25.00 $625.00 WC-223 9999.o002 Field OrderAllowance(by TPW) TPW 20,000.00 EA $1.00 $20,000.00 SUBTOTAL: 64,367.00 WESTCLIFF UNIT 3: DRAINAGE IMPROVEMENTS (TPW) WC-3 3 3471.0002 Portable Message Sign TPW 46.00 WK $550.00 $25,300.00 WC-3 11 0241.3015 Remove 24" Storm Line TPW 2.00 LF $50.00 $100.00 WC-318 3341,0201 21 " RCP, Class III TPW 40.00 LF $85.00 $3,400.00 WC-329 3349.50o3 20'curb inlet TPW 7.00 EA $12,500.00 $87,500.00 WC-330 3349.8001 10'Type 2 inlet TPW 1.00 EA $7,500.00 $7,500.00 WC-3 46 3232.0201 TxDOT Std Rat Wall - RW 1(L) A TPW 62.00 SY $250.00 $15, 500.00 WC-347 3292.0100 Block Sod Placement TPW 1,900.00 Sy $10.00 $19,000.00 WC-3 54 9999.0007 Clean culverts under walking path TPW 45.00 LF $150.00 $6, 750.00 WC-358 9999.0011 Miscellaneous Utility Relocation (irrigation allowance) TPW 1.00 LS $10,000.00 $10,000.00 WC-359 9999.0012 Field OrderAllowance(by TPlh9 TPW 14,386.78 EA $1.00 $14,386.78 WC-371 Additional Paving Mobilization TPW 1.00 LS $6,500.00 $6,500.00 95,93 .7 WESTCLIFF UNIT 4: PAVING IMPROVEMENTS (TPW) WC-4 5 0241.0402 Remove Asphalt Drive TPW 40.00 SF $5.00 $200.00 WC-46 o241.moo Remove ConcPvmt TPW 361.00 Sy $5.00 $1,805.00 WC-410 3217.4307 Remove Raised Marker TPW 255.00 EA $2.00 $510.00 WC-412 0241,1700 Pavement Pulverization (II'pulverize,3"cut)(50% Anita, Suffolk) TPW 2,878.00 Sy $11.50 $33,097.00 WC-414 3211.0600 Cement (26lbs/sy) (50•9 Anita) TPW 8.00 TON $335.00 $2, 680.00 WC-416 3212.03033" Asphalt Pavement Type D(50%Anita, Suffolk) TPW 2,878.00 Sy $21.10 $60,725.80 WC-4 19 3216.0101 6" Conc Curb and Gutter (100%Trail Lake, Manderly) TPW 694.00 LF $35.00 $24, 290.00 WC-4 20 3216.0101 6" Conc Curb and Gutter (50%Anita, Suffolk) TPW 138.25 LF $35.00 $4,838.75 WC-4 21 3213.0401 6" Concrete Driveway(100/ Trail Lake, Mannerly) TPW 672.49 SF $20.00 $13,449.80 WC-425 3291,0100 6" Topsoil (50% Anita, Suffolk) TPW 5,00 Cy $25.00 $125.00 WC-4 27 3292.0100 Block Sod Placement (50%Anita, Suffolk) TPW 42.00 Sy $10.00 $420.00 WC-430 3305.0107Manhole Adjustment, Minor (100%Trail Lake, Manderly) TPW 7.00 EA $1,500.00 $10,500.00 WC-431 3305.0107 Manhole Adjustment, Minor (50% Anita, Suffolk) TPW 4.00 EA $1,500.00 $6,000.00 WC-4 33 3305.0111 Valve Box Adjustment (w/Concrete Cellar) (50%Anita, Suffolk) TPW 7.00 EA $550.00 $3,860.00 WC-435 3217.2001 Raised Marker TYW TPW 255.00 EA $10.00 $2,550.00 WC-436 3217.2103 REFL Raised Marker TY 11-A-A TPW 7.00 EA $15.00 $105.00 WC-4 39 9999.0001 8-Inch Chem -Lime Stabilizatkn @ 32LbsBY (100% Trail Lake, Manderly) TPW 31.50 TON $325.00 $10, 237.50 WC-4 41 9999.0003 Traffic Guard Fence TPW 125.00 LF $25.00 $3,125.00 WC-442 9999.0004 Field OrderAllowance (by TPM TPW 50,000.00 EA $1.00 $50,000.00 WC-4 48 Curb and Gutter Updated (CO 3) TPW 4,452.00 LF $43.75 $194, 775.00 SUBTOTAL: $423,283.85 TPW 720,562.63 Water $812,984.28 Sewer $940,345.54 bUb Total Deletions 2,473,892.45 Change Order Deletions Page 2 of 2 FORT WORTH:. MAYOR AND COUNCIL COMMUNICATION 7.1.8 WESTCLIFF PHASE 1 AND CONTRACT 91 PT 2 CHANGE ORDER 4 DATE: 06/23/26 M&C FILE NUMBER: M&C 26-0517 DEPARTMENT: TRANSPORTATION PUBLIC WORKS SUBJECT (CD 3 and CD 9) Authorize Execution of Change Order No. 4, in the Amount of Negative $210,006.05, and the Addition of 308 Calendar Days to a Construction Contract with William J. Schultz, Inc. dba Circle C Construction Company for the Westcliff Drainage Improvements, Phase 1, and Sanitary Sewer Rehabilitation Contract 91, Project Part 2 RECOMMENDATION It is recommended that the City Council authorize execution of Change Order No. 4 to City Secretary Contract No. 57280, a construction contract with William J. Schultz, Inc. dba Circle C Construction Company, in the amount of negative $210,006.05, and the addition of 308 calendar days for the construction of the Westcliff Drainage Improvements, Phase 1 (City Project No. C01669), and Sanitary Sewer Rehabilitation Contract 91, (City Project No. C01957) Part 2, for a revised contract amount of $17,791,709.90. DISCUSSION The purpose of this Mayor and Council Communication (M&C) is to authorize execution of Change Order No. 4 to City Secretary Contract No. (CSC) 57280 a construction contract with William J. Schultz, Inc. dba Circle C Construction Company, in the amount of negative $210,006.05. On February 22, 2022, by M&C 22-0120, the City Council authorized a contract with William J. Schultz, Inc. dba Circle C Construction Company in the amount of $14,663,252.60 for the construction of Westcliff Drainage Improvements, Phase 1, and Sanitary Sewer Rehabilitation Contract 91, Part 2. The project provides for the installation or replacement of storm drainpipes, deteriorated sanitary sewer mains, and deteriorated water mains. The drainage pipe improvements are the final phase of the four -phase Westcliff Drainage Improvements project, which aims to mitigate flooding in the Westcliff neighborhood. The sanitary sewer component of this project is part of the Water Department's Sanitary Sewer Overflow Initiative Program. The contract was subsequently revised by Change Order No. 1 to add needed construction items in the net amount of $59,500.00, (Administratively authorized February 3, 2023). The contract was further revised to add needed construction items and a survey for easement 1of3 FORT WORTH:. negotiations by Change Order No. 2 (M&C 24-0393), in the amount of $1,657,740.00, and added 190 calendar days to the contract. The contract was further revised by Change Order No. 3, (M&C 25-0607) to add needed construction items in the amount of $1,621,223.35 and added an additional 192 calendar days to the contract. Change No. 4 is the final reconciliation change order to balance contract quantities to match the actual installed quantities. Quantity changes occurred due to the addition of new items in previous change orders, updated quantity measurements, and field changes. The original contract (CSC No. 57280, M&C 22-0120) included $590,293.00 (Water: $93,583.00; Sewer: $120,710.00; Storm Drain: $376,000.00) for project contingencies. An additional $1,283,497.00 (Water: $937,484.00; Sewer: $346,013.00; Storm Drain: $0.00) for contingencies was provided by M&C 24-0393, and an additional $1,464,673.35 (Water: $345,525.69; Sewer: $600,484.49; Storm Drain $518,663.17) for contingencies was provided M&C 25-0607 to cover the costs for change orders 1, 2 and 3. Change order 4 will require additional funding of $29,747.57 for Sewer. Change Order No. 4 will add an additional 308 calendar days due to the changes in scope, discussed above, for a total contract time of 1,430 days. The following table summarizes previous contract actions and Change Orders: Construction Contract MSC Date Amount Original Contract M&C 22-0120 02/22/2022 $14,663,252.60 Change Order 1 Administrative 02/03/2023 $59,500.00 Change Order 2 M&C 24-0393 05/14/2024 $1,657,740.00 Change Order 3 M&C 25-0607 06/24/2025 $1,621,223.35 Change Order 4 This M&C ($210,006.05) Revised Contract Amount $17,791,709.90 No additional funding is needed for this change order. The construction cost will be shared between the Transportation and Public Works Department Stormwater Division and the Water Department. The Stormwater construction cost will decrease by $98,870.48, and the Water Department costs will decrease by $111,135.57 (Water: decrease by $140,883.14; Sewer: increase by $29,747.57). 2of3 FORT WORTH:. Funding is budgeted in the W&S Capital Projects Fund for the Water Department for the purpose of funding the SS Rehab Contract 91 project. This project is located in COUNCIL DISTRICTS 3 and 9. This contract requires a Form 1295. FISCAL INFORMATION/CERTIFICATION The Director of Finance certifies that funds are available in the current capital budget, as previously appropriated, in the W&S Capital Projects Fund for the SS REHAB CONTRACT 91 project to support the approval of the above recommendation and execution of the change order. Prior to any expenditure being incurred, the Transportation & Public Works and Water Departments have the responsibility of verifying the availability of funds. SUBMITTED FOR CITY MANAGER'S OFFICE BY: Jesica L. McEachern, # 5804 ORIGINATING BUSINESS UNIT HEAD: Lauren Prieur, #6035 ADDITIONAL INFORMATION CONTACT: Monty Hall, #8662 ATTACHMENTS 1. MAP WESTCLIFF PHASE 1 AND CONTRACT 91 PT 2 [7.1.8.1 -1 page] 2. SAM Search [7.1.8.2 - 3 pages] 3. CONFIDENTIAL REDACTED - Form 1295 [7.1.8.3 -1 page] 4. CONFIDENTIAL REDACTED - FID Table [7.1.8.4 -1 page] 5. CONFIDENTIAL REDACTED - Funds avail (3) [7.1.8.5 -1 page] 6. CONFIDENTIAL REDACTED - CO 4 to CSC 57280 [7.1.8.6 - 5 pages] 3 of 3 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6 if there are interested parties. Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. OFFICE USE ONLY CERTIFICATION OF FILING Certificate Number: 2026-1453353 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. William J Schultz Inc dba Circle C Construction Company Fort Worth, TX United States Date Filed: 04/27/2026 2 Name of governmental entity or state agency that is a parry to the contract for which the form is being filed. City of Fort Worth C Date Acknowledged: 3 Provide the identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract. 01957 Sanitary Sewer Rehabilitation Contract 91 Part 2 & Westcliff Drainage Improvements Phase 1 Change Order Number 4 Nature of interest 4 Name of Interested Party City, State, Count lace of business ty, Country (p ) (check applicable) Controlling Intermediary Skelly, Teresa Fort Worth, TX United States X 5 Check only if there is NO Interested Party. 6 UNSWORN DECLARATION My name is _ 7,i— l�Q cJl� 1and my date of birth is�� My address is ,,�00 W �% �a rrz !�� !� /.),o /14 70 (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. / Executed in T� !) _County, State of / e Qs on the Z 7day of Vi ! 20 I V (month) (year) Signature of authorized agent of contra . ing business entity (Declarant) Forms provided by Texas Ethics Commission www.ethlcs.state.ix.us vriaiVii V1+.1.V.UUC71�aa� CS57280 C01669 Westcliff Drainage Change Order 4 Interim Agreement Report Created: 2026-07-09 By: Cindy Sengathith (cindy.sengathith@fortworthtexas.gov) Status: Out for Signature Transaction ID: CBJCHBCAABAA-gCelkZonNhLrufXzJKUCNHru8CaYDRy Agreement History 2026-08-11 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. "CS57280 C01669 Westcliff Drainage Change Order 4" History Document created by Cindy Sengathith (cindy.sengathith@fortworthtexas.gov) 2026-07-09 - 8:21:29 PM GMT- IP address: 208.184.124,181 Document emailed to Berton Guidry (berton.guidry@fortworthtexas.gov) for signature 2026-07-09 - 8:27:22 PM GMT Li Email viewed by Berton Guidry (berton.guidry@fortworthtexas.gov) 2026-07-09 - 9:30:17 PM GMT- IP address: 104.47.65.254 Document e-signed by Berton Guidry (berton.guidry@fortworthtexas.gov) Signature Date: 2026-07-09 - 9:32:45 PM GMT - Time Source: server- IP address: 204.10.90.100 - Signature Appearance Selected: IMAGE Document emailed to Keegan Jonkers (k.jonkers@circlecconstruction.com) for signature 2026-07-09 - 9:32:48 PM GMT 1 Email viewed by Keegan Jonkers (k.jonkers@circlecconstruction.com) 2026-07-09 - 9:58:43 PM GMT- IP address: 146.75.164.0 Document e-signed by Keegan Jonkers (k.jonkers@circlecconstruction.com) Signature Date: 2026-07-10 - 12:52:04 PM GMT - Time Source: server- IP address: 68.191.221.209 - Signature Appearance Selected: IMAGE Document emailed to Brian McGill (Brian. 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McGill@fortworthtexas.gov) 2026-07-13 - 12:34:58 PM GMT- IP address: 104.47.64.254 Document e-signed by Brian McGill (Brian.McGill@fortworthtexas.gov) Signature Date: 2026-07-13 - 12:35:31 PM GMT - Time Source: server- IP address: 204.10.91.100 - Signature Appearance Selected: DRAW Document emailed to Anthony Sholola (Anthony.Sholola@fortworthtexas.gov) for approval 2026-07-13 - 12:35:34 PM GMT i Email viewed by Anthony Sholola (Anthony.Sholola@fortworthtexas.gov) 2026-07-21 - 4:49:31 PM GMT- IP address: 104.47.64.254 Document approved by Anthony Sholola (Anthony.Sholola@fortworthtexas.gov) Approval Date: 2026-07-21 - 4:50:26 PM GMT - Time Source: server- IP address: 204.10.90.100 - Signature Appearance Selected: TYPE Document emailed to Thanaa Maksimos (Thanaa.Maksimos@fortworthtexas.gov) for signature 2026-07-21 - 4:50:28 PM GMT c Document e-signed by Thanaa Maksimos (Thanaa.Maksimos@fortworthtexas.gov) Signature Date: 2026-07-21 - 7:41:09 PM GMT - Time Source: server- IP address: 204.10.90.100 - Signature Appearance Selected: IMAGE Document emailed to Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) for signature 2026-07-21 - 7:41:11 PM GMT `L 1 Email viewed by Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) 2026-07-21 - 9:42:41 PM GMT- IP address: 104.47.65.254 `0 Document e-signed by Lissette Acevedo (Lissette.Acevedo@fortworthtexas.gov) Signature Date: 2026-07-21 - 9:48:35 PM GMT - Time Source: server- IP address: 204.10.90.100 - Signature Appearance Selected: IMAGE Document emailed to Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) for signature 2026-07-21 - 9:48:38 PM GMT r,'o Signer Patricia Wadsack (patricia.wadsack@fortworthtexas.gov) entered name at signing as Patricia L. Wadsack 2026-07-28 - 3:54:05 PM GMT- IP address: 208.184.124.181 Document e-signed by Patricia L. Wadsack (patricia.wadsack@fortworthtexas.gov) Signature Date: 2026-07-28 - 3:54:07 PM GMT - Time Source: server- IP address: 208.184.124.181 - Signature Appearance Selected: TYPE Document emailed to Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) for signature 2026-07-28 - 3:54:11 PM GMT Email viewed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) 2026-07-28 - 4:07:27 PM GMT- IP address: 104.47.65.254 FORTINORTH. Po%*rwby Adobe Acrobob at Sign Document e-signed by Lauren Prieur (Lauren.Prieur@fortworthtexas.gov) Signature Date: 2026-07-28 - 4:08:12 PM GMT - Time Source: server- IP address: 76.227.105.128 - Signature Appearance Selected: DRAW Document emailed to Lorita Lyles (Lorita.Lyles@fortworthtexas.gov) for approval 2026-07-28 - 4:08:15 PM GMT `i Email viewed by Lorita Lyles (Lorita.Lyles@fortworthtexas.gov) 2026-07-29 - 1:02:50 PM GMT- IP address: 104.47.64.254 Document approved by Lorita Lyles (Lorita.Lyles@fortworthtexas.gov) Approval Date: 2026-07-29 - 1:08:13 PM GMT - Time Source: server- IP address: 208.184.124.181 - Document emailed to Douglas Black (Douglas.Black@fortworthtexas.gov) for signature 2026-07-29 - 1:08:16 PM GMT Document e-signed by Douglas Black (Douglas.Black@fortworthtexas.gov) Signature Date: 2026-08-03 - 5:38:28 PM GMT - Time Source: server- IP address: 208.184.124.181 - Signature Appearance Selected: DRAW Document signing automatically delegated to Dianna Giordano (dianna.giordano@fortworthtexas.gov) by Jesica McEachern Oesica.mceachern@fortworthtexas.gov) 2026-08-03 - 5:38:30 PM GMT Document emailed to Dianna Giordano (dianna.giordano@fortworthtexas.gov) for signature 2026-08-03 - 5:38:31 PM GMT Document emailed to Jesica McEachern Qesica.mceachern@fortworthtexas.gov) for signature 2026-08-03 - 5:38:31 PM GMT FORTWORTH. P--dby Adobe Acrobob at Sign FORT WORTH, Routing and Transmittal Slip Transportation & Public Works Department DOCUMENT TITLE: C01669 Westcliff Drainage Change Order 4 M&C: 26-0517 CPN: C 01669 CSO: 57280 DOC#: Date: To: Name Department Initials Date Out 1. Berton Guidry - Signature TPW BBG 07/09/2026 2 Keegan Jonkers k.'onkers circlecconstruction.com Contractor X C O 07/10/2026 3. Brian McGill TPW I-- W GII 07/13/2026 4. Tony Sholola Water 07/21/2026 5. Thanaa Maksimos — Review TPW TP 07/21/2026 6. Lissette Acevedo - Review TPW C�v 07/21/2026 7. Patricia Wadsack TPW P[,W 07/28/2026 8. Lauren Prieur TPW xxv_ 07/28/2026 9. Doug Black - Signature Legal „9as81ack 08/03/2026 10. Jesica McEachern - Signature CMO 08/14/2026 11. Katherine Cenicola - Review CSO Kc 08/17/2026 12. Jannette Goodall - Signature CSO ��etla;, 08/17/2026 13. Allison Tidwell - Review CSO 08/18/2026 14. TPW—SW—Contracts TPW SW 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, David will review and take the next steps. NEEDS TO BE NOTARIZED: OYES ®No Return to: tpw sw contracts(& fortworthtexas.2ov Call 817-229-3283 with questions. Thank you! FORT WORTH, City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: Circle C Construction Company Subject of the Agreement: Change Order #4 - final reconciliation change order. 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 8 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. 57280 C04 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 8 No ❑ *If so, please ensure it is attached to the approving M&C or attached to the contract. Project Number: If applicable. C01669 & C01957 *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.