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Contract 41805-CO1
copy P 04� ;L. CITY SECRETARY, FORT WORTH., City of Fart Wirth CONTRACT NO. 'Change Order Request Project Namel HMAC Surface Overlay(2011-1)At various Locations City Sec# 1 41805 Client Project#(s)l C293-541200-206620161883 DOE:6560 Project Description 50/50 HMAC Surface Overlay Throughout the City Contractorl JLB Contracting, LLC Change Order# �1 Date 1 3/26/2012 City Project Mgr.1 Kristian Sugrim (817)392-8902 City Inspector Ali Motamed (817)944-1174 Dept. TPW Water Sewer Contract Time Totals CD Original Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Extras to Date Credits to Date Pending Change Orders(in M&C Process) Contract Cost to Date $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Go to ADD&DEL Tabs to Enter CO Backup 0.00 0.00 $0.00 32 Revised Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 272 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 $0.00 $0.00 Additional Funding(if necessary) CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.00% MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $2,091,117.50 JUSTIFICATION(REASONS),FOR CHANCE ORDER The submission of this Change Order is to request that an additional 32 calendar days be added to this contract to compensate for the delays associated with Gas and Water Utility conflicts on the alveston Ave.(W.Vickery Blvd.-W. Broadway Ave.),and Wosley Dr. (Westcreek Dr.-Woodway Dr.). 7 .,�°0°°p°°q � CD Of 00, • ry s¢��'jY` °°o �7� OFFICIAL RECORD N A by ,�►°°°°qpq°q° CITY SECRETARY o vv� FT. WORTH, TX .ty z It is understood and agreed that the acceptance of this Change Order by the contractor constitutes an accord and satisfaction and represents payment in full(both time and money)for all costs arising out of,or incidental to,the above Change Order. ContracEo S COM11my Name CWft*Dr Name Dade JLB Contracting, LLC �a$ Z- l2ppWorfln Daft ftjw M Date CAI- 41 Assistant Directs t Date C Dade t7 7- 3 y Cound Arlon d AXM&C Number M&C Date Approved �� f f i / 9y ? 6 FORT WORTH; City of Fort Worth f Change Order Request Project Name I HMAC Surface Overlay(2011-1)At various Locations City Sec# 1 41805 Client Project#(s)l C293-541200-206620161883 DOE:6560 Project Description 50/50 HMAC Surface Overlay Throughout the City Contractorl JLB Contracting, LLC Change Order# Date 1 3/26/2012 City Project Mgr.I Kristian Sugrim (817)392-8902 City Inspector Ali Motamed (817)944-1174 Dept. TPW Water Sewer Contract Time Totals CD Original Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Extras to Date Credits to Date Pending Change Orders(in M&C Process) Contract Cost to Date $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Go to ADD&DEL Tabs to Enter CO Backup 0.00 $0.00 $0.00 32 Revised Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,8947 272 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 $0.00 $0.00 Additional Funding(if necessary) CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT I 0.00% MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $2,091,117.50 JUSTIFICATION(REASONS)FOR CHANGE ORDER The submission of this Change Order is to request that an additional 32 calendar days be added to this contract to compensate for the delays associated with Gas and Water Utility conflicts on the following streets:Galveston Ave. (W.Vickery Blvd.-W. Broadway Ave.),and Wosley Dr. (Westcreek Dr.-Woodway Dr.). 4 I� I 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 Name Contract re Dad JLB Contracting, LLC to or/in Kton ate Man /P ra M Date Assistant Director De t D e DftGtDr,Cc)ptrahbng artmwt Date ry Date C4 M Council Action � ,:� M&C Number r M&C Date Approved �� L ���IN FORT WORTH. City of Fort Worth i Change Order Request Project Namel HMAC Surface Overlay(2011-1)At various Locations City Sec# 41805 Client Project#(s)l C293-541200-206620161883 DOE:6560 Project Description 50/50 HMAC Surface Overlay Throughout the City Contractorl JLB Contracting, LLC Change Order# Date 1 3/26/2012 City Project Mgr.1 Kristian Sugrim (817)392-8902 City Inspector Ali Motamed (817)944-1174 Dept. TPW Water Sewer Contract Time Totals CD Original Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Extras to Date Credits to Date Pending Change Orders(in M&C Process) Contract Cost to Date $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Go to ADD&DEL Tabs to Enter CO Backup $0.00 0 $0.00 32 Revised Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 272 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 $0.00 $0.00 Additional Funding(if necessary) CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.00% MAX ALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25%) $2,091,117.50 JUSTIFICATION(REASONS)FOR CHANGE ORDER The submission of this Change Order is to request that an additional 32 calendar days be added to this contract to compensate for the delays associated with Gas and Water Utility conflicts on the following streets:Galveston Ave.(W.Vickery Blvd.-W. Broadway Ave.),and Wosley Dr. (Westcreek Dr.-Woodway Dr.). f 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 CoffWy Name Contractor Name Contract Signature Date JLB Contracting, LLC Ins for/Ins tion rvis ate Project Man r/Pr ram Man er Date Assistant Director(De pt) D e Drectpr,Contr rtment t Date Date Assistant City Man v Counal Action if required) M&C Number M&C Date Approved FORT WORTM, City of Fort Worth Change Order Request Project Namel HMAC Surface Overlay(2011-1)At various Locations City Sec# 1 41805 Client Project#(s)l C293-541200-206620161883 DOE:6560 Project Description 50/50 HMAC Surface Overlay Throughout the City Contractorl JLB Contracting, LLC Change Order# Date 3/26/2012 City Project Mgr.I Kristian Sugrim (817)392-8902 1 City Inspector Ali Motamed (817)944-1174 Dept. TPW Water Sewer Contract Time Totals CD Original Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Extras to Date Credits to Date Pending Change Orders(in M&C Process) Contract Cost to Date $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 240 Go to ADD&DEL Tabs to Enter CO Backup 0.00 0.00 0.00 32 Revised Contract Amount $933,317.95 $443,745.63 $295,830.42 $1,672,894.00 272 Original Funds Available for Change Orders $0.00 Remaining Funds Available for this CO $0.00 $0.00 $0.00 Additional Funding(if necessary) CHANGE ORDERS to DATE(INCLUDING THIS ONE)AS%OF ORIGINAL CONTRACT 0.00% MAXALLOWABLE CONTRACT AMOUNT(ORIGINAL CONTRACT COST+25/) $2,091,117.50 JUSTIFICATION(REASONS)FOR CHANGE ORDER The submission of this Change Order is to request that an additional 32 calendar days be added to this contract to compensate for the delays associated with Gas and Water Utility conflicts on the following streets:Galveston Ave.(W.Vickery Blvd.-W. Broadway Ave.),and Wosley Dr. (Westcreek Dr.-Woodway Dr.). 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 Name Contract Signature Date JLB Contracting, LLC 4 ' - 1 Inspector/Inspection pervisqf Pat% Project Manager/Prograrn Manager Date Assistant Director(Dept) Date Director,Contracting Department(Dept) Date Assistant City Attorney Date Assistant City Manager We, Council Action if required) M&C Number M&C Date Approved 1, q L o O co Li v N V O 1` N 0 O U O Cn C _A pp U m O c a> E O M co o LO g co w *k Q O (D D O CD O 1 IC-4 0 O tw ri U a) w tko m U a t Q 0 'a Z o Li 'a co Q a a, 00 O G1 CU a J c O c O 00 L O 0 U U > m M Q o co m cu N O � CO > > m O N N U CD co V J O O J cm a� N N c E j N Q (`U6 = C U o U ED �o N M N S U Y Li 2 (D c GC E o ° rn 3 aD n m z o cu a a a o (D Y 3) U a U o i.L o U d CoC? o° ta�- cu 0 0 0 0 m 3 0 N O N W W m a- 0 a a� o` a, W r_ V rr 9 0 0 C) o o � CD 0 COD / CD / ƒ J / 4t J _ « p g o I ED / 0 k co I / g k R § Q / k ? n ° N J o � / 00 \ _ CA) 0 n k 0 § = 7 $ a / �cn 2 2 CD (D o R a ® 1 4 ƒ O CL rr CD C © rr (D D ■ C a 2 cn % g 0 o / CD O » CD k I m $ S 3 E S ~ 2 S / 2 k � + 0 Cn m s CTQ CD O CL CD v 0 f d ao m N O N cn c O CD y C� CD O fD C CD O N EH fA O O O O O O O MIWBE Breakdown for this Change Order MWBE Sub Type of Service Amount for this CO Total L $0.00 Previous Change Orders co# DATE AMOUNT Total $0.00 0 I 0 i I Oc � R 0 M u' 0) N N N 69 E9 69 69 69 69 69 69 <") M M Lu co V) LO N Nt Nt a 69 69 6e 69 6e 69 69 69 LO LO LO rn rn rn o ' o o ' N M a^O Oct O V 0) 0) 0) o 69 69 6% 69 6% 69 ER 69 U a Cl o o Z ° ° C) W M c W Q 0) v o .-� M N O O O V t. o M M M '^ c N OD OD OD :3 VI tom.. N R 69 6R 6A 69 6g 69 6R 69 69 O IL `;l U � O II O • • O }, O d �C1 U V J f- LO a ao °0 Z O0 OF ti W ti cu a) e tp tG tp N i u W O� O fR fA Ef? fA tf} Ei? 64 44 N O U m s � •� cpc U a l f m n m � -o r O a) • O a m 0 0 O N `; O N a) a) d co CD T- CO O C:_ 70 = UzoU L cc i� Z O U Q L CQ cn L � O � O c m U ca m a m Q o ° o m Q cn Q>cn :3 CL C:Q o o z o o - i c Z Z Z X >,W E L- U Z cc o U U o o .m Z o U Q p U c c� W a) a) O U E C c O >, c 0 c o c E a _ U F U U m m U o Q Q it af Q