HomeMy WebLinkAboutContract 41968-CO1 Ceyx/
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FORT WORTH.. City of Fort Worth CITY SECRETARY �O
Change Order Request CONTRACT NO.
Project Namel HMAC Surface Overlay(2011-7)At Various Locations City Sec# 1 41968
Client Project#(s)l C293-541200-203620171683 City Project No:01716 DOE:6655
Project Description HMAC Surface Overlay Throughout The City
Contractorl JLB Contracting,LLC Change Order# 0 Date 5/29/2012
City Project Mgr.I Kristian Sugrim (817)392-8902 City Inspector David W. Bowers (817)350-3522
Enter Department(s)to the Right and TPW Totals Contract Time
Contract Day Type CD
Original Contract Amount $777,943.65 $777,943.65 120
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $777,943.65 $777,943.65 120
Amount of Proposed Change Order $0.00 0.00 128
Revised Contract Amount $777,943.65 $777,943.65 248
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $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%) $972,429.56
JUSTIFICATION,(REASONS)FOR CHAFE ORDER
This change order is to request that 128 Calendar Days(CD)be added to this contract due to Atmos franchise utility work on Marys Lane and
Sanguinet Dr.
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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.
ContrwWs Company game Conkador tame Contu d Date
JLB Contracting, LLC �..�
to /t Date
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Assi Date Dir t t Date
L lI Loi'` �1
Dab Assisoi City MwWW Dale
Council Action d mprecQ
M&C Number M&C Date Approved
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FORT WORTH. City of Fort Worth P
Change Order Request
Project Namel HMAC Surface Overlay(2011-7)At Various Locations City Sec# 41968
Client Project#(s)l C293-541200-203620171683 City Project No:01716 DOE:6655
Project Description HMAC Surface Overlay Throughout The City
Contractorl JLB Contracting, LLC Change Order# 0 Date 1 5/29/2012
City Project Mgr.1 Kristian Sugrim (817)392-8902 City Inspector David W. Bowers (817)350-3522
Enter Department(s)to the Right and TPW Totals Contract Time
Contract Day Type CD
Original Contract Amount $777,943.65 $777,943.65 120
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date ! $777,943.65 $777,943.65 120
Amount of Proposed Change Order 0.00 0.00 128
Revised Contract Amount $777,943.65 $777,943.65 248
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $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%) $972,429.56
JUSTIFICATION(REASONS)FOR CHANGE ORDER
This change order is to request that 128 Calendar Days(CD)be added to this contract due to Atmos franchise utility work on Marys Lane and
Sanguinet Dr.
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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 Contract Name Contrail Sionature Date
JLB Contracting, LLC
In or/ln D to M� an Date
Assists mate Di Con Date
Dale I Assisten Dale
Cowl Action rf
c
M&C Number L M&C Date Approved
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FORT WORTH,. City of Fort Worth
Change Order Request r
Project Name I HMAC Surface Overlay(2011-7)At Various Locations City Sec# 41968
Client Project#(s)l C293-541200-203620171683 City Project No:01716 DOE:6655
Project Description HMAC Surface Overlay Throughout The City
Contractorl JLB Contracting, LLC Change Order# Date 1 5/29/2012
City Project Mgr.1 Kristian Sugrim (817)392-8902 City Inspector David W. Bowers (817)350-3522
Enter Department(s)to the Right and TPW Contract Time
Contract Day Type Totals
CD
Original Contract Amount $777,943.65 $777,943.65 120
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $777,943.65 $777,943.65 120
Amount of Proposed Change Order $0.00 $0.00 128
Revised Contract Amount ff $777,943.65 $777,943.65 248
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $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%) $972,429.56
JUSTIFICATION(REASONS)FOR CHANGE ORDER
This change order is to request that 128 Calendar Days(CD)be added to this contract due to Atmos franchise utility work on Marys Lane and
Sanguinet Dr.
J � 1
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.
Contrador's Company Name Contractor Name Contract Signature Date
JLB Contracting, LLC � _ //;- 1
Inspector/InWe0on Supwiisor D e Project Manager/ProgW Manager Date
r
Assists t . Date Di r or,Contracti rtment , t Date i
Date Assiswt,City Manager i Date
Council Action if required)i
M&C Number 7/ : M&C Date Approved
`fit.
FORT WORTH. City of Fort Worth
Change Order Request
Project Namel HMAC Surface Overlay(2011-7)At Various Locations City Sec# 41968
Client Project#(s)l C293-541200-203620171683 City Project No:01716 DOE:6655
Project Description HMAC Surface Overlay Throughout The City
Contractorl JLB Contracting, LLC Change Order# Date 5/29/2012
City Project Mgr.1 Kristian Sugrim (817)392-8902 City Inspector I David W. Bowers (817)350-3522
Enter Department(s)to the Right and TPW Contract Time
Contract Day Type Totals
CD
Original Contract Amount $777,943.65 $777,943.65 120
Extras to Date
Credits to Date
Pending Change Orders(in M&C Process)
Contract Cost to Date $777,943.65 $777,943.65 120
Amount of Proposed Change Order $0.00 0.00 128
Revised Contract Amount $777,943.65 $777,943.65 248
Original Funds Available for Change Orders $0.00
Remaining Funds Available for this CO $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%) $972,429.56
JUSTIFICATION(REASONS)FOR CHANGE ORDER
This change order is to request that 128 Calendar Days(CD)be added to this contract due to Atmos franchise utility work on Marys Lane and
Sanguinet 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&gnature Date
JLB Contracting, LLC
Inspector/Inspection Su sor Dpte Project Manager/Program Manager Date
AssistantVirector Pet Date Director,Contracting Department t Date ti
As3i9tffi*4City AtImMy, Date Assistant City Manapr Dft
CouncH Action ff uirW
M&C Number M&C Date Approved
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MIWBE Breakdown for this Change Order
MWBE Sub Type of Service Amount for this CO
Total
Previous Change Orders
Co# DATE AMOUNT
Total $0.00
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