HomeMy WebLinkAboutCHANGE ORDER - REQUISITION - 29898Change Order Form
CiOartCoUfm
&alillneering Departmaot
PROJECT TITLE: E. Prospect - LPATH Berm Erosion Protection Measure
PROJECT NUMBER: 30521700.6 (Bid No. 5998)
'CONTRACTOR: J2 Contractors (P.O No. 6607396)
CHANGE ORDER NUMBER: 9
n prepanng c ange orders Show In order as separate numbered paragraphs the following:
1. Reason for change. 2. Description of change.
3. Change In contract cost. 4, Change In contract time.
1 &2. See attached sheet for detail.
3. The contract cost will Increase by $ 4,920.00
4. The contract Ume will Increase by 2 working days.
ORIGINAL CONTRACT COST
$899,998.50
TOTAL APPROVED CHANGE ORDERS
($10,153.03)
TOTAL PENDING CHANGE ORDERS
$0.00.
TOTAL THIS CHANGE ORDER
$4,920.00
TOTAL % OF THIS CHANGE ORDER
0.49%
TOTAL C.O. % OF ORIGINAL CONTRACT
-0.52%
ADJUSTED CONTRACT COST
$994,763:47
(Assuming all change orders approved)
ACCEPTED BY:
171
DATE: 0 •
REVIEWED BY:
clots Represen
DATE: T 16 6 i
(Engineer)
ACCEPTED BY:
DATE:
(Project Manager-- E ering)
ACCEPTED BY: ,KenO4
ktl 0,� Vi t�A
Q
DATE: V 0
(Project Manager - Natural Res urces)
ACCEPTED BY: �r DATE:
(Project Manager - Stormwater)
ACCEPTED BY: Chi1atLL DATE: 4 -11-0 7
(Depar(ment Head)
APPROVED BY:
cc Coneador
PurdWep
Pmje d Fie
(Purchasing Agent over MAW)
$0.00 EnvkmwN
i4,9=00 Newel Reeoi =
$0.00 stormwaW
DATE:
Engineering Department • 281 North College Avenue • P.O. Box 580 • Fort Collins, CO 80522-0680 • (970) 221-6605
Engineering Department
281 North Collage Avenue • P.O. Box 580 • Fort Collins, CO 80522-0580
act o Tel: (970) 221-6605 - Fax: (970) 221-6378
Change Order
Project LPATH Berm Erosion Protection Measure
Contract! Bid No.: 5998
Contractor. J-2 Contracting Company
CHANGE ORDER NO.: 9 (Natural Resources Only)
DESCRIPTION:
1. Reason for Change: Additional work requested by Natural Resources
2. Description of Change:
Item
Item Description
Unit
Unit PrIcel
Adjust
Adjust
Current
New
3
Quantity
Amount $
Quanti
Qt
27
Resurface North Parkin Lot
LS
4,920.00
1
4,920.00
0
1
Total Adjustment
4,920.00
3. Change in Contract Cost $4,920.00
4. Change in Contract Time: 2 working days
CHANGE IN WORK REQUEST (CWR) "7' -RECYCLED ASPHALT PARKING LOT AND TOPSOIL SPREADING
Initiation Date: 3/4/2007
Project: LPATH Berm Erosion Protection Measures
Owner: City of Fort Collins - Engineering
To: J-2 Contracting Co.
Requested by: Jin Wang
Authorized by: An Wang
Please furnish change in contract sum for the change in work described below. Do not order material or start any work until approval is
received. Every effort will be made to incorporate this change into the work without affecting the contract date.
Descriptlon of Proposed Changes
Amount
1)
Furnish all material, equipment, and labor to install 3" depth of Recycled Asphalt in the North
Riverbend Ponds Parking Lot (Approximately 8200 Sq. Ft.). Parking lot to be wheel -rolled with Cat
430 TLB after 3" lift is placed.
$ 4,920.00
2)
Furnish all material, equipment, and labor to spread and amend high-grade compost into disturbed
areas at a rate of 2 Cubic Yards/1000 Square Feet (approx. 350 CY total). Areas for soil amendment
to be identified by City of Fort Collins Representative. Price per acre = $1950 . Estimated number of
acres = 4. Total number of amended acres to be calculated for payment using City of Fort Collins
Survey Crew.
$ 7 800.00
CWR TOTAL ($)
$12,720.00
J-2 Contracting Co. , agrees to change the work described above for the change in price shown below. I have
attached a breakdown which lists all costs of labor, materials, taxes, overhead, profit, and all other changes and/or charges involved.
Signature of the Contractor indicates his agreement herewith, including any adjustment in the Contract Sum or Contract Time.
The Contract Time will be by 5 Days.
No change in Contract Sum (Initial if no change)
ADD to the Contract Sum $ 12,720.00
DEDUCT from the Contract Sum $ 0.00
This information shall be valid for thirty (30) calendar days from the date of signature below.
CONTRACTOR'S SIGNATURE DATE:
CO"IM"Or shall Main one (1) ropy and renvn ORIGINAL ro Owner
APPROVED BY OWNER: DATE:
Accepted change in work request will be included in a future formal change order. DO NOT billfor this change until a formal change
order has been executed by all parties. Acceptance is direction to proceed with the work described herein. Not valid unless signed by the
owner and the contractor.