HomeMy WebLinkAboutCHANGE ORDER - PURCHASE ORDER - 9113890(‘IIAN(iL
ORI)LR
No.
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Coatings
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ion
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CON’Ilj\(
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1
lydro
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‘onstruclion
(‘oinpany,
Inc.
P.O.
N(iMI3ER:
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VENDOR
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JMIILR:
109420
CHAR(
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NI
JMBLR:
50363
15304.565080.6
DESCRIPTION
In
preparing
change
Or(lers
show
inorder
as
separate
numbered
paragraphs
the
foil
ow
i
ii:
I .
Reason
Acpt:caoon ‘or Payment
PROJECT: DWRF Coatings & Humidification (M-WRF-20’Il-E)
Page 1 of 2
OWNER: City of Fort Collins - Utilities CONTRACTOR: Hydro Construction Co., Inc. APPLICATION NUMBER: 4 FINAL
700 Wood Street 301 0. Lincoln Ave. APPLICATION DATE: 10/1/2011
Fort Collins, CO 80522 Fort Collins, CO 80524 PERIOD BEGINNING: 9/1/2011
PERIOD ENDING: 9/30/2011
ENGINEER: N/A
P0 NUMBER: 9113890
CHANGE ORDERS: PAY APPLICATION: RETAINAGE:
NUMBEF DATE AMOUNT Appl:cation is made for Payment as shown below in connection with the Contract.
The present status of the account for this Contract to as foltows.
Original Contract Amount S 198,962.00 Retainage to Date: S 9.94810
Net Change by Change Order 9gne8 etainage Previous S 9.94810
Reeised Current Contract Amount: $198,962.00 Chan in Retainage: S
Total Work Completed and Stored to Date:
ess evious Payrn st
Amount due this Pay Application before rctainage/ S 26,214.91
Less Pefainage. 5 9,948.10
Net Change by Change Order S0.0D AMOUNT DUE THIS APPLICATION: S 16,266,81
Change Order ‘U 0 00’U
CEF1FICATION.
e undersigned CON7PAC”OR nerbties :hat a/ cbtigahor.s of CONTRACTCF wourred in connection wi/n
, :v i.CRK rsve been sa1:sfed as required in paraaanh ‘4 3
of he General Ccr,bitionu c’ the Contract.
a
abovevo tD S pp at c is eqs uted
:
:
of the acove Amount Due This Aoplicabcn is re:onmended
:
7
°c:’-en D’i’rv a2ove AO’ou’t Due Tb’s ‘n / a:: has
bete/ewed by the O’A’I1ER’S Pro/cot Manage’.
Doe . By:
°s.”e’: of he above Amosnf Due ‘ms Anol;catior is approeed by the OWNEF
:
‘
By 11-01-241
Apphcation for Payment
PROJECT: DWRF Coatings & Humidification (M-WRF-2011-6)
Page 2 of 2
OWNER: City of Fort CoFns - Utihties
700 Wood Street
Fort Collins, CO 80522
ENGINEER:
CONTRACTOR: 1-lydro Construction Co., Inc.
301 E. Lincoln Ann.
Fort Collins, CO 80524
APPLICATION NUMBER: 4 FINAL
APPLICATION DATE: 10/01/11
PERIOD BEGINNING: 09/01/11
PERIOD ENDING: 09/30/11
SCHEDULE OF VALUES
P0 NUMBER: 5113890
Item Job — Contract Summary Billed This Period Billed Previous Billed Total to Date Stored Total Billed Cost Billed Percent
9 Code 8 Description 5y UOM Unit Price Total Amount Amount
y, Amount Qty. I Amount Materials & Stored to Date Remaining Complete
‘ Bond & csran:e 1 LS 53,084.00 5 3.084,00 100% 5 - 101% S 3,130.00 100% S 3,130.00 S - S 3.13000 S (46,00) 101%
2 General Conditions 1 LS 514.82400 S 14 824.00 1% S 86.81 69% S 10,301.84 31% S
10,388.65 S - S 10.38865 4,435.35 100%
3 Coalir.gs 1 LS 5119.718.00 S 119718.00 0% S - 111% 5 133219.49 74% S 133,219.49 5 - S 133219.49 S (13.501.49) 100%
4 i-iurr dAcalior 1 LS 536.79600 S 36,796.00 44% S 16.180,00 9 18,628.33 0% 5 34,808.33 5 - 5 34,808.33 S 1987.67 100%
Contract Summary:
Sub-Thtats i 5 174,422.00 S 16,266.81 S 165 279.66 S 181,548.47 S 181.546,47 5 (7,124.47) 100%
: r.xe0 ree cnornes S 2454002 0%’ S - 100% S 24,540.00 55% 5 24.540,00 S 24,540.00 5 - 100%
GRAND SUB-TOTALS: S 962.00 S 16.265,81 5 189.819,66 5 205,086.47 S 206,086.47 5 (7,124.47) 100%
Pend’rg Issues:
H
H H
H
Pending issues Sub-Totals: S
PAY APPLICATION TOTALS: 5 190,962.00 $ 16,266.81 S 189,819.66 $ 206,086.47
$ 206,086.47
br
change.
2.
l)escription
of
change.
3.
Change
in
contract
cost.
4.
(Thangc
in
contract
lime
1.
Additional
elTon
required beyond
the
scope
of
the
contract
2.
Atmospheric
conditions (humidity)
beyond
the
contractors
control required
considerably
more
ebbont
and
sta
3.
$7,124.47
4. No
change
in
contract
time.
(Attach additional
sheets
as
required)
ORIGINAL CONTRACT
COST
$198,962.00
TOTAL APPROVED CHANGE
ORDERS
$0.00
TOTAL
PENDING
CHANGE
ORDERS
$0.00
TOTAL
THIS
CHANGE
ORDER $7,124.47
TOTAL
%
OF
ORIGINAL
CONTRACT,
THIS
CO:
3.46%
TOTAL
r/
OF
ORIGINAL
CONTRACT,
ALL
CO’S:
ADJUSTED CONTRACT
COST
$206,086.47
(Assuming
all
chaiwe
or(jrs
v
)
ACCEPTED
.
DATE:
///
/ZMZ_
(Contictor,
epiesentative)
REVIEWED
BY:
DATE:
(Project Manager)
APPROVED
BY:
,
DATE:
-
(Water
Resources
and
Treatment Operations
Manager)
CC:
City
Clerk
Purchasing
NOTE:
Signature
of Contractor
indicates
Contractor
Project
File
agreement herewithin,
including
any
adjustment
Storrnwater
Finance
Manager
in
contract
sum
or
contract
time.