HomeMy WebLinkAboutCHANGE ORDER - RFP - 7406 BOBCAT RIDGE HISTORIC BUILDINGS REHABILITATION (2)CHANGE ORDER NO.3•
PROJECT TITLE: Bobcat Ridge Historic Rehab6itadm
CONTRACTOR: Warne 6 Daub Contractors Inc
PROJECT NUMBER: OP-440934
DESCRIPTION: Chinking B Daubing Work
Fort of
In preparing change orders show In order as separate numbered paragraphs the following:
i. Reason for change: Chinking & daubing work that the Slate of Colorado required on the chicken coup.
2. Description of change' !Inking a daubng work was done to the existing chicken coup" This was done
n mu a ora yore to a ow now the post lomed.is was driven by the ate.
3. Change in contract host Yes, this will increase the contract amount by $4.805.
4. Change In contract bme:No.
(Attach additional sheets as required)
ORIGINAL CONTRACT COST
TOTAL APPROVED CHANGE ORDERS
TOTAL PENDING CHANGE ORDERS
TOTAL THIS CHANGE ORDER
TOTAL % OF THIS CHANGE ORDER
Total C.O. % of Original Contract
ADJUSTED CONTRACT COST
(Assuming all change orders approved)
$95,642.00
$1,180.00
SO.00
4,805.00
5.o2%
626%
.51o1,6zzop
ACCEPTED BY: A ' Con o s Representabve - Kton McGougA Date
ACCEPTED BY:
Project Manager hall Coaens
Dale -..
REVIEWED BY:
Print Name Date
,f�
77
APPROVED BY:-. �- d4/ � �=
P Arne Kee MannonlDale
c= City Clerk Project File
Contractor Purchasing
Engineer
Page lot
SCHEDULE OF VALUES AND CERTIFICATE FOR PAYMENT NO.07
PROJECT TITLE: Bobcat Ridge- Interior and Exterior Restoration
PROJECT NUMBER: CHSfSHF Pm)ec1 #2012-01.040
INSTITUTIONIAGENCY: City of Fort Collirhs
For Period: 04I0112013-06292013 -
SCNFni11 FOF VAl IIFR
Attach supporting detail sheets:
.
TOTAL
VALUE
VALUE OF WORK COMPLETED
PERCENT
COMPLETE
PREVIOUS
VALUE
TO DATE
VALUE
THIS
REPORT
CURRENT
VALUE
TO DATE
A
B
C
U•B+C
E-O/A
ORIGINAL CONTRACT ( sum of P3 forms )
95.642
95,642
0
95.642
100.00%
APPROVED CHANGE ORDERS ( sum of P2 forms
5,965
1,180
4.805
5.985
100.00%
ADJUSTED CONTRACT TOTAL
101.627
96,822
4,805
101,827
100A0%
LESS: RETAINAGE
5,11m
240
5,340
NET REOUISTION AMOUNT
91,T22
A.,50
96,287
CONTRACTOR CERTIFICATION
The undersigned Contractor requests payment of that portion of the contract price shown on the last One
of the foregoing Schedule of Values, and represents and warrants to the Owner that: (1) the data shown an the
Schedule of Values Is accurate and correct; (2) the Work covered by this Certificate has been completed in
accordance with the Contract Documents; (3) all previous progress payments received from Owner on account of Work done
under this Contract have been applied to discharge in fug (except for allowable relalnage) all Obligations of Contractor
Incurred In connection with Work covered by prior Certificates for Payment numbered Ql through Q¢ inclusive, and
(4) ti0e to all materials and equipment for which payment is requested in this Certificate, whether or not Incorporated
In said Work, will pass to Owner at time of payment free and dear or all liens, claims,. security interests and
encumbrances (except such materials and equipment which are covered by a Bond previously accepted by Owner).
FEW 8: SM311020 Contractor. Wattle R Daub Contractors... Inc. 4
Date; staz/;Lfe...ao13 By' ""1�ikl ,LL
Type Name: Byron Mc&ugh
ARCHITECTIENGINEER CERTIFICATION
This Is to certify that, In accordance with the terms of a contract for Project Number executed
the day of by and between,
Owner, for work at_
Contractor the amount of
the contractor, and the City of Fort Collins,
there Is due to the
Dollars,
AIE:
By.
Type
Name:
AGENCY ACTI ON
Amount approved for payment this certificate W
Dollars (
By Title:
By. Title:
Ta M
�IQ3 OI`�Lnll�
45o3a
Dale:
Date:
Dale:
V
� yrit-3
I
1111110
Page 2 of 4
SCHEDULE OF VALUES AND CERTIFICATE FOR PAYMENT NO.07 (continued)
•' • APPROVED CHANGE ORDERS • •'
PROJECT TITLE: Bobcat Ridge - Interior and E)derior Restoration
PROJECTNUMBER: CHSISHF Project#2012-01-040
For Period: 041012013 - M912013
CHANGE
ORDER
NUMBER
CHANGE ORDER
DESCRIPTION
TOTAL
VALUE
VALUE OF WORK COMPLETED
PERCENT
COMPLETE
PREVIOUS
VALUE
TO DATE
VALUE
THIS
REPORT
CURRENT
VALUE
TO DATE
A
B
C•11-B
D•AaE
E
1
Barn Shed Roof Adjustments
1.780
1,780
1.780
100%
2
Deduct Tree Removal
-600
-600
-600
100%
3
Chinking & Daubing
6,067
AA6$ C
4,805
Alm.
UBTOTAL APPROVED CHANGE ORDERS
7.247
1.180
4,Eit5
5,985