Contract - Muniz Construction - 6/22/2017 Form 2146-L
(Rev.10/11) CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: 4
Page 1 of 1
1.CONTRACTOR: Muniz Concrete&Contracting Inc. CCSJ: 0914-05-161
2.Change Order Work Limits:Sta. A165/8100/adal/sprl to Sta. 7223/2843/364/314 Project: STP 2009(376)MM
3.Type of Change(on federal-aid non-exempt projects): Major (Major/Minor) Highway:
4.Describe the change and the reason for the change order. When necessary,include County: Williamson
exceptions to this agreement.
District:
Change Order#4 adds balance of agreed upon Proposal 8 items. Seeding,
flagstone pavement,bench,excavation and embankment are quantitiy extensions. Contract
Remove and relocate Rock blocks,swale downstream of parking lot and Number:
realignment to tie into other subcontractor's sidewalk are new items.
5.New or revised plan sheet(s)are attached and numbered: n/a
Each signatory hereby warrants that each has the authority to execute this Change Order.
By signing this changeorder,the contractor agrees to waive anyand all The following information must be provided
claims for additional compensation due to any and all other expenses;
additional changes for time,overhead and profit;or loss of compensation Time Ext.#: 4 Days added on this C.O.: 59
as a result of this change.Further,the contractor agrees that this agreement
is made in accordance with Item 4 and the Contract.Exceptions should be
noted in the a or above. Amt.added by this change order: $137,019.02
.-- �te
For TxDOT use only:
THE CONTRACTOR Days participating:
By Muniz Concrete&Contracting,Inc. Amount participating:
Typed/Printed Name Gregg Matocha
Signature Date
Typed/Printed Title Project Manager/Estimator
Name/Title
RECOMMENDED FOR EXECUTION:
N me itleate Name/Title n a ( , Date
plrtl�,y� _ (,�V& o?Mn ,0T A#-NA&6_e-- • ]APPROVED 'S FkQUES'fAPPROVAL
Name/Title Date Name/Title Date
❑APPROVED ❑REQUEST APPROVAL
Name/Title Date Name/Title Date
APPROVED F-1 REQUEST APPROVAL
Name itle Dat ` Name/Title Date
APPROVED
Engineer's Seal:
MSN TD
44TON10 A.PR
8158 ��
►G`o�cr'�
CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: 4
Estimated CnsC
CCSJ:
TABLE A:Force Account Work and Materials Placed Into Stock Pard by Invoicel i oves M No
LA R
HOURLY RATE EQUIPMENT I HOURLYRATE
TABLE B:Contract Items
ORIGINAL+PREVIOUSLY NEW
REVISED
ITEM DESCRIPTION UNIT UNIT PRICE QUANTITY ITEM COST QUANTITYtTEM COST OV UNI
UNDERRUN
2 Excavation(Roadway) CY 16.00 2,731.00 43,696.00 4,298.51 68,776.16 25,080.16
3 Embankment(Final)(OrdComp)(C) CY 24.00 2,195.00 52,680.00 5,113.54 122,724,96 70,044.96
4 Broadcast Seed(Perm)(Rural)(Clay) SY 0.17 18,934.00 3,218.78 50,197.00 8,533.49 5,314.71
S Broadcast Seed(Temp)(Warm) SY 0.17 9,467.00 1,609,39 9,467.00 1,60939 0.00
6 Broadcast Seed(Temp)(Cool) SY 0.17 9,467.00 1,60939 25,098.50 4,266.74 2,657.36
7 Soil Retention Blankets(CL 1)(TY A)SY 138 5,360.00 7,396.80 3,996.00 5,514.48 - 1,882.32
B Soil Retention Blankets(CL 2)(TY H)SY 21AD 475A0 9,975.00 930.60 19,542.60 9,567.60
9 F le x Base(Cm p I n Pla ce)(TYA G R 1) CY 65.00 2.259,00 146,835.00 1,993.00 129,545.00 17,290.00
30 Concrete Curb(Ribbon)(Mod)(12-) LF 12.00 49,00 588.00 0.00 0.00 588.00
37 Ref Pav Mrk TY 11(W)12"(SLD) LF 1.05 4200. 44.10 0.00 0.00 - 44.10
45 Retaining Wall(4x2x2 Limestone) 5F 26.00 3,865.00 100,490.00 4,196.00 109,096.00 8,606.00
51 Flagstone Pavement SF 12.00 707.00 8,484.00 1,076,00 12,912.00 4,428.00
S5 Bench EA 1,300.00 14.00 18,200,00 17.00 22,100.00 3,900.00
62 Interpretive Signage(Allow 57,000)LS 3,500.00 2.00 7,000.00 0.00 0.00 - 7,000.00
63 Interpretive Sign Structures EA 1,650.00 2.00 3,300.00 0.00 0.00 - 3,300.00
67 Pedestrian Handrail LF 82.00 288,00 23,616.00 494.00 40,508.00 16,892.00
C04-1 Rmv/Reloc Ret.Wall Blocks SF 29.28 0.00 0.00 176,00 5,153.28 5,153,28
C04-2 install Swale of Parking Lot LS 5,75250 0.00 0,00 1,001 5,752.50 5,752.50
C04.3 Realign trail to tie into sidewalk LS 7,393.13 0.00 0.00 1.00 7,393.13 7,393.13
C04-4 Item 33;Conc Sidewalk S'R&R SY 39.50 0.00 0.00 32,50 1,283.75 1,283.75
C04-5 Parking Lot Sleeves LF 10.00 0.00 0.00 105.00 1,050.00 1.050.00
TOTALS 428,742.46 565,761.4 137,019.0
TXDOT Form 2146 L TAB(Rev.10/11)Page 1 of 2
CONSTRUCTION CONTRACT CHANGE ORDER NUMBER: 4
TABLE B:Contract Items(Continued) CC51:
ORIGINAL+PREVIOUSLY NEW
REVISED
ITEM DESCRIPTION UNIT UNIT PRICE QUANTITY ITEM COST QUANTITY ITEM COST OVERRUN/
UNDERRUN
The'Totals`from Table B of the previous work sheet: 428,742.4 565,761.4 137,019.02,1
TOTALS 428,742.4 565,761.4 137,019.0
TXDOT Farm 214mL TAB(Rev 10/11)Page 2 of 2
CERTIFICATE OF INTERESTED PARTIES
FORM 3.295
10f1
Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-222715
Muniz Concrete&Contracting, Inc.
Austin,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/13/2017
being filed.
City of Round Rock Date Acknowledged:
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
000000
Brushy Creek Regional Trail Gap Project, CSJ 40914-05-161
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
Rodriguez, Lonny D. Austin,TX United States X
Muniz,Jose Juan Austin,TX United States X
5 Check only if there is NO Interested Party. ❑
6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
�Mr FRANCISCO JAVIER GUERRA JR
Notary ID 0 130654692
My,Commission Expires L �)
May 10,2020 -'Signature of auth rized agent of contracting 6usiness entity
AFFIX NOTARY STAMP/SEAL ABOVE
Swor to and subscribed before me,by the said 14 //. ,this the day of
20 ,to certify which,witness my hand and seal of office.
Aam�ZAU
Signa re fficer acKinistering oath Printed name of officer ad inistering oath itle f fficer administering oat
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883
CERTIFICATE OF INTERESTED PARTIES FORM 1295
10f1
Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-222715
Muniz Concrete&Contracting, Inc.
Austin,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/13/2017
being filed.
City of Round Rock Date Acknowledged:
06/14/2017
3 Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
000000
Brushy Creek Regional Trail Gap Project, CSJ#0914-05-161
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
Rodriguez, Lonny D. Austin,TX United States X
Muniz,Jose Juan Austin,TX United States X
5 Check only if there is NO Interested Party. 0
6 AFFIDAVIT I swear,or affirm,under penalty of perjury,that the above disclosure is true and correct.
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said this the day of
20 ,to certify which,witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883