Contract - Atkins North America, Inc. - 8/24/2017 STATE OF TEXAS §
COUNTY OF WILLIAM S ON §
SUPPLEMENTAL CONTRACT NO.4
TO CONTRACT FOR ENGINEERING SERVICES
FIRM: ATKINS NORTH AMERICA,INC. ("Engineer")
ADDRESS: 11801 Domain Boulevard, Suite 500,Austin, TX 78758
PROJECT: E. Bagdad Avenue Extension
This Supplemental Contract No. 4 to Contract for Engineering Services is made by and between
the City of Round Rock, Texas, hereinafter called the "City" and Atkins North America, Inc.,
hereinafter called the "Engineer".
WHEREAS, the City and Engineer executed a Contract for Engineering Services, hereinafter
called the "Contract", on the 24th day of September, 2015 for the E. Bagdad Avenue Extension
Project in the amount of$104,700.41; and
WHEREAS,the City and Engineer executed Supplemental Contract No. 1 on March 10, 2016 to
amend the scope of services and to increase the compensation by $326,360.94 to a total of
$431,061.35; and
WHEREAS, the City and Engineer executed Supplemental Contract No. 2 on September 8,
2016 to amend the scope of services and to increase the compensation by$85,675.85 to a total of
$516,737.20; and
WHEREAS, the City and Engineer executed Supplemental Contract No. 3 on April 3, 2017 to
amend the work schedule; and
WHEREAS, it has become necessary to amend the Contract to modify the provisions for the
scope of services and to increase the compensation by$199,281.31 to a total of$716,018.51;
NOW THEREFORE, premises considered, the City and the Engineer agree that said Contract
is amended as follows:
I.
Article 2, Engineering Services and Exhibit B, Engineering Services shall be amended as set
forth in the attached Addendum To Exhibit B. Exhibit C, Work Schedule shall be amended as
set forth in the attached Addendum To Exhibit C.
Supplemental Contract Rev.06/16
�'0119�9.1539;00383246 84275
1�,U 1q-— �03 1
II.
Article 4, Compensation and Exhibit D, Fee Schedule shall be amended by increasing by
$199,281.31 the lump sum amount payable under the Contract for a total of $716,018.51, as
shown by the attached Addendum to Exhibit D.
IN WITNESS WHEREOF, the City and the Engineer have executed this Supplemental
Contract in duplicate.
[signature pages follow]
Supplemental Contract Rev.06/16
0199.1539;00383246 84275
2
ATKINS NORTH AME CA,INC.
By:
Date
Supplemental Contract Rev.06/16
0199.1539;00383246 84275
3
CITY OF OUND ROCK APP ED AS TO ORM:
By: _ . M
Craig MYorg ,May Steph L. Sheets, City Attorney
Date
Supplemental Contract Rev.06/16
0199.1539;00383246 84275
4
ADDENDUM TO EXHIBIT B
Engineering Services
PROJECT DESCRIPTION
The proposed project will include a new location 3-lane extension of McNeil Rd between Mays
St and S Black St as well as the widening of S Georgetown St to 3-lanes between S Black St and
E Main St. Lampasas St will be extended from its current termini at Bagdad Ave to the new
McNeil Rd extension. Lewis St and Stone St will also be extended to connect to McNeil Rd.
The approximate length of the project is 0.54 miles.
This supplemental removes the Sheppard St extension from the project and separates the project
into two phases. The first phase will include all the improvements west of and including the
intersection at Burnet St. The second phase will include the proposed improvements east of
Burnet St.
TASK 1: PROJECT MANAGEMENT
1. Prepare monthly project status updates and invoices.
2. Manage sub-consultants.
TASK 2: SURVEYING
No changes with this supplemental.
TASK 3: ENVIRONMENTAL STUDIES
No changes with this supplemental. Previously completed.
TASK 4: PRELIMINARY DESIGN/30% PLANS
No changes with this supplemental. Previously completed.
TASK 5: DIRECT EXPENSES
1. TCEQ WPAP Application fee
TASK 6: GEOTECHNICAL DESIGN
1. Test borrow material from the City of Round Rock stockpile to verify it meets the
requirements of class A material. All the field sampling and laboratory tests will be
performed according to typical geotechnical standards, where applicable, or with other
well established procedures. HVJ will test the material as required for Atterberg Limits
(ASTM D4318), gradation(ASTM D422), and compaction properties (ASTM D698).
2. Provide an alternate pavement design for Phase 2. This design will include a combination
of LTS and removal and replacement with select fill. The LTS layer will be set as 8", and
the resulting depth of removal and replacement will be calculated to minimize PVR. The
design will be based on design traffic loads as defined in HVFs final design report for the
project as well as geotechnical borings and lab testing results.
Page 1 of 4
TASK 7: 60% PLANS
No changes with this supplemental. Previously completed.
TASK 8: 95% PLANS (Replace previous scope for Task 8 with the following)
All Disciplines
1. Address comments from the City of Round Rock 60%review.
2. Remove the Sheppard St extension from the project.
3. Revise the Lampasas St typical section to include in each direction of travel an 11' lane,
an 8' wide parallel parking area, 2' curb and gutter, 5' sidewalk and 2' buffer. The
Lampasas St alignment between McNeil Rd and Bagdad Ave will also be revised to
accommodate the needs of The Depot Townhomes. The resulting alignment includes one
horizontal curve that does not meet 30 mph, so a design exception will be prepared.
4. Remove landscaping, irrigation and sidewalk along the south side of McNeil between
station 17+00 and Burnet St.
5. Develop 95% plans for phase 1 which includes work west of and including the Burnet St
intersection. Develop 95% plans for phase 2 which includes work east of Burnet St. An
interim design will be included at Burnet St to accommodate the temporary condition
created upon the completion of Phase 1 before Phase 2 is constructed. The ultimate
design at Burnet St will be included in Phase 2. The interim condition will reflect
temporary signing, striping and drainage improvements. The existing ditch east of
Burnet St will need to be regraded to accommodate the interim design.
6. Complete redesign of water and wastewater improvements to accommodate The Depot
Townhomes design.
7. Partial redesign of storm water system to accommodate changes in the water and
wastewater design.
8. Update drainage report to document phasing of project and address previous comments.
9. Add roadway lighting east of Burnet St(Phase 2).
10. Revise design speed from 25 mph to 30 mph and develop necessary design exception
requests. There are two horizontal curves on McNeil Rd and one horizontal curve on
Lampasas St (See note#3)that will not meet a 30 mph design speed.
11. Continue development and detailing of sheets.
12. Prepare construction cost estimate, specifications, and general notes.
13. Atkins will provide Storm Water Pollution Prevention Plans (SWPPP) to minimize
sediment discharge from the project area during construction in accordance with best
management practices.
TASK 9: 100% PLANS/FINAL SUBMITTAL (Replace previous scope for Task 9 with the
following)
All Disciplines
1. Address comments from the City of Round Rock 95%review of the phase 1 and 2 plans.
Page 2 of 4
2. Prepare construction cost and construction time estimates.
3. Prepare specifications and general notes.
4. Prepare bid packages for Phase 1 and Phase 2.
TASK 10: WATER QUALITY PLANS AND WATER POLLUTION ABATEMENT
PLANS (WPAP)
No changes with this supplemental.
TASK 11: LANDSCAPING AND IRRIGATION PLANS
1. Landscaping and irrigation will be removed from the project
TASK 12: BARRIER WITH FENCE
1. If necessary, Atkins will prepare a detail, special specification and design for a proposed
barrier with a fence on top along the railroad ROW from Mays Street to Burnet Street.
The details of this barrier and fence are to be determined, so an assumed level of effort is
included in this supplemental. Atkins will only invoice for work under this task based on
the actual effort required to prepare the fence design, details and specifications. Any
budget remaining will not be invoiced. If the assumed budget is insufficient, a
supplemental will be necessary.
NOT INCLUDED WITHIIN THIS SCOPE
The following items are not included with this scope. These items, if necessary, would be added
to the scope through a supplemental agreement.
1. The project team assumes the project will be constructed using local funding sources and
will not require any federal permitting.
2. TxDOT environmental document
3. Environmental permitting or agency coordination other than TCEQ coordination for
WPAP approval
4. Concrete fence plans
5. Public involvement
6. Storm water detention design or associated plans
DELIVERABLES
Project Management
No changes with this supplemental.
95% Submittal
1. Electronic submittal and two 11"X 17" plan sets to include all revised plan sheets and
cross sections. Separate submittals will be made for the phase 1 and phase 2 projects.
2. Revised drainage report submitted with each project phase.
3. 95% construction cost estimate for phase 1 and phase 2 projects
Page 3 of 4
4. A list of Specifications, Special Provisions and General Notes
100% Submittal
1. Electronic submittal and two final signed and sealed sets of 11"X17" full-scale paper
drawings for the phase 1 and phase 2 projects. Specifications and special provisions will
be complete and suitable for bidding and award of a construction contract.
2. One electronic file of drawings, cross sections and supporting data
3. 100% cost estimate for each phase
4. Construction time estimate for each phase
5. Bid packages for each phase
Water Ouality
No changes with this supplemental.
Landscaping and Irrigation
No changes with this supplemental.
Page 4 of 4
ADDENDUM TO EXHIBIT C
Work Schedule
Attached Behind This Page
E BAGDAD AVE EXTENSION SUPPLEMENTAL#4
ID Task Name IStart IFinish 2015 2016 2017
i Q3 Q4 Q1 Q2 Q3 Q4 i Q1 Q2 Q3 Q4 Q1_II
1 NTP Tue 9/29/15 Tue 9/29/15
2 Anticipated NTP Supplemental#1 Wed 9/30/15 Wed 9/30/15
3 Anticipated NTP Supplemental#2 Mon 9/12/16 Mon 9/12/16
4 Anticipated NTP Supplemental#4 Thu 8/24/17 Thu 8/24/17 k 1
5 :Survey Wed 9/30/15 Fri 5/6/16
6 Environmental Tech Memo Thu 10/1/15 Mon 5/9/16 i
7 Prepare 30%Plans Thu 10/1/15 Tue 7/5/16 {
8 Roadway&Drainage Design Thu 10/1/15 Fri 6/3/16
9 QA/QC Mon 6/6/16 Fri 6/10/16
10 Submit 30%Plans and Environmental Tech Memo Mon 6/13/16 Mon 6/13/16 !
11 City Review 30%Plans and Environmental Tech Memo Tue 6/14/16 Fri 7/1/16
12 Meet with City to Review 30%Plans and Environmental Tue 7/5/16 Tue 7/5/16
13 Geotech Pavement Design Mon 3/21/16 Fri 7/1/16
14 !Prepare 60%Plans Tue 9/13/16 Fri 12/9/16 i
15 Roadway,Traffic,Utility&Drainage Design Tue 9/13/16 Wed 10/19/16 !
1 QA/QC Thu 10/20/16 Wed 10/26/16
17 Submit 60%Plans Thu 10/27/16 Thu 10/27/16
18 City Review 60%Plans Fri 10/28/16 Thu 12/8/16
19 Meet with City to Review 60%Plans Fri 12/9/16 Fri 12/9/16 h
20 'Prepare 95%Plans Phase 1 Mon 12/12/16 Fri 5/5/17
21 Roadway,Traffic,Utility&Drainage Design Mon 12/12/16 Fri 4/7/17 Tv A
22 QA/QC Mon 4/10/17 Thu 4/13/17 .L
23 Submit 95%Plans Fri 4/14/17 Fri 4/14/17
24 City Review 95%Plans Mon 4/17/17 Fri 5/5/17
25 Prepare 100%Plans Phase 1 Fri 5/19/17 Fri 9/22/17
26 Roadway,Traffic,Utility&Drainage Design Fri 5/19/17 Thu 9/14/17
27 QA/QC Fri 9/15/17 Thu 9/21/17 h
28 Submit 100%Plans Fri 9/22/17 Fri 9/22/17
29 Water Pollution Abatement Plan Tue 9/13/16 Mon 11/6/17
30 Bid Phase Services Tue 11/7/17 Mon 12/11/17
31 Prepare 95%Plans Phase 2 Fri 8/25/17 Mon 11/20/17
32 Roadway,Traffic,Utility&Drainage Design Fri 8/25/17 Fri 10/20/17
33 QA/QC Mon 10/23/17 Fri 10/27/17
34 Submit 95%Plans Mon 10/30/17 Mon 10/30/17
35 City Review 95%Plans Tue 10/31/17 Mon 11/20/17
36 !Prepare 100%Plans Phase 2 Tue 11/21/17 Wed 3/7/18
37 Roadway,Traffic,Utility&Drainage Design Tue 11/21/17 Mon 1/15/18
38 QA/QC Tue 1/16/18 Tue 1/30/18
39 Submit 100%Plans Wed 1/31/18 Wed 1/31/18
40 Bid Phase Services Thu 2/1/18 Wed 3/7/18
Paaa 1 -11ndated. Tile 811117
ADDENDUM TO EXHIBIT D
Fee Schedule
Attached Behind This Page
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#4
EXHIBIT D
Project Name: E Bagdad Ave Extension
Total Total Other TOTALS
Task Labor Hours Loaded Labor Cost Direct Costs Subconsultants
Task 1: Project Management 38.0 $6,714.73 $6,714.73
Task 5: Direct Expenses $4,000.00 $4,000.00
Task 6: Geotechnical Design $5,700.00 $5,700.00
Task 8:95% Plans 929.0 $113,358.93 $113,358.93
Task 9: 100%Plans/Final Submittal 434.0 $53,401.52 $53,401.52
Task 12: Barrier with Fence 133.0 $16,106.13 $16,106.13
GRAND TOTAL: 1534 $189,581.311 $4,000.001 $5,700.001 $199,281.31
Overhead Rate= 157.53% Atkins Raw Labor= $ 65,727.89
Profit Rate= 12% Atkins Overhead= $ 103,541.15
Atkins Profit= $ 20,312.27
Atkins Total Labor= $ 189,581.31
Page 1
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#4
EXHIBIT D
Task 1: Project Management
Task Description Project Design Design CADD GIS Admin/ Total
Manager Engineer EIT Operator Graphics Clerical Hours
Rates $ 75.00 $ 43.27 $ 32.50 $ 25.74 $ 25.00 $ 31.50
A. Project Management
1. Prepare monthly project status updates and invoices 18 6 24
2. Manage sub-consultants 8 6 14
Totals 26 12 38
Raw Labor $1,950.00 $ - $ - $ - $ - $ 378.00 $ 2,328.00
Multiplier 2.88 2.88 2.88 2.88 2.88 2.88
$ 5,624 $ - $ - $ - $ - $ 1,090 $ 6,714.73
Page 2
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#2
EXHIBIT D
Task 5: Direct Expenses
Direct Cost Unit Quantity Unit Price Total
Site Visits&Meetings
Mileage Mile $0.575 $0.00
Permits/Fees
TCEQ WPAP Application fee EA 1 $4,000.00 $4,000.00
Printing
Exhibits Color on Bond SF $5.00 $0.00
Photocopies B/W 8.5 X 11 EA $0.05 $0.00
Photocopies B/W 11 X 17 EA $0.10 $0.00
Mylar Plots 11 X 17 EA $2.50 $0.00
Overnight Mail-letter size EA $17.50 $0.00
Overnight Mail-oversized box _ EA _ $35.00 $0.00
Courier Services EA $37.501 $0.00
Total Direct Expenses $4,000.00
Page 3
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#4
EXHIBIT D
TASK 8:95%PLANS
Project Senior Senior Design Design Senior Senior CADD GIS Admin/ Total
Task Description Engineer Eng CADD
Manager (QAQC) Engineer Engineer EIT Tech Operator Operator Graphics Clerical Hours
Rates $ 75.00 $ 62.10 $ 51.53 $ 43.27 $ 32.50 $ 43.23 $ 43.26 $ 25.74 $ 25.00 $ 31.50
A. Roadway
1. Remove Sheppard St extension 2 2 4.0
2. Separate plans into 2 phases and develop additional sheets
a.Cover 1 2 2 5.0
b.Index 4 4 8.0
c.General notes 1 2 8 11.0
d.Project layout 2 4 6.0
e.Typical sections 1 4 4 9.0
f. Quantities 1 8 8 1 16.0
g.Construction sequence/TCP 2 1 16 16
35.0
h.Roadway P&P(6 sheets) 4 12 12 24 52.0
i.Cross Sections 1 20 21.0
j.Standards 2 2
4.0
k.Cost estimate 4 16 1 20.0
3. Revise design speed to 30 mph 2 4 4 10.0
4. Prepare separate submittal packages for each phase(cost estimate&spec lists) 4 2 8 16 30.0
5. QA/QC 2 16 16 16 50.0
B. Drainage
1. Remove Sheppard St extension 2 2.0
2. Separate plans into 2 phases and develop additional sheets
a.Quantities 8 8.0
b.Drainage P&P sheets 40 26 66.0
c.Interim/Ultimate outfall and ditch design 5 26 31.0
d.SWPPP and erosion control plans 6 6.0
3. Storm water redesign to accommodate wateriwastewater redesign required for The De t 40 40.0
4. Revise drainage report to address phasing of project 20 20.0
5. Prepare separate submittal packages for each phase cost estimate&spec lists 2 2.0
6. QA/QC 12 10 22.0
C.Utilities
1. Redesign water and wastewater improvements to accommodate The Depot 37 43 62 142.0
2. Separate plans into 2 phases and develop additional sheets
a.Quantities 8 8.0
b.Watertwastewater P&P sheets 21 39 45 105.0
3. Continue utility coordination 16 5 4 25.0
4. Continue developer coordination 8 4 5 17.0
5. QA/QC 16 4 20.0
D.Traffic
1. Remove Sheppard St extension 2 8 10.0
2. Separate plans into 2 phases and develop additional sheets
a.Quantities 8 8.0
b.Signing&Pavement Marking sheets 4 36 40.0
3. Add roadway lighting east of Bumet St 16 52 68.0
4. QA/QC 8 8.0
Totals 17.0 52.0 255.0 112.0 309.0 116.0 68.0 929.0
Raw Labor $1,275.00 $3,229.20 $13,140.15 $ 4,846.24 $10,042.50 $ - $5,018.16 $1,750.32 $ - $ - $ 39,301.57
Multiplier 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88
$ 3,678 $ 9,314 $ 37,901 $ 13,978 $ 28,966 $ $ 14,474 $ 5,049 $ $ - $ 113,358.93
Page 4
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#4
EXHIBIT D
TASK 9:100%PLANS
Project Senior Senior Design Design Senior Senior CADD GIS Admin/ Total
Task Description Manager Engineer Engineer Engineer EIT Eng CADD Operator Graphics Clerical Hours
(QAQC) Tech Operator
Rates $ 75.00 $ 62.10 $ 51.53 $ 43.27 $ 32.50 $ 43.23 $ 43.26 $ 25.74 $ 25.00 $ 31.50
A. Roadway
1. Address comments on new phase 2 sheets
a.Cover 1 2 3.0
b.Index 1 3 4.0
c.General notes 1 4 5.0
d.Project layout 1 2 3.0
e.Typical sections 1 2 3.0
f. Quantities 1 8 10 19.0
g.Construction sequencerrCP 2 1 4 8 15.0
h.Roadway P&P 4 1 2 4 11.0
i.Cross Sections g 8.0
j.Standards
k.Cost estimate 1 g 9.0
2. Prepare separate submittal packages for each phase cost estimate&spec lists 4 1 8 8 20.0
3. Prepare bid packages for phases 1 and 2 8 20 40 68.0
4. Prepare construction time estimate for phase 2 2 24 26.0
5. QA/QC 2 12 8 8 30.0
B. Drainage
1. Address comments on new phase 2 sheets
a.Quantities 1 4 4.0
b.Drainage P&P sheets 8 16 24.0
c.Intedrn/Ultimate outfall and ditch design 4 8 1 12.0
d.SWPPP and erosion control plans 8 8 16.0
2. Prepare separate submittal packages for each phase cost estimate&spec lists 2 2,0
3. QA/QC 12 8 20.0
C. Utilities
1. Address comments on new phase 2 sheets
a.Quantities 3 1 3.0
b.Watertwastewater P&P sheets 7 25 9 41.0
2. Continue utility coordination 4 4.0
3. QA/QC 8 2 10.0
D. Traffic
1. Address conxnents on new phase 2 sheets
a.Quantities 6 6.0
b.Signing&Pavement Marking sheets 2 28 30.0
d.Roadway lighting east of Burnet St 4 28 32.0
2. QA/QC 6 6.0
Totals 27.0 38.0 82.0 64.0 183.0 9.0 31.0 434.0
Raw Labor $2,025.00 $2,359.80 $ 4,225.46 $ 2,769.28 $ 5,947.50 $ - $ 389.34 $797.94 $ - $ - $ 18,514.32
Multiplier 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88
$ 5,841 $ 6,806 $ 12,188 $ 7.988 $ 17,155 $ $ 1,123 $ 2,302 $ $ $ 53,401.52
Page 5
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#4
EXHIBIT D
TASK 12: BARRIER WITH FENCE
Senior Senior Senior
Project (QAQC) Senior Design Design Tech Operator CADD GIS Admin/ Total
Task Description Manager Engineer Engineer Engineer EIT Eng CADD Operator Graphics Clerical Hours
Rates $ 75.00 $ 62.10 $ 51.53 $ 43.27 $ 32.50 $ 43.23 $ 43.26 $ 25.74 $ 25.00 $ 31.50
A. Barrier with Fence
1. Prepare fence details 2 16 16 32 66.0
2. Prepare fencespecification 2 8 16 26.0
3. Add fence to plans and quantities 8 16 24.0
4. QA/QC 1 4 4 8 17.0
Totals 5.0 4.0 24.0 44.0 56.0 133.0
Raw Labor $ 375.00 $ 248.40 $ 1,236.72 $ 1,903.88 $ 1,820.00 $ - $ - $ - $ - $ - $ 5,584.00
Multiplier 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88
$ 1,082 $ 716 $ 3,567 $ 5,491 $ 5,249 $ SS $ $ $ 16,106.13
Page 6
CERTIFICATE OF INTERESTED PARTIES FORM 3.295
1 of 1
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. 2017-244171
Atkins North America, Inc.
Tampa, FL United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 08/02/2017
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.
E Bagdad Ave Extension Project
Supplemental#4: Phasing of Project and design changes for The Depot Townhomes
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
The Atkins North America Holdings Corporation Tampa, FL United States X
Nash, George Edison, NJ United States X
Edgar IV, C. Ernest Tampa, FL United States X
Newton, Michael M. Tampa, FL United States X
Schulz, Barry J. Denver, CO United States X
Steele Jr.,James R. Tampa, FL United States X
Quinn Sr., David D. Boston, MA United States X
Burns Jr., Kenneth J. Denver, CO 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.
,,•Q;A.�':ti; ., AMPARO A.GONZALEZ
MY COMMISSION#GG 083290
EXPIRES:March 15,2021 .�•---
•' Bonded Thru Notary Pubic Underwriters
Signature of authorized agent of contracting business entity
Rene de los Rios,Assistant Secretary
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said Rene de los Rios,Assistant Secretary this the 2nd day of August
20 17 to certify which,witness my hand and seal of office.
4 Amparo A.Gonzalez Notary
Signature of icer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provide by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.883
CERTIFICATE OF INTERESTED PARTIES FORM 1295
1 of 1
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. 2017-244171
Atkins North America, Inc.
Tampa, FL United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 08/02/2017
being filed.
City of Round Rock Date Acknowledged:
08/09/2017
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.
E Bagdad Ave Extension Project
Supplemental#4: Phasing of Project and design changes for The Depot Townhomes
4
Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
The Atkins North America Holdings Corporation Tampa, FL United States X
Nash, George Edison, NJ United States X
Edgar IV, C. Ernest Tampa, FL United States X
Newton, Michael M. Tampa, FL United States X
Schulz, Barry J. Denver,CO United States X
Steele Jr.,James R. Tampa, FL United States X
Quinn Sr., David D. Boston, MA United States X
Burns Jr., Kenneth J. Denver,CO 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.
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