Loading...
Contract - Whitestone Civil - 11/9/2017 I City of Round Rock, Texas Contract Forms Standard Form of Agreement: Section 00500 City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor st— AGREEMENT made as of the ety- tet (e{)day of acf/ in the year 20/P. BETWEEN "Owner" "City") the Owner: City of Round Rock,Texas(hereafteror City ) 221 East Main Street Round Rock,Texas 78664 GG c and the Contractor Vv V1� S�UA V I CO sirucf•Owl ("Contractor") PO B oK /5'37 C '&Jar Fade) ' Vi. 7'8& (3 The Project is described as: Greenlawn Annexation Wastewater I The Engineer is: Kit Perkins,P.E. 2008 Enterprise Dr. ✓fO amu/'ocie,yr 7f4 / For and in consideration of the mutual terms, conditions and covenants of this Agreement and all accompanying documents between Owner and Contractor, the receipt and sufficiency of which are hereby acknowledged, Owner and Contractor agree as follows: ARTICLE I THE CONTRACT DOCUMENTS The Contract Documents consist of this Agreement,Conditions of the Contract(General,Supplementary and other Conditions),Drawings, Specifications,Addenda issued prior to execution of this Agreement, other documents listed in this Agreement and Modifications issued after execution of this Agreement;these form the Contract,and are as fully a part of the Contract as if attached to this Agreement or repeated herein. The Contract represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations,representations or agreements, either written or oral.An enumeration of the Contract Documents,other than Modifications,appears in Article 7. ARTICLE 2 THE WORK OF THIS CONTRACT Contractor shall fully execute the Work described in the Contract Documents,except to the extent specifically indicated in the Contract Documents to be the responsibility of others. I 00500 4-2016 Page 1 of 5 Standard Form of Agreement 00307791 l20 --- det,ts I ARTICLE 3 DATE OF COMMENCEMENT; DATE OF SUBSTANTIAL COMPLETION;DATE OF FINAL COMPLETION 3.1 The date of commencement of the Work shall be the date of this Agreement unless a different date is stated below or provision is made for the date to be fixed in a Notice to Proceed issued by Owner. 3.2 The Contract Time shall be measured from the date delineated in the Notice to Proceed. 3.3 Contractor shall commence Work within TEN ( 10 ) calendar days from the date delineated in the Notice to Proceed. 3.4 Contractor shall achieve Substantial Completion of the items of Work listed on Attachment A to this Agreement no later than N/A ( N/A )calendar days from issuance by Owner of Notice to Proceed, and Contractor shall achieve Substantial Completion of the entire Work no later than ninety ( 90 ) calendar days from issuance by Owner of Notice to Proceed, subject to adjustments of this Contract Time as provided in the Contract Documents. 3.5 If Contractor fails to achieve Substantial Completion of the Work(or any portion thereof) on or before the date(s)specified for Substantial Completion in the Agreement,Contractor shall pay to Owner,as liquidated damages, the sum of five hundred and No/100 Dollars($500.00 ) for each calendar day that Substantial Completion is delayed after the date(s) specified for Substantial Completion. It is hereby agreed that the liquidated damages to which Owner is entitled hereunder are a reasonable forecast of just compensation for the harm that would be caused by Contractor's failure to achieve Substantial Completion of the Work(or any portion thereof)on or before the date(s)specified for Substantial Completion in the Agreement. It is agreed that the harm that would be caused by such failure,which includes loss of expected use of the Project areas,provision of alternative storage facilities and rescheduling of moving and occupancy dates,is one that is incapable or very difficult of accurate estimation.It is hereby agreed that if Substantial Completion of the Work (or any portion thereof) is not achieved on or before thirty (30) days after the date(s) specified for Substantial Completion in the Agreement,the Owner shall have the option to either collect liquidated damages as set forth herein or to thereafter rely on its remedies under the Contract Documents and at law and in equity, including without limitation,the recovery of actual damages.The date(s)specified for Substantial Completion of the Work(or any portion thereof)in the Agreement shall be subject to adjustment as provided in the Contract Documents. 3.6 Contractor shall achieve Final Completion of the entire Work no later than ninety ( 90 )calendar days from issuance by Owner of Notice to Proceed. ARTICLE 4 CONTRACT SUM 4.1 Owner shall pay Contractor the Contract Sum in current funds for Contractor's performance of the Contract. The Contract Sum shall be 0/70 ilu,70411:Ree J,.)'1Ys., 7 ()oda,et Di'e Q C hfy - .47-az a4d 00//oa da//a . ($ //G,J/'5:C O ),subject to additions and deductions as provided in the Contract Documents. 4.2 Does the Contract Sum include alternates which are described in the Bid Form? No X . Yes .If yes,please provide details below: I I 00500 4-2016 Page 2 of 5 Standard Form of Agreement 00307791 1 1 ARTICLE 5 PAYMENTS 5.1 PROGRESS PAYMENTS 5.1.1 Based upon Applications for Payment submitted to Engineer and Owner by Contractor,and Certificates for Payment issued by Engineer and not disputed by Owner and/or Owner's lender,Owner shall make progress payments on account of the Contract Sum to Contractor as provided below, in Article 14 of the City of Round Rock General Conditions,and elsewhere in the Contract Documents. 5.1.2 The period covered by each Application for Payment shall be one calendar month ending on the last day of the month. 5.1.3 Provided that an Application for Payment is received by Engineer and Owner, and Engineer issues a Certificate of Payment not later than the tenth(10th) day of a month, Owner shall make payment to Contractor not later than the tenth(10th) day of the next month. If an Application for Payment is received by Engineer and Owner after the application date fixed above,payment shall be made by Owner not later than one month after the Engineer issues a Certificate for Payment. 5.1.4 Each Application for Payment shall be based on the most recent schedule of values submitted by Contractor in accordance with the Contract Documents.The schedule of values shall allocate the entire Contract Sum among the various portions of the Work. The schedule of values shall be prepared in such form and supported by such data to substantiate its accuracy as Engineer and Owner may require.This schedule,unless objected to by Engineer or Owner, shall be used as a basis for reviewing Contractor's Applications for Payment. 5.1.5 Applications for Payment shall warrant the percentage of completion of each portion of the Work as of the end of the period covered by the Application for Payment. 5.1.6 Subject to other provisions of the Contract Documents, the amount of each progress payment shall be computed as provided in Article 14 of the City of Round Rock General Conditions. 5.1.7 Except with Owner's prior written approval, Contractor shall not make advance payments to suppliers for materials or equipment which have not been delivered and stored at the site. 5.2 FINAL PAYMENT 5.2.1 Final payment, constituting the entire unpaid balance of the Contract Sum, shall be made by Owner to Contractor when: .1 Contractor has fully performed the Contract except for Contractor's responsibility to correct Work, and to satisfy other requirements,if any,which extend beyond final payment;and .2 a final Certificate for Payment has been issued by Engineer. 5.2.2 Owner's final payment to Contractor shall be made no later than thirty (30) days after the issuance of Engineer's final Certificate for Payment. In no event shall final payment be required to be made prior to thirty(30) days after all Work on the Contract has been fully performed.Defects in the Work discovered prior to final payment shall be treated as non-conforming Work and shall be corrected by Contractor prior to final payment,and shall not be treated as warranty items. ARTICLE 6 TERMINATION OR SUSPENSION 6.1 The Contract may be terminated by Owner or Contractor as provided in Article 15 of the City of Round Rock General Conditions. 00500 4-2016 Page 3 of 5 Standard Form of Agreement 00307791 I 6.2 The Work may be suspended by Owner as provided in Article 15 of the City of Round Rock General Conditions. ARTICLE 7 ENUMERATION OF CONTRACT DOCUMENTS 7.1 The Contract Documents,except for Modifications issued after execution of this Agreement,are enumerated as follows: 7.1.1 The Agreement is this executed version of the City of Round Rock, Texas Standard Form of Agreement between Owner and Contractor,as modified. 7.1.2 The General Conditions are the "City of Round Rock Contract Forms 00700," General Conditions, as modified. 7.1.3 The Supplementary,Special,and other Conditions of the Contract are those contained in the Project Manual dated 7.1.4 The Specifications are those contained in the Project Manual dated J//fl/Jr 7.1.5 The Drawings,if any,are those contained in the Project Manual dated fit!//9 7.1.6 The Insurance&Construction Bond Forms of the Contract are those contained in the Project Manual dated December 2017 7.1.7 The Notice to Bidders,Instructions to Bidders,Bid Form,and Addenda,if any,are those contained in the Project Manual dated N/A 7.1.8 If this Agreement covers construction involving federal funds, thereby requiring inclusion of mandated contract clauses, such federally required clauses are those contained in the "City of Round Rock Contract Forms 03000,"Federally Required Contract Clauses,as modified. 7.1.9 Other documents,if any,forming part of the Contract Documents are as follows: N/A ARTICLE 8 MISCELLANEOUS PROVISIONS 8.1 Where reference is made in this Agreement to a provision of any document, the reference refers to that provision as amended or supplemented by other provisions of the Contract Documents. 8.2 Owner's representative is: Jeff Bell Project Manager 200, Enterprise Drive RoutdRock,TX 78664 8.3 Contractor's representative is: friOlti' Lean S CNA - W ln.lop C'i v CO✓VStaI CA') C PO �^ 7 (- a✓ P*y 71- X8633 8.4 Neither Owner's nor Contractor's representative shall be changed without ten(10)days'written notice to the other party. 8.5 Waiver of any breach of this Agreement shall not constitute waiver of any subsequent breach. 00500 4-2016 Page 4 of 5 Standard Form of Agreement 00307791 I I I I 8.6 Owner agrees to pay Contractor from available funds for satisfactory performance of this Agreement in accordance with the bid or proposal submitted therefor,subject to proper additions and deductions,all as provided in I the General Conditions, Supplemental Conditions, and Special Conditions of this Agreement, and Owner agrees to make payments on account thereof as provided therein. Lack of funds shall render this Agreement null and void to the extent funds are not available. This Agreement is a commitment of City of Round Rock's current revenues only. I8.7 Although this Agreement is drawn by Owner,both parties hereto expressly agree and assert that,in the event of any dispute over its meaning or application,this Agreement shall be interpreted reasonably and fairly,and neither more strongly for nor against either party. I8.8 This Agreement shall be enforceable in Round Rock,Texas,and if legal action is necessaryby either party with respect to the enforcement of any or all of the terms or conditions herein, exclusive venue for same shall lie in Williamson County, Texas. This Agreement shall be governed by and construed in accordance with the laws and Icourt decisions of the State of Texas. 8.9 Both parties hereby expressly agree that no claims or disputes between the parties arising out of or relating I to this Agreement or a breach thereof shall be decided by an arbitration proceeding,including without limitation,any proceeding under the Federal Arbitration Act(9 USC Section 1-14)or any applicable state arbitration statute. 8.10 The parties, by execution of this Agreement, bind themselves, their heirs, successors, assigns, and legal Irepresentatives for the full and faithful performance of the terms and provisions hereof. This Agreement is entered into as of the day and year first written above and is executed in at least three(3) I original copies, of which one is to be delivered to Contractor, one to Engineer for use in the administration of the Contract,and the remainder to Owner. IOWNER CONTRACTOR CITY OF R ND R 0 ,T 'AS tf.SV/11 /r t� CSCuPrinted Nam-. tatra �� A Printed Name: Title kit d11( Title: hutnid r t Date Signed: I . . Ith Date Signed: ( —V=1 V I ATTEST: it/rvi City Clerk 1 FOR,r Y,APPROVE 1 AS TO FORM: 404 . ,in 41' 1 L. IiiiL...) ICity A limey 00500 4-2016 Page 5 of 5 Standard Form of Agreement 00307791 I I 1 ® DATE(MM/DD/YYYY) AC�i o CERTIFICATE OF LIABILITY INSURANCE L,,, 01/23/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Jeremy Farque NAME: Whorton Insurance Services PHONE (A/C,No,Ext): ((512)338 1191 A/C No (512)338-1196 11200 Jollyville Rd. ADDRESS: JeremyF@whortonins.com INSURER(S)AFFORDING COVERAGE NAIC# Austin TX 78759-4813 INSURERA: FCCI Insurance Co 10178 INSURED INSURER B: Whitestone Civil Construction LLC INSURER C: P.O.Box 1537 INSURER D: INSURER E: Cedar Park TX 78630 INSURER F: COVERAGES CERTIFICATE NUMBER: CL17112214934 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDCSUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD wD/Y VD POLICY NUMBER (MM/DYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITYEACH OCCURRENCE $ 1,000,DAMAGE 000 CLAIMS-MADE XI OCCUR PREM SESO(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 A Y CPP00251781 11/20/2017 11/20/2018PERSONAL&ADV INJURY $ 1,000,000 ^ GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2,000,000 POLICY XI PRO LOC 2,000,000 JECT PRODUCTS-COMP/OP AGG $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ A OWNED X SCHEDULED Y CA100019602-00 11/20/2017 11/20/2018 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XHIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY X AUTOS ONLY (Per accident) PIP-Single limit $ 2,500 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE Y UMB100019610-00 11/20/2017 11/20/2018 AGGREGATE $ 5,000,000 DED RETENTION$ 0 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER , , A ANY PROPRIETOR/PARTNER/EXECUTIVE Y N/A Y WC000046671 11/20/2017 11/20/2018 E.L.EACH ACCIDENT $ 1 000 000 OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below Limit 100,000 Inland Marine A Leased/Rented Equipment CPP00251781 11/20/2017 11/20/2018 Deductible 1,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Round Rock listed as certificate holder and Additional Insured.The General Liability and Auto Liability policies include a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status.The General Liability,Auto Liability and Workers Compensation policies include a blanket waiver of subrogation endorsement that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it. The General Liability Policy contains a special endorsement with "Primary and Noncontributory"wording. The Commercial General Liability,Auto Liability and Workers Compensation policies include a blanket notice of cancellation to the certificate holders endorsement,providing for 30 days'advance notice if the policy is cancelled by the ` CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ICity of Round Rock ACCORDANCE WITH THE POLICY PROVISIONS. 221 E Main Street AUTHORIZED REPRESENTATIVE • f •/ Round Rock TX 78664 f I r/ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 1 1052001 Hanover ",,,,e,,,,Insurance Group ,, . Statutory Performance Bond 111 r Specialty .w "` STATUTORY PERFORMANCE BOND ::„ PURSUANT TO CHAPTER 2253 OF THE TEXAS GOVERNMENT CODE (McGREGOR ACT - PUBLIC WORKS) KNOW ALL MEN BY THESE PRESENTS: That, Whitestone Civil Construction, LLC (hereinafter called the Principal), as Principal, and The Hanover Insurance Company a corporation organized and existing under the laws of the State of lbw Hampshire , with its principal office in the City of Worcester (hereinafter called the Surety), as Surety, are held and firmly bound unto City of Round Rock (hereinafter called the Obligee) in the amount of One Hundred Sixteen Thousand One Hundred Eighty Five and 00/1.00 Dollars ($ 116_,L185.00 J, for the payment whereof, the said Principal and Surety bind themselves, and their heirs, administrators, I executors, successors and assigns,jointly and severally,firmly by these presents. .31 WHEREAS the Principal has entered into a certain written contract with the Obligee, dated they' day ofe 1�4,..-2.0j to Greenlawn Wastewater Extension which contract is hereby referred to an made a part hereof as fully and to the same extent as if copied at length herein. I NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal shall faithfully perform the work in accordance with the plans, specifications and contract documents, then this obligation shall be void; otherwise to remain in full force and effect. IPROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253 of the Texas Government Code, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter to the same extent as if it were copied at length herein. I IN WITNESS WHEREOF, the said PrincipalSurety and havesigned and sealed this instrument g this 6th day of December , 2017 . i W tness. (if not a corporation) Attest: (if a . poration) Whit--tone Civil Con-tr F. LLC -., , 1 B � �I/,iii. B 4 A . / (SEAL) y , . - - - � � -� � ) o Matt Lewis _ Carrie Lewis Name: Name: Member Member Title: Title: Attest/Surety Witness The er Insurance Company By: Lam' B : (SEAL) y Rachel Martinez Jere Far.ue Name: Attorney-in-Fact: Attorney In Fact Title: The Hanover Insurance Company 1440 Lincoln Street,Worcester,MA 01653 Citizens Insurance Company of America 1645 West Grand River Avenue,Howell,MI 48843 141-0834(5/13)Page 1 of 1 Massachusetts Bay Insurance Company 1440 Lincoln Street,Worcester,MA 01653 hanover.com ,, 1052001 IIi !au1I ,�.p- Statutory Payment Bond �'°� Specialty -A STATUTORY PAYMENT BOND .. .:,4.- . PURSUANT TO CHAPTER 2253 OF THE TEXAS GOVERNMENT CODE (MCGREGOR ACT - PUBLIC WORKS) KNOW ALL MEN BY THESE PRESENTS: That, Whitestone Civil Construction, LLC (hereinafter called the Principal), as Principal, and The Hanover Insurance Company , a corporation organized and existing under the laws of the State of New±lampsbire , with its principal office in the City of Worcester (hereinafter called the Surety), as Surety, are held and firmly bound unto City of Round Rock (hereinafter called the Obligee) in the amount of One Hundred Sixteen Thousand One Hundred Eighty Five and 00/100 — Dollars ($ 116 185.00 _— J, for the payment whereof, the said Principal and Surety bind themselves, and their heirs, administrators, executors, successors and assigns,jointly and severally, firmly by these presents. WHEREAS, the Principal has entered into a certain written contract with the Obligee, dated the ' day of E 14 "2_t , for GreenlawnWastewater Extension—_--_—_--_— which contract is hereby' referred to an made a part hereof as fully and to the same extent as if copied at length herein. NOW, THEREFORE, THE CONDITIONS OF THIS OBLIGATION IS SUCH, that if the said Principal shall pay all claimants supplying labor and material to him or a subcontractor in the prosecution of the work provided for in said contract, then this obligation shall be void; otherwise to remain in full force and effect. PROVIDED, HOWEVER, that this bond is executed pursuant to the provisions of Chapter 2253 of the Texas Government Code, and all liabilities on this bond shall be determined in accordance with the provisions of said Chapter to the same extent as if it were copied at length herein. IN WITNESS WHEREOF, the said Principal and Surety have signed and sealed this instrument this 6th day of December , 2017 . Witness: (if not a corporation) Attest: (if a c,*rpo „ hitesto e Civil Constr ct oto LC /r By: 0/%/r By: _ _._ ._ . _ Ai -- -(cEAL) Matt Lewis Carrie Lewis Name: Name: Member Member Title: Title: Attest/Surety Witne The Hanover Insurance Company By: /_____ed_ By: (SEAL) Rachel Martinez _ Jere` Far-sue _ Name: Attorney-i'-Fact: Attorney In Fact Title: The Hanover Insurance Company 1440 Lincoln Street,Worcester,MA 01653 p Citizens Insurance Company of America 1645 West Grand River Avenue,Howell,MI 48843 141.0835(5/13)Page 1 of 1 Massachusetts Bay Insurance Company 1440 Lincoln Street,Worcester,MA 01653 hanover.com i J THE CITY OF ROUND ROCK BIDS EXTENDED AND CHECKED Utilities & Environmental Services f 2008 Enterprise Drive BY : AM Round Rock, Texas 78664 DATE : Septmember 12,2017 BID TABULATION SHEET: 1 of 1 ...................... ........................ ....................................................................................................:.:...:...:.:.:.:.:.:.:.:.....:.:.:. :.:.:...:.:.: CONTRACT : Greenlawn Wastewater Extension Whitestone Civil Austin Underground Bruce Flanigan N/A LOCATION : Round Rock,TX Statement of Safety?Yes Statement of Safety?Yes Statement of Safety? Yes Statement of Safety? DATE: Septmember 12,2017 Addendum(s)? N/A Addendum(s)?N/A Addendum(s)?N/A Addendum(s)? Bid Bond? Yes Bid Bond? Yes Bid Bond?Yes Bid Bond? ............................... ................................ APPROX. UNIT UNIT UNIT UNIT ITEM h ITEM DESCRIPTION QTY. UNIT PRICE COST PRICE COST PRICE COST PRICE COST MOBILIZATION (NOT 1 TO EXCEED 5%) 1 LS $3,000.00 $3,000.00 $3,500.00 $3,500.00 $6,464.00 $6,464.00 $0.00 2 MULCH LOG 150 LF $15.00 $2,250.00 $13.00 $1,950.00 $13.70 $2,055.00 $0.00 PVC SDR-26 PRESSURE PIPE, 6-IN DIA. 3 INCLUDING EXCAVATION AND BACKFILL 125 LF $50.00 $6,250.00 $42.00 $5,250.00 $103.60 $12,950.00 $0.00 POLY SDR-9 PRESSURE PIPE, 1.5-IN DIA. 4 INCLUDING EXCAVATION AND BACKFILL 985 LF $20.00 $19,700.00 $11.00 $10,835.00 $30.90 $30,436.50 $0.00 5 TRENCH SAFETY SYSTEM 125 LF $5.00 $625.00 $4.50 $562.50 $14.10 $1,762.50 $0.00 6 WASTEWATER CLEANOUT 2 EA $400.00 $800.00 $750.00 $1,500.00 $1,555.00 $3,110.00 $0.00 BORE UNDER DRIVEWAY INCLUDING 4- 7 INCH CASING PIPE 80 LF $130.00 $10,400.00 $225.00 $18,000.00 $48.20 $3,856.00 $0.00 8 GRINDER PUMP STATION 1 LS $28,000.00 $28,000.00 $19,000.00 $19,000.00 $31,979.00 $31,979.00 $0.00 ELECTRICAL WIRING FOR GRINDER PUMP STATION INCLUDING EXCAVATION 9 BACKFILL AND CASING PIPE 1 LS $37,000.00 $37,000.00 $39,000.00 $39,000.00 $27,261.00 $27,261.00 $0.00 10 TIE INTO EXISTING MANHOLE 1 EA $1,800.00 $1,800.00 $4,500.00 $4,500.00 $1,878.00 $1,878.00 $0.00 CUT AND PLUG EXISTING WATERLINE 11 STUBOUT 1 LS $400.00 $400.00 $2,300.00 $2,300.00 $855.00 $855.00 $0.00 12 RESTORE EXISTING SITE IRRIGATION 280 LF $7.00 $1,960.00 $29.00 $8,120.00 $13.40 $3,752.00 $0.00 13 REVEGITATE DISTURBED AREAS 1 LS $4,000.00 $4,000.00 $6,400.00 $6,400.00 $3,562.00 $3,562.00 $0.00 TOTAL: $116,185.00 $120,917.50 $129,921.00 $0.00 CERTIFICATE OF INTERESTED PARTIES FORM 1295 10f1 Complete Nos.1-4 and 6 it there are interested parties. OFFICE USE ONLY Complete Nos.1,2,3.5,and 6 it 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 lCertificate Number: of business. 2017-279717 Whitestone Civil Construction LLC Cedar Park,TX United States Date Filed: 2 Name of governmental entity;;state agency that is a party to the contract for which the Yorm is 11/03/2017 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. Greenlawn Wastewater Extension Installation of utilities 4 Nature of interest Name of Interested Patty City,State,Country(place of business) (check applicable) Controlling intermediary 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. §ignatrL--a,-wt!Lqri*agent of contracting business entity AFFIX NOTARY STAMP I SEAL ABOVE orn and subscribed before* by the said this th e day 20 to certify which, h, ltno-ss my hand and seat of office, ............ A E=LEIN Texas State of Toxa Public. Sta -242021 Expires 09-24-20121 CARRIE LEWIS P6;! Notary PublIc.State Of Texas rnrri�Expires 09-24-2021 —E Co 8 80 5802 8058028 L Signature of ffiiWadrtnistering oath Printed name ot*­officer administering M-3icer administering oath Forms provided by Texas Ethics Commission wwwethics,state.mus Version V1.0.3337 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. 2017-279717 Whitestone Civil Construction LLC Cedar Park,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 11/03/2017 being filed. City of Round Rock Date Acknowledged: 11/08/2017 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. Greenlawn Wastewater Extension Installation of utilities 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary 5 Check only if there is NO Interested Party. X 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 V1.0.3337