Contract - Cash Construction - 2/8/2018 r ,
Page 1 of 3
Contract Quantity Adjustment/Change Order
'RCHtND RM'lC,7�.15
rev,08/12
Department: Transportation
Project
Name: CORR SWDT Ph 5B Date: 12/27/17
City Project Change Order/Quantity
ID Number SWDT5 Adjustment No. 3
Justification
Additional concrete items such as turndown rockwalls,sidewalk,steps,and driveways added to project scope. Also,dumpster pads,and rock pedestal added
too.
SUMMARY Amount %Change
Original Contract Price: $4,315,214.00
Previous Quantity Adjustment(s): $83,988.00
This Quantity Adjustment: $55,310.00
Total Quantity Adjustment(s): $139,298.00
Total Contract Price with Quantity Adjustment(s): $4,454,512.00
Previous Change Order(s): $50,765.00 1%
This Change Order: $51,367.00 1%
Total Change Order(s)To Date: $102,132.00 2%
Adjusted Contract Price [Original Contract Price Plus Quantity Adjustment(s)
Plus Change Order(s)]: $4,556,644.00
Difference between Original and Adjusted Contract Prices: $241,430.00
Original Contract Time: 360 Calendar Days
Time Adjustment by previous Quan.Adj./Change Order: 0 Calendar Days
Time Adjustment by this Quan.Adj./Change Order: 0 Calendar Days
New Contract Time: 360 Calendar Days
Submitted for Approval
Prepared By: B.J.Cash,Cash Construction �(2�
Signature Printed Name,Title,Company Date
Approvals
Contractor: '7`�!(.tl1�� B.J.Cash,Cash Construction
Signature Printed Name,Title,Company Date
City Project
Manager: Bill Stablein, Project Manager,CORR
Signa re Printed Name,Title Date
Mayor/City A46A h
Manager , Mayo,CORR `
Signa re Printed Name,Title Date
r •
Page 2 of 3
Contract Quantity Adjustment/Change Order
.,i '�it()I.IND RM:K TF.XAi
rev,08/12
Project Name: CORR SWDT Ph 5B
Quan.Adj./Change Order No.: 3
Change Order Data
Contract
Time
Adjustment
Item# Item Description Unit Qty. Unit Price Amount (Davs)
Leffingwell Sign Fix LS 1 $1,450.00 $1,450.00
Handrail at Leffingwell LS 1 $495.00 $495.00
Lee's Body Shop Gate remove&replace(6'x20'swing
gate with wheels,'sch 40 posts set in concrete footers,
&3 strand barb wire) LS 1 $3,460.00 $3,460.00
Business ADA Ramp Layout LS 1 $427.00 $427.00
Dumpster Pad(34.5'x 8') LS 1 $7,865.00 $7,865.00
6'Tall CMU Walls LS 1 $8,305.00 $8,305.00
Bollards EA 18 $615.00 $11,070.00
Rock Pedestal Excluding the Engraving LS 1 $18,295.00 $18,295.00
$0.00
$0.00
$0.00
TOTALS: $51,367.00 0
Page 3 of 3
Contract Quantity Adjustment/Change Order
'RfN.iND RC1CK TE7i\5
rev,08/12
Project Name: CORR SWDT Ph 5B
Quan.Adj./Change Order No.: 3
Quantity Adjustment Data
Contract
Time
Adjustment
Bid Item# Item Description Unit Qty. Unit Price Amount (Days)
Contract Adds
P.C. Reinforced Concrete Steps(for Fire Station
14-360-6046 2)(Leffingwell18) LF 20 $330.00 $6,600.00
5-530-6004 P.C. Reinforced Concrete Driveway SY 68 $60.00 $4,080.00
9-529-6033 P.C. Reinforced Concrete Retainer Curb,Type A, LF 38 $75.00 $2,850.00
Portland Cement Reinforced Concrete Sidewalks to fl-
inch Thickness(as needed to match existing sidewalk on
site for each address at ROW)24SY WHERE+ 75SY
8-531-6042 SICFIT SY 99 $85.00 $8,415.00
Turndown Mortared Rock Limestone Block(6"x6"x up to
24")Wall,with mortared joints up to 3-feet tall,
including foundation, (measured square feet of face of
11-423-6015 block)complete in place per square foot(WHERE) SF 297 $45.00 $13,365.00
50 Trench Drain per LF(if required)(RFI#6) LF 10 $2,000.00 $20,000.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS: $55,310.001 0
CERTIFICATE OF INTERESTED PARTIES
FORM 129J
10f1
Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos.1,2,3,5,and 6 if there are no interested parties. CERTIFICATION OF FILING
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2018-297842
Cash Construction Company, Inc.
Pflugerville,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 01/02/2018
being filed.
City of Round Rock Date Acknowledged:
g Provide the identification number used by the governmental entity or state agency to track or identify the contract,and provide a
description of the services,goods,or other property to be provided under the contract.
CORR SW Downtown 5B
Additional concrete items such as turndown rockwalls,sidewalk,steps and driveways added to project scope.Also,dumpster pads
and rock pedestals added.
4
Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
5 Check only if there is NO Interested Party.
X
6 UNSWORN DECLARATION
My name is 6-5 L and my date of birth is Z(P-
My
-My address is 1 ! 4% (A�&AAIVJ r j) ,
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in I' LI V 1 S County, State of Q,4$ on the day of K 20 b
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us 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. 2018-297842
Cash Construction Company, Inc.
Pflugerville,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 01/02/2018
being filed.
City of Round Rock Date Acknowledged:
02/01/2018
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.
CORR SW Downtown 5B
Additional concrete items such as turndown rockwalls,sidewalk, steps and driveways added to project scope.Also,dumpster pads
and rock pedestals added.
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 UNSWORN DECLARATION
My name is and my date of birth is
My address is ,
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of on the day of 20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.3337