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Contract - Lone Star Paving - 10/11/2018 AMENDMENT NO. 1 TO STANDARD FORM OF AGREEMENT BETWEEN CITY OF ROUND ROCK AND LONE STAR PAVING This Amendment No. 1 to Standard Form of Agreement Between City of Round Rock and Lone Star Paving (this "Amendment") is made by and between the City of Round Rock ("Owner") and Lone Star Paving ("Contractor"). WHEREAS,the Owner and Contractor executed the Standard Form of Agreement on the 13th day of July, 2017 in the amount of$527,623.75; and WHEREAS,during Contractor's execution of the Work, it was determined that serious failures and defects existed in University Blvd.that resulted in potential harm to the public health and safety of City residents; and WHEREAS, the cost of repairing said failures and defects exceeds the amount allowed by state law for change orders; and WHEREAS, because the defects and failures impact the public health and safety, it is not necessary to advertise for bids for the cost of the repairs; NOW THEREFORE, premises considered, the Owner and Contractor agree that said Standard Form of Agreement is amended as follows: I. The Work of this Amendment 1.1 The Work of this Amendment shall consist of two passes of full width milling on University Blvd. between AW Grimes and CR 110. Each pass shall be the depth of at least 1.5 inches for a total of 3.0 inches. The milling depth shall be more than 3.0 inches if required to completely remove the top lift overlay of asphalt surface course.The Contractor shall fully execute the Work as described above. II. Commencement and Completion of the Work 2.1 The Contract Time for this Amendment shall be measured from the date delineated in the Notice to Proceed. 2.2 Contractor shall commence the Work within 10 calendar days from the Notice to Proceed. 2.3 Contractor shall achieve Substantial Completion of the Work no later than 30 calendar days from issuance of the Notice to Proceed. Contract Amendment No 1 2.4 Contractor shall achieve Final Completion of the Work no later than 30 calendar days from issuance of the Notice to Proceed. III. Contract Sum 3.1 Owner shall pay Contractor the amount of$192,500.00 for the Contractor's performance of the Work described in this Amendment. IV. Payments 4.1 Owner shall pay Contractor progress payments and the final payment in accordance with the terms and provisions of Article 5 of the Standard Form of Agreement. V. Bonds 5.1 Contractor agrees to provide the Owner with supplemental Payment and Performance Bonds to reflect the increase in the Contract Sum reflected by this Amendment. VI. Definitions 6.1 All capitalized terms used in this Amendment shall have the meanings ascribed to them in the Contract Documents, or as otherwise provided herein. VII. Effect of this Amendment 7.1 Except as specifically provided in this Amendment,the terms of the Standard Form of Agreement and the Contract Documents continue to govern the rights and obligations of the Owner and Contractor, and all terms of the Agreement and Contract Documents remain in full force and effect. OWNER CITY OF ROUND ROCK,T XAS B v: Craig ' organ ayor rth- Signed this 1 day of abitt27.2018 [Type here] CONTRACTOR LONE STAR PAVING By: 44-f,4/411 (signature) a (printed name) C• • 0 (title) Signed this/C11-day of ‘--4;644--, 2018 [Type here] . L s E x yd 6 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of2 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. 2018366793 Asphalt Inc.,LLC dba Lone Star Paving Company Austin,TX United States pate Filed: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/12/2018 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. Project 4 Type F Overlay 2017 Street Maintenance Program Project 4 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling intermediary Carroll,Brian San Antonio,TX United States X Condon,Josh Austin,TX United States X Ramming,John Austin,TX United States X Naiver,Joe Georgetown,TX United States X Playfalr,Thomas New Braunfels,TX United States X Knox,Allen Austin,TX United States X Ohlendorf,Ryan Buda,TX United States X Lundquist, Dean Leander,TX United States X Carroll,Ben San Antonio,TX United States X Cabaza,Aaron Austin,TX United States X Spinn,Steve Austin,TX United States X Wheeler,John Austin,TX United States X Patrick Wheeler Heritage Trust Austin,TX United States X Nolan Wheeler Heritage Trust Austin,TX United States X Kaitlin Wheeler Heritage Trust Austin,TX United States X Asphalt Inc Employee Investments Austin,TX United States X t Preferred Materials.,Inc Round Rock,TX United States X Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.5523 u I e I B CERTIFICATE OF INTERESTED PARTIES PoRM 1295 2of2 I Complete Nos.1-4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos.1,2,6,5,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 lCeilificate Number: j of business. 2018-366793 Asphalt Inc.,LLC dba Lone Star Paving Company i Austin,TX United States Date Piled: 2 Name of governmental entity or state agency that is a party to the contract for which the form is 06/12/2018 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. Project 4 Type F Overlay 2017 Street Maintenance Program Project 4 4 Nature ofinterest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary x i F t S ry 5 Check only if there is NO Interested Party. 6 UNSWORN DECLARATION ] My name is Z/-r*"/ Y and m date of birth is d �fl � € � - � My address is 1"11 Stt�0� Ait- t k1-A-1 - �Ft�c(nr..�t I�IE t y (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in 14AJ t� County, State of ���� ,on the day of (month) (year) ................. Signature of au orized agent of ontracting business entity (Declarant Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.5523 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1 of 2 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. 2018-366793 Asphalt Inc., LLC dba Lone Star Paving Company 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 06/12/2018 being filed. City of Round Rock Date Acknowledged: 10/09/2018 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. Project 4 Type F Overlay 2017 Street Maintenance Program Project 4 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Carroll, Brian San Antonio,TX United States X Condon,Josh Austin,TX United States X Ramming,John Austin,TX United States X Naiver,Joe Georgetown,TX United States X Playfair,Thomas New Braunfels,TX United States X Knox,Allen Austin,TX United States X Ohlendorf, Ryan Buda,TX United States X Lundquist, Dean Leander,TX United States X Carroll, Ben San Antonio,TX United States X Cabaza,Aaron Austin,TX United States X Spinn, Steve Austin,TX United States X Wheeler,John Austin,TX United States X Patrick Wheeler Heritage Trust Austin,TX United States X Nolan Wheeler Heritage Trust Austin,TX United States X Kaitlin Wheeler Heritage Trust Austin,TX United States X Asphalt Inc Employee Investments Austin,TX United States X Preferred Materials., Inc Round Rock,TX United States X Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.5523 CERTIFICATE OF INTERESTED PARTIES FORM 1295 2 of 2 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. 2018-366793 Asphalt Inc., LLC dba Lone Star Paving Company 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 06/12/2018 being filed. City of Round Rock Date Acknowledged: 10/09/2018 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. Project 4 Type F Overlay 2017 Street Maintenance Program Project 4 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. ❑ 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 V1.0.5523