Contract - Smith Contracting Co, Inc. - 11/8/2018 Pagel of 3
Contract Quantity Adjustment/Change Order RU R� I 1!N A
ROl1NOOIXTEXAS �i
2v,01/16
Department: TRANSPORTATION
Project
Name: ROUNDVILLE LANE Date: 10/19/18
City Project Change Order/Quantity
ID Number Adjustment No. 2
Vendor SMITH CONTRACTING CO.INC. 15308 GINGER ST AUSTIN TX 78728 512-990-7640
Company Name Address Phone No.
Justification
Quantity adjustments were made based upon existing conditions not foreseen during design.The project encountered hard rock instead of the
expected clay material.An on-site meeting with the geotech resulted in removing sections of lime treatment and adding 6"of base material to
areas where the lime treatment was not required.A waterline had to be relocated,as it was not located where our GIS had it called out.
Additional headwalls were required due to offsite developments.
SUMMARY Amount %Change
Original Contract Price:
F-s2,699,825.69 --
Previous Quantity Adjustment(s): $35,439.25
IL I
This Quantity Adjustment: $71,324.50
Total Quantity Adjustment(s): $106,763.75
Total Contract Price with Quantity Adjustment(s): $2,806,589.44
Previous Change Order(s): $18,170.00
This Change Order: $20,522.50 1%
Total Change Order(s)To Date: $38,692.50 1%
Adjusted Contract Price [Original Contract Price Plus ---- --�
Quantity Adjustment(s)Plus Change Order(s)]: $2,845,281.94
Difference between Original and Adjusted Contract Prices: $145,456.25
Original Contract Time: 270
Time Adjustment by previous Quan.Adj./Change Order: 13
Time Adjustment by this Quan.Adj./Change Order: 23
New Contract Time: 306
Submitted for Approval
Prepared By: h,�.✓-- OC 4—� ►1 ✓ � ET � l ��
- --
Signature J Printed Na e,T brie,Company JDate
_ Approvals
Contractor: Hardin Camp II Vp,Smith Contracting Co. Inc. 10-19-18
Signature Printed Name,Title,Company Date
City Project (
Manager: vi .P,✓ tz, 44 BEr/'
qhs
Signa e Pri ted Name,Title ate
Mayor/City
Manager
Signa re Pr ted Arne,TitleJ Date
Page 2 of 3
Contract Quantity Adjustment/Change Order
r
ROL1N❑ROCK TEXAS
rev,01/16
Project Name: ROUNDVILLE LANE
Quan.Adj./Change Order No.: 2
Change Order Data
Contract
Time
Adjustment
Item # Item Description Unit Qty. Unit Price Amount (Days)
CO 2-1 RAIL TYPE T631 (STEEL RAIL ONLY) LF 149 $109.25 $16,278.25 1
CO 2-2 WATERLINE RELOCATION LS 1 $4,244.25
$4,244.25 5
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
e -
Page 3 of 3
Contract Quantity Adjustment/Change Order
ROUND ROIX TEXAS
rev,01/16
Project Name: ROUNDVILLE LANE
Quan, Adj./Change Order No.: 2
Quantity Adjustment Data
Contract
Time
Adjustment
Bid Item# Item Description Unit Qty. Unit Price Amount (Davs)
38 GUARDRAIL END TREATMENT(TYT-- --Ew- 2 $2,400.00 $4,800.00
4 STREET EXCAVATION --CT- bbu $11.00 $6,050.00 1
6 203-0 TYPE B LIME SLURRY TON 2.1 $165.00 $346.50
9 CL C CONC(MISC) CY 58.15 $800.00
$46, 0.00 10
$8.00 $4
24 PC CONCRETE DRIVEWAY SF 5 $40.00
37 MTL W-BEAM GD FEN (TIM POST) LF _4i,),
$ .00 -$2,560.00
39 CHAIN LINK FENCE REMOVAL LF 542
$9
76 FLEXIBLE BASE CY 250 $9.00 $4,878.00 2
$45.00 $11,250.00 5
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$71,324.50 17
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. 2018-416901
SMITH CONTRACTING CO INC
Round Rock,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 10/19/2018
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.
Roundville Lane Project
Roadway reconstruction.
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 %n:t4-3 and my date of birth is
My address is 200
C:-1—
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
gk/-4Executed inCounty, State of_ � � on the
ay 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 V1.0.6711
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. 2018-416901
SMITH CONTRACTING CO INC
Round Rock,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 10/19/2018
being filed.
City of Round Rock Date Acknowledged:
10/24/2018
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.
Roundville Lane Project
Roadway reconstruction.
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 V1.0.6711