Contract - Atkins North America, Inc. - 11/20/2018 STATE OF TEXAS §
COUNTY OF WILLIAM S ON §
SUPPLEMENTAL CONTRACT NO. 7
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. 7 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, the City and Engineer executed Supplemental Contract No. 4 on August 24, 2017
to amend the scope of services and to increase the compensation by $199,281.31 to a total of
$716,018.51; and
WHEREAS, the City and Engineer executed Supplemental Contract No. 5 on March 22, 20189
to amend the scope of services and to increase the compensation by $100,929.81 to a total of
$816,948.32; and
WHEREAS, the City and Engineer executed Supplemental Contract No. 6 on July 12, 2018, to
amend the scope of services and to increase the compensation by $68,879.10 to a total of
$885,827.42; 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$97,471.52 to a total of$983,298.94;
Supplemental Contract Rev.06/16
0199.1539;00412462 84275
fes'
1
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.
II.
Article 4, Compensation and Exhibit D, Fee Schedule shall be amended by increasing by
$97,471.52 the lump sum amount payable under the Contract for a total of $983,298.94, 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;00412462 84275
2
ATKINS NORTH AMERICA,INC.
By:
r"
Date
Supplemental Contract Rev.06/16
0199.1539;00412462 84275
3
CITY OF R UND ROCK APP O D AS TORM:
By: L.q
Craig Mor n, or Stepha L. Sheets, City Attorney
11 .z� .
Date
Supplemental Contract Rev.06/16
0199.1539;00412462 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 will be extended to connect to McNeil Rd. Stone St will be
improved and extended to connect Main St and McNeil Rd. An alley will be included from
Georgetown St west towards Black St. The existing City owned parking lot between Sheppard St
and Burnet St will be reconstructed to provide improved drainage. The approximate length of
the project is 0.54 miles.
The project will be constructed in 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.
This supplemental includes improvements to and extension of Stone St, the alley connecting to
Georgetown St, the parking lot improvements, surveying services to support these efforts, and
construction phase services for phase 2.
TASK 1: PROJECT MANAGEMENT
1. Project management, oversight and coordination of efforts
TASK 2: SURVEYING
1. In accordance with previously approved methodology, the following items are added to
the survey efforts:
• Survey the existing City of Round Rock owned parking lot on Bagdad Ave between
Sheppard St and Burnet St.
• Locate and provide flow line/material information for existing City of Round Rock
wastewater manholes along proposed alley improvements between Georgetown St
and Stone St.
• Develop acquisition documents for ROW being acquired from Union Pacific
Railroad.
• Survey the alley between Georgetown St and Black St.
• Mark the temporary construction easements along Lewis St.
TASK 3: ENVIRONMENTAL STUDIES
No changes with this supplemental.
TASK 4: PRELIMINARY DESIGN/30% PLANS
No changes with this supplemental.
00412489.DOC Page 1 of 5
TASK 5: DIRECT EXPENSES
No changes with this supplemental.
TASK 6: GEOTECHNICAL DESIGN
No changes with this supplemental.
TASK 7: 60% PLANS
No changes with this supplemental.
TASK 8: 95% PLANS
No changes with this supplemental.
TASK 9: 100% PLANS/FINAL SUBMITTAL
Phase 2 of the McNeil Rd Extension is being modified to include an alley from Georgetown St
towards Black St. The alley will utilize the commercial driveway concrete pavement section. In
addition, Stone St will be improved to include 24' of pavement with a ribbon curb from Main St
to McNeil Rd. Pavement designs for Lewis St and Stone St will match the flexible pavement
design with geogrid for an urban local street with high swell conditions as shown in table 3-11 of
the May 2018 draft City of Round Rock Transportation Criteria Manual.
The plan revisions anticipated to be included are:
Roadway
1. Add 2 parallel parking spots on the west side of Georgetown St south of the proposed
alley.
2. Prepare cross-sections (50' intervals), calculate limits of construction, verify ROW and
construction easements, and compute earthwork quantities for the proposed Stone St
improvements.
3. Prepare additional typical sections for Stone St and the alley connecting to Georgetown
St.
4. Revise the Lewis St pavement design on the typical sections and cross sections to match
the flexible pavement design with geogrid for an urban local street with high swell
conditions as shown in table 3-11 of the May 2018 draft City of Round Rock
Transportation Criteria Manual.
5. Prepare one additional removal layout for Stone St.
6. Add one plan &profile sheet for the Stone St.
7. Add an alley plan and profile sheet.
8. Add grading plans for the Stone St intersections at McNeil Rd and Main St.
9. Provide driveway profiles for the 3 driveways on Stone St.
10. Update the traffic control plan narrative, sequence of construction traffic control plan,
and standards for the above changes.
11. Update the quantities to reflect the above changes.
00412489.DOC Page 2 of 5
Drainage
1. Revise the drainage design to accommodate the proposed changes to Stone St and the
alley.
2. Update hydraulic data, drainage area map, drainage plan & profile, and lateral profile
sheets.
3. Update the SWPPP and erosion control plan sheets to include the Stone St and alley
improvements.
4. Update the quantities to reflect the above changes.
Utilities
1. No third-party utility design or coordination is included. Atkins will provide an updated
plan set to the City of Round Rock for the purposes of utility coordination.
2. The wastewater line in the alley between Georgetown St and Black St will be lowered to
accommodate the proposed alley. Resulting conflicts with the existing water lines will
also be addressed.
3. The proposed wastewater improvements along Georgetown St will be extended to the
north side of Main St.
4. Update the quantities to reflect the above changes.
Traffic
1. Update the signing and pavement marking layouts to include the Stone St improvements
and to accommodate the proposed alley.
2. Prepare small sign and pavement marking summaries for the revisions.
TASK 10: WATER QUALITY PLANS AND WATER POLLUTION ABATEMENT
PLANS (WPAP)
No changes with this supplemental.
TASK 11: LANDSCAPING AND IRRIGATION PLANS
This task is no longer needed, and any remaining budget will be reallocated to other items.
TASK 12: BARRIER WITH FENCE
This task was completed under budget. Any remaining budget will be reallocated to other items.
TASK 13: CONSTRUCTION PHASE SERVICES (Add Phase 2)
These services will be provided on an as requested by the City of Round Rock basis. Invoicing
for these services will be based on actual labor charged to the project at the contract multiplier.
Any budget remaining at the end of the contract will not be invoiced. If all the budget is used,
then a supplemental will be needed to continue these services.
1. Attend weekly meetings with the City and the Contractor to appraise and answer general
questions and provide clarification that pertains to the plans and construction of McNeil
Rd Extension Phase 2.
00412489.DOC Page 3 of 5
2. Review shop drawings. Shop drawings will be reviewed based on the following
procedures:
• Review the drawings for conformity to the plans, specifications and special
provisions, as well as conformity to any subsidiary standards or criteria referred to by
the plans, specifications or special provisions.
• If the drawing is found to be in conformity, or an alternate design is adequate and
acceptable, the drawing shall be marked "No Exceptions Taken" with signature, date
and statement that "Review is only for general conformance with the design concept
of the contract documents. Markings or comments shall not be construed as relieving
the contractor from compliance with the project plans and specifications, nor
departures there-from. The Contractor remains solely responsible for details and
accuracy, for confirming and correlating all quantities and dimensions, for selecting
fabrication processes, for techniques of assembly, for safety and for satisfactory
performance of his work."
• If there are only minor corrections, the incorrect information shall be crossed out and
the correct information shall be written next to the crossed-out information. All
redlines shall be done in indelible red ink. The submittal shall be returned marked
"Make Correction as Noted"and no re-submittal shall be required.
• If the corrections are more significant and the Engineer does not concur with the
information on the drawings, then the submittal shall be marked "Amend and
Resubmit." The drawings must then be resubmitted for a second review.
• If the drawings are found not to be in conformity, the drawings shall be marked
"Rejected See Remarks." An explanation of why the submittal was disapproved shall
be provided in enough detail for the Contractor to be able to make the corrections for
re-submittal.
• Shop drawing and submittal reviews include the following:
(1) Culverts, Manholes, & Inlets
(2) Concrete and Asphalt Mix Designs
(3) Water/Wastewater Infrastructure Components
(4) Signs
3. Respond to requests for information (RFIs). The engineer shall document each question
in sufficient detail, formulate a response and submit a written version of the response to
the City for distribution to all involved parties.
4. Provide minor redesign (major redesign should be handled with a contract supplement).
5. Develop change orders. Change orders documents will be submitted to the City in
electronic format.
6. Assemble updated plans based upon redesign requests performed under Task 13. Two (2)
hard copies and an electronic version of the updated plans will be submitted to the City
upon project completion. The Contractor will be responsible for marking any additional
updates not addressed through plan revisions and providing the final as-built plans.
00412489.DOC Page 4 of 5
7. Review monthly pay applications. Reviews will consist of reviewing calculations.
Engineer is not responsible for quantity calculations or confirmation.
8. Participate in final walkthrough and prepare the punch list.
NOT INCLUDED WITHIN 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. All inspection services, including but not limited to:
a. Geotechnical investigations and analysis
b. Materials testing
c. Construction survey; verification of contractor's horizontal and vertical control
2. All tasks related to delay and cost claims shall be considered supplemental services and
subject to additional fee, specifically, but not limited to:
d. Time Impact Analyses (TIA)for delay claims
e. Claims defense, response and resolution
3. No third-party utility design or coordination is included. Atkins will provide plans to the
City of Round Rock for the purposes of utility coordination.
DELIVERABLES
100% Submittal (Phase 2 Only)
1. A draft of the 100% plans will be submitted for review in advance of the previously
scoped 100%plan submittal.
Construction Phase Services
1. Reviewed shop drawings/submittals
2. Responses to RFIs
3. Minor redesign plan revisions
4. Change orders
5. Updated plans per Task 13 item 6
6. Review of monthly pay applications including supporting documentation
7. Punch list
00412489.DOC Page 5 of 5
ADDENDUM TO EXHIBIT C
Work Schedule
Attached Behind This Page
E BAGDAD AVE EXTENSION SUPPLEMENTAL#7
EXHIBIT C
ID Task Name Start [Finish (Predecessors Successors Resource Names 2015 j 2016 2017 2018
- Q3 94 Q1 Q2 I Q1-L Q4 _Ql Q2 ._Q3 Q4 Q1 _ Q2 Q3 .-Q4_ Q1
1 NTP Tue 9/29/15 Tue 9/29/15 2,8,10,11,3,6,4,5, ------ ------ T - r---
2 Supplemental#1 Thu 3/10/16 Thu 3/10/16 1 15,18
3 Supplemental#2 Thu 9/8/16 Thu 9/8/16 1 18,32
43 Supplemental#3 Mon 4/3/17 Mon 4/3/17
4 Supplemental#4 Fri 8/25/17 Fri 8/25/17 1 35,29FF+15 days
5 Supplemental#5 Thu 3/22/18 Thu 3/22/18 1
6 Supplemental#6 Thu 7/12/18 Thu 7/12/18 1 40
7 Anticipated NTP Supplemental#7 Tue 11/20/18 Tue 11/20/18 1
8 Survey Wed 9/30/15 Mon 12/31/18 1
9 Environmental Tech Memo Thu 10/1/15 Mon 5/9/16 12
10 Prepare 30%Plans Thu 10/1/15 Tue 7/5/16 1
11 Roadway&Drainage Design Thu 10/1/15 Fri 6/3/16 1 12
12 QA/QC Mon 6/6/16 Fri 6/10/16 11,9 13
13 Submit 30%Plans and Environmental Tech Memo Mon 6/13/16 Mon 6/13/16 12 14
14 City Review 30%Plans and Environmental Tech MemTue 6/14/16 Fri 7/1/16 13 15
15 Meet with City to Review 30%Plans and Tue 7/5/16 Tue 7/5/16 14,2 18
Environmental Tech Memo
16 Geotech Pavement Design Mon 3/21/16 Fri 7/1/16 18
17 Prepare 60%Plans Fri 9/9/16 Wed 12/7/16
18 Roadway,Traffic,Utility&Drainage Design Fri 9/9/16 Mon 10/17/16 3,2,15,16 19
19 QA/QC Tue 10/18/16 Mon 10/24/16 18 20 h
20 Submit 60%Plans Tue 10/25/16 Tue 10/25/16 19 21 j
21 City Review 60%Plans Wed 10/26/16 Tue 12/6/16 20 22
22 Meet with City to Review 60%Plans Wed 12/7/16 Wed 12/7/16 21 24
23 Prepare 95%Plans Phase 1 Thu 12/8/16 Wed 5/3/17
24 Roadway,Traffic,Utility&Drainage Design Thu 12/8/16 Wed 4/5/17 22 25
25 QA/QC Thu 4/6/17 Tue 4/11/17 24 26
26 Submit 95%Plans Wed 4/12/17 Wed 4/12/17 25 27 j
27 City Review 95%Plans Thu 4/13/17 Wed 5/3/17 26 29
28 Prepare 100%Plans Phase 1 Fri 5/19/17 Thu 1/11/18
29 Roadway,Traffic,Utility&Drainage Design Fri 5/19/17 Fri 12/1/17 27,4FF+15 day 30
30 QA/QC Mon 12/4/17 Fri 12/8/17 29 31 h
31 Submit 100%Plans Mon 12/11/17 Mon 12/11/17 30 33 I 1
32 Water Pollution Abatement Plan Thu 9/15/16 Wed 11/8/17 3
33 Bid Phase Services Tue 12/12/17 Thu 1/11/18 31 44
34 Prepare 95%Plans Phase 2 Mon 8/28/17 Tue 5/8/18
35 Roadway,Traffic,Utility&Drainage Design Mon 8/28/17 Wed 1/3/18 4 36
36 QA/QC Thu 1/4/18 Wed 1/10/18 35 37
37 Submit 95%Plans Thu 1/11/18 Thu 1/11/18 36 38
38 City Review 95%Plans Wed 4/18/18 Tue 5/8/18 37 40
39 Prepare 100%Plans Phase 2 Mon 10/22/18 Tue 1/1/19
40 Roadway,Traffic,Utility&Drainage Design Mon 10/22/18 Fri 12/14/18 38,6 41
41 QA/QC Mon 12/17/18 Mon 12/31/18 40 42
42 Submit 100%Plans Tue 1/1/19 Tue 1/1/19 41
44 Construction Phase Services Fri 1/12/18 Fri 2/28/20 33
Page 1 Updated: Mon 10/29/18
ADDENDUM TO EXHIBIT D
Fee Schedule
Project Name: E Bagdad Ave Extension
Total Total Other
Task Labor Hours Loaded Labor Cost Direct Costs Subconsultants TOTALS
Task 1: Project Management 64.0 $11,871.93 $11,871.93
Task 2:Surveying $15,000.00 $15,000.00
Task 9: 100% Plans/Final Submittal 665.0 $83,083.30 $83,083.30
Task 11: Landscaping and Irrigation Plans -$8,288.48 -$8,288.48
Task 12: Barrier with Fence -$14,290.41 -$14,290.41
Task 13:Construction Phase Services 52.0 $10,095.18 $10,095.18
Task
TOTAL: 1781 $90,760.001 $0.001 $6,711.521 $97,471.52
Overhead Rate= 157.53% Atkins Raw Labor= $ 31,466.51
Profit Rate= 12% Atkins Overhead= $ 49,569.20
Atkins Profit= $ 9,724.29
Atkins Total Labor= $ 90,760.00
Page 1
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#7
EXHIBIT D
Task 1: Project Management
Task Description Project Design Design CADD GIS Admin/ Total
Manager Engineer EIT Operator Graphics Clerical Hours
Rates $ 84.00 $ 45.00 $ 32.00 $ 27.00 $ 25.00 $ 31.50
A. Project Management
1. Prepare monthly project status updates and invoices 40 24 64
Totals 40 24 64
Raw Labor $3,360.00 $ - $ - $ - $ - $ 756.00 $ 4,116.00
Multiplier 2.88 2.88 2.88 2.88 2.88 2.88
$ 9,691 $ - $ - $ - $ - $ 2,181 $11,871.93
Page 2
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#7
EXHIBIT D
TASK 9: 100%PLANS
Project Senior Senior Design Design Senior Senior
Task Description � 9 9 CADD GIS Admin/
p Manager Engineer Engineer Engineer EIT Eng CADD Operator Graphics Clerical
(QAQC) Tech Operator
Rates $ 84.00 $ 60.00 $ 54.00 $ 45.00 $ 32.00 $ 44.50 $ 35.00 $ 27.00 $ 25.00 $ 31.50
A. Roadway
1. Georgetown parallel parking 2 8 16
2. Stone St cross-sections 2 8 16
3. Stone St and alley typical sections 1 6 8
4. Stone St removal layout 1 4 8
5. Lewis St pavement design 1 8 8
6. Stone St plan and profile sheet 8 24 40
7. Alley plan and profile sheet 8 16 32
8. Stone St intersection grading plans 2 16 24
9. Stone St driveway profiles 1 12 16
10.Traffic control 2 8 16
11. Revised quantities 2 8 24 32
12.QA/QC 24 8 16
B. Drainage
1. Stone St and alley drainage design 16 6
2. Stone St and alley SWPPP 8 8
3. Revised quantities 4 8
4. QA/QC 8 8
C. Utilities
1. Alley wastewater line design 4 6 16 12 24
2. Extend Georgetown St wastewater improvements 4 2 12 4 16
3. Revised Quantities 1 2 4 4
4. QA/QC 2 4 2
D. Traffic
1. Signing&pavement marking for Stone St and alley 4 24
2. Revised quantities 2 4
3. QA/QC 4 2 1 4
Totals 41.0 40.0 36.0 136.0 88.0 104.0 188.0 30.0 2.0
Raw Labor $3,444.00 $2,400.00 $ 1,944.00 $ 6,120.00 $ 2,816.00 $4,628.00 $6,580.00 $ 810.00 $ - $ 63.00
Multiplier 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88
$ 9,934 $ 6,922 $ 5,607 $ 17,652 $ 8,122 $ 13,349 $ 18,979 $ 2,336 $ - $ 182
Page 3
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#7
EXHIBIT D
Task Description Total
Hours
Rates
A. Roadway
1. Georgetown parallel parking 26.0
2. Stone St cross-sections 26.0
3. Stone St and alley typical sections 15.0
4. Stone St removal layout 13.0
5. Lewis St pavement design 17.0
6. Stone St plan and profile sheet 72.0
7. Alley plan and profile sheet 56.0
8. Stone St intersection grading plans 42.0
9. Stone St driveway profiles 29.0
10.Traffic control 26.0
11. Revised quantities 66.0
12.QA/QC 48.0
B. Drainage
1. Stone St and alley drainage design 22.0
2. Stone Stand alley SWPPP 16.0
3. Revised quantities 12.0
4. QA/QC 16.0
C. Utilities
1. Alley wastewater line design 62.0
2. Extend Georgetown St wastewater improvements 38.0
3. Revised Quantities 11.0
4. QA/QC 8.0
D. Traffic
1. Signing&pavement marking for Stone Stand alley 28.0
2. Revised quantities 6.0
3. QA/QC 10.0
Totals 665.0
Raw Labor $ 28,805.00
Multiplier
$ 83,083.30
Page 4
E BAGDAD AVE EXTENSION
SUPPLEMENTAL#7
EXHIBIT D
TASK 13:CONSTRUCTION PHASE SERVICES
Project Senior Senior Senior
Task Description � Engineer Senior Design Design En CADD CADD GIS Admin' Total
Manager Engineer
Engineer Engineer EIT g Operator Graphics Clerical Hours
Tech Operator
Rates $ 82.00 $ 65.00 $ 62.00 $ 45.00 $ 32.50 $ 44.00 $ 35.00 $ 26.00 $ 25.00 $ 31.50
A. Construction Phase Services Phase 1 only)
1. Attend weekly meetings 4 4.0
2. Shop drawing/submittal review 4 8 4 1.0
3. Respond to RFIs
4. Assemble updated plans 4 4 4 8.0 5. Review pa 8.0 applications 4 4.0
6. Walkthough and punch list 4 8 12.0
Totals 24.0 16.0 12.0
52.0
Raw Labor $ 1,968.00 $ - $ 992.00 $ 540.00 $ - $ - $ $ - $ - $ - $ 3,500.00
Multiplier 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88 2.88
$ 5,676 $ - $ 2,861 $ 1,558 $ - $ - $ - $ $ $ 10,095.18
Page 5
CERTIFICATE OF INTERESTED PARTIES
FORM 1.295
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.
2018-420449
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 10/30/2018
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.
E Bagdad Ave Extension Project
Supplemental#7;Stone St Extension,Alley Improvements and Phase 2 Construction Phase Services
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
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 UNSWORN DECLARATION
My name is Donya M.Becton,Assistant Secretary and my date of birth is May 16th,1978
My address is 800 Waterford Way,Suite 700 Miami FL 33126 U.S.
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Miami-Dade County, State of Florida ,on the 30th day of October ,2018
(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 3.295
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. 2018-420449
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 10/30/2018
being filed.
City of Round Rock Date Acknowledged:
11/01/2018
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.
E Bagdad Ave Extension Project
Supplemental#7; Stone St Extension,Alley Improvements and Phase 2 Construction Phase Services
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
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 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