Contract - Chasco Constructors - 1/10/2019 Page I oF2
R• Contract Quantity Adjustment/Change Order
' ROUND ROCK It X',
rev,01/16
Department: 23000
Project
Name: Clay Madsen Soccer Field Project Date: 12/3/18
City Project Change Order/Quantity
ID Number Adjustment No. 2
Vendor Chasco Constructors P.O. Box 1057, Round Rock,TX 78680 512-244-0600
Company Name Address Phone No.
Justification
Waiting for the utility companies to move their lines caused construction to be delayed over nine months. During that time,construction costs
increased to the degree that it warranted an adjustment. Fence system added to ensure driver safety on the adjacent Gattis School Road by
keeping balls on the playing field.Adjustments made in the field necessitated the installation of a concrete pad for the electrical panel. Decision
to keep cut topsoil on site reduced haul off charges.
SUMMARY Amount %Change
Original Contract Price: $639,915.50
Previous Quantity Adjustment(s): $0.00
This Quantity Adjustment: $0.00
Total Quantity Adjustment(s): $0.00
Total Contract Price with Quantity Adjustment(s): $639,915.50 M
Previous Change Order(s): $40,237.25 6%
This Change Order: $78,664.98 12%
Total Change Order(s)To Date: $118,902.23 19%
Adjusted Contract Price [Original Contract Price Plus
Quantity Adjustment(s)Plus Change Order(s)]: $758,817.73
Difference between Original and Adjusted Contract Prices: $118,902.23
Original Contract Time: 150 days
Time Adjustment by previous Quan.Adj./Change Order: N/A
Time Adjustment by this Quan.Adj./Change Order: 30
New Contract Time: 180 days
Submitted for Approvals
Prepared By: Rachel Morris, Park Development Specialist, CORR 12/3/18
Signature Printed Name,Title,Company Date
Approval
Contractor: Leslie Heine, Project Manager, Chasco Constructors 12/4/18
- 9',��y,,.if�ti
Signature Printed Name,Title,Company Date
City Project
Manager: Rachel Morris, Park Development Specialist 12/3/18
Signat a Printed Name,Title Date
Mayor/C
Managerlty I oA
v -ow 10-11
Signa re Printed 4me,Title J Date
Page 2 of 2
Contract Quantity Adjustment/Change Order
-ROUNO ROCK it•.
rev,OV16
Project Name: Clay Madsen Soccer Field Project
Quan.Adj./Change Order No.: 2
Change Order Data
Contract
Time
Adjustment
Item # Item Description Unit Qty. Unit Price Amount (Days)
1 Delay in Construction Costs LS 1 $16,010.00 $16,010.00 0
2 Alumagoal Fence System LS 1 $64,261.98 $64,261.98 30
3 Concrete Pad for Electrical Panel LS 1 $5,943.00 $5,943.00 0
4 Haul Off Deduction LS 1 -$7,550.00 -$7,550.00 0
TOTALS: $78r664.98 j 30
CERTIFICATE OF INTERESTED PARTIES
FORM 129
loll
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. 2019-43792.5
Chasco Constructors
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 01/04/2019
being filed.
City of Round Rock Parks and Recreation Department 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.
010-021
Clay Madsen Soccer Fields-Change Order#2
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
King,Charles Round Rock,TX United States X
Glace Jr.,Charles J. Round Rock,TX United States X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is Charles King and my date of birth is 07/24/55
My address is 2801 E.Old Settlers Blvd Round Rock TX 78665 US
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Williamson County, State of Texas ,on the 4th day of January 2019
(month) (year)
Signature of auth ized 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 129J
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 of Certificate Number:
business. 2019-437925
Chasco Constructors
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 being 01/04/2019
filed.
City of Round Rock Parks and Recreation Department Date Acknowledged:
01/08/2019
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.
010-021
Clay Madsen Soccer Fields-Change Order#2
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
King, Charles Round Rock,TX United States X
Glace Jr., Charles J. Round Rock,TX 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