Contract - Prota Construction Inc. - 6/13/2019Page 1 of 3
Contract Quantity Adjustment/Change Order
ROUND ROM �
rev, 41/16
Department:
Project
Name: SE GST Pump improvements & S81 Pump Station Date: 5/11/19
Utilities & Environmeental Services
City Project Change Order/Quantity
ID Number SEPMP Adjustment No. 1
Vendor Prota Construction Inc & Prota Inc P.O. Box 342195 Austin, TX 78734
Company Name Address Phone No.
]ustification
Several Change Order Proposals
SUMMARY
Original Contract Price:
Previous Quantity Adjustment(s):
This Quantity Adjustment:
Total Quantity Adjustment(s):
Total Contract Price with Quantity Adjustment(s):
Previous Change Order(s):
This Change Order:
Total Change Order(s) To Date:
Adjusted Contract Price [Original Contract Price Plus
Quantity Adjustment(s) Plus Change Order(s)]:
Difference between Original and Adjusted Contract Prices:
Original Contract Time:
Time Adjustment by previous Quan. Adj./Change Order:
Time Adjustment by this Quan. Adj./Change Order:
New Contract Time:
Signature
Contractor:
City Project
Manager:
Mayor/City
Manager Z/�
4 Signatu
Amount
$2,076,000.00
$0.00
$61,242.00
$61,242.00
$2,137,242.00
$0.00
$2,137,242.00
$61,242.00
300 Days
300 Days
Submitted +,for Approval
u/
�£'riy liT I /I/i.-(pr->!J /��e- L`,
Printed Name, Title, Company
Approvals
rn: 74%
Printed Name, Title, Company
Printed Name, Title
e,
016 Change
0%
0.00%
0.00%
ZOO,
Date
Date
REN
Date
Page 2 of 3
I!,-ti- Contract Quantity Adjustment/Change Order
rev, 01/16
Project Name: SE GST Pump improvements & S81 Pump Station
Quan, Adj./Change Order No.:
Chanqe Order Data
Item #
Item Description
Unit
Qty.
Unit Price
Amount
Contract
Time
Adjustment
(Working Days)
COP #1
Installation of Four- 24' Bell Restraints to
Existing Pipeline
EA
4
$2,519.25
$10,077.00
8
COP #2
Installation of 20 to 1' Threaded MI
Plug and Reconnection of 20" Existing
Pipeline
LS
1
$5,529.00
$5,529.00
5
COP #3
Potholing for Location of Drain Pipeline
LS
1
$13,147.00
$13,147.00
18
COP #4
Installation of Structural Angular at the
Slab to attach the Building Wall Panels
LF
40
$43.00
$1,720.00
4
COP #5
Furnishing & Installation of Additionals
Risers for Each Concrete Vault
LS
1
$4,402.00
$4,402.00
3
COP #6
Installation of 15"x45 Bends instead
installation of 15"x22.5 Bends
LS
1
$363.00
$363.00
3
COP #7
Installation of 20" M] Gate Valve
LS
1
$9,423.00
$9,423.00
10
COP #8
Concrete Slab and Piers Demolition an
Disposal
LS
1
$9,970.00
$9,970.00
15
COP #9
Works Sttoped until decide the location
of the 20" Gate Valve
$0.00
7
COP #10
VFD Cables
LS
1
$2,878.00
$2,878.00
5
COP #11
Sidewalk Construction at S81EST Site
LS
1
$1,897.00
$1,897.00
1.5
COP #12
Stem Valve Covers
LS
1
$1,836.00
$1,836.00
0.5
$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
$61,242.001
so
Page 3 of 3
Contract Quantity Adjustment/Change Order
ROUND ROCK 1 i �.i
rev, 01/16
Project Name: SE GST Pump improvements & S81 Pump Station
Quan. Adj./Change Order No.:
Quantity Adjustment Data
MF
.
•Unit
Price
Contract
Time
Adjustment
•
-,
14
-_
_
• ••
_
• of
_
• of
_
•.•
to
M
O_
(D
O 0
Z
F LL
U p
w O O
w
w w
a a
C
N
E
0
a
E
U)
L
O
N
YJ
a
E
a
W�
w
WGo
N ((o
o:0e00
Lu w
w
w F-
O N L)
Of
CD w
Z a
c
2 it o
U d of
U
z
Z
0
LO
LO
LO N LO
U) a M
Zafao�uO
O w
U N xN N
OF-
0
a N J Q
CL - u.
vi
o
o
r
�
u
C
O
C7
7
co
a)
go
QD
LO
N
cc�
L6
N
cc
.4
a
W
LO
v,
u�
�
I.O
T
1f9
g
O
tD
O
L i
�rn
m��
�
-.
M
M
f»
4
m
C
N LL
�X
W
O
C
J
H
r t
�
O
o
C
m N
y
N V
Gf
Q
� fCQ
�
` T
O `
LL �
w
O
C
w+ G7
t6 C_
•N
ram+
U)a
c a
a
0
o LO
o
x*
o rn
0
0
0 0
x
N LO
N
O
X
_ X
� o
U 3
i M
O
M O O M a)
N
n Cl
o
am o 0 0;
ti
�
w
LO aFs Wn m
coo
1l
O
N N 69!
N
ai
o
Es» W).
yr
w
p
Z
a
Z
Op
m
W
'o
U
Z
Q
In
W
m
Z
c
o
(n
Z
W
p
E w
Q
Z
Q
m
a
C c c
d
o
J
W
U
0
U J
IQ-
Z
FQ-
O
Of
m E
m
:3
0
E L m Y
O W
0
0 0 0 0
O
O O O Lo
o
LO o 0
N
N O O
O
O
N
LO
N
a)
w
0
Q
d
$
96
000
000
000
00000CDEo�
-496
o00
000
00000d
o,*
oaa
dad
_ma
mad
a_e
dad
a6\\a7
2_/
mam__�gmIn
m
m
Q
p
E
/
0
CD
/
/
\
\X5
2
&
mamma
&G
2
\\\/E
/E
=
m
o
d
e
a
0
#r
§
m
m
/
G
C
r
%
/
0
°
o
°
°
c
�w
/
E6
Q
c
b
/
I
�
§
�
0
OD O O O 'Cr co
CV" 0 00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Ui I�
0- m CD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 N
0 0 6) M M O O O O O O O O O O O O O O O O p 0 M
EA CO — ri " " 69 Eli 64 64 64 (f) ua Eli Ef3 64 Ely Esi 6'i 69 64 ul � r - of 00
,
in
en Eh
0 tU o
Lo
O
O
CD
0
0
� H 5
CD 0
N
ao
ao
�
�
LL 0 F-
L
O
(,O _ � 00 CDCDCDN 00 O Lo
cu
vmmmr
am
H
Z
w
2
a
cr
w
o n
L
u
O M r
O N 00
64 C 00
07 Ali
EA
96
W
00
00
0 0
E19 U')
0
0
0
o
Ln —
O N [9
O
U) 0
n
a
Ao
—
O
0
0
0
O
O
O
O
O
00
2
0
0
0
0
0
0
0
0
0
00
o
6
6
6
6
6
6
6
6
0
6
Cl)
to
ER
Yy
61!)
l
Gl y
Y3
EA
6r)
U-+
u
4
Or
sio;ea;uosgnS
0
o
0
tAt
ro
a
a)
v
#A
C
d
E
a
a
E
a
C
O
y
w
a
E
a
Wuj
F-
uj
cn co
T
WNN (n (o
1(. 00
W
W r
O UJ U
U Of
Z -, v
c
_ a o
U a �
Z
O
P: LO
f) in
LO N LO
LO
U) -0 � Ul CM
Z 0 � LO
O v,
U G H N N
Q 0 v
F- C
Q' 0 � W X
av QE-LL
0
oCD
c
c
o
`fl
CO
C
0
y
rn
�
ti
4
W
O
Of
(D
N
to
cri
N
N
CV
E}
d3
O
O
O
a0 ;
CD
(h
M
N
tV
a
t.i
R
fv
a
'a
�
g
=
o
co
X
y
C
� W
y
N
r0+ O
C
O O
N w,
O d
C O
O C
O
R U
_ d
N
i
0
0
O LO
o
*_
XCD
O O
o
O
N
O O
X
LO LO
N
Cl) O
X X
m m
c
.o �
n
OD
O
M O O m m
w
w
O
N O O N h
C"
Ql
w
G1
N
00 O O EO O
CO fR (ti Cl) N
CO
LO
Cl)
N7
r EH
�
t(j
((�
tR
�
V!
W
r
0
Z
Q
W
p
U)
U
w
m
H
U O
Z
W
N ia
Z
Q
C
N
O U
a
IL
co
E
J
W
n a J
U
Q
Z
Q
o
<
o�
E — Y Y
o
0
0 0 0 LO
M
(n CD
Cl
N 00 O
o
�
0
N
C�
W
0
O
O
o
O
O
O
O
0
0
0
O
O
O
O
O
CD
O
CD
O
O
c
N
O
N
O
Lj
0
0
0
Cl
0
0
0
0
0
0
0
Lo
CD
0
T000
o00
000
00000Lnrno
Cl)
EFi
N
61)
E0
if3
4i9
CO
r-
H3
ca
f-q
cri
V).
Ica!
L
L
L
L
O
O
p
CD
C
p
o
co
Y
L
rn
rn
rn
c6
`
L
L
L
L
L
L
�
cfT
EH
�
ER
�
EA
0
cft
cfT
fA
0
0
0
0
0
O
O
0
0
Cl
0
0
O
O
co
0)
LO
LO
CD
LO
p
V'
LO
O
m
RS
c
U
�
co0-0�m
0
a�
c
+�
N
0
N
(II
C
cm
y
L
J
J
Y
W
U
0
cn
w
l
T
tu
r
r
h�
V
0
po 0 00
O p O
O LOO N M
N c�qUl N
.n
w o
N f�0 r m
� � O
rt D 0 ~
0�a
0)
c
i
0 V 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 C" CND LO ma
0 d: 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0000
0 0 0 o rn W o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 W o(D m
Ef3 N (fj ER 6FJ 64 ua 6R 61) Ei3 (a 6), 6R va 6<3 69 69 6R 6R 6F? lY N (D to
—L--L—L 601�
L
L
L
O N O
Q
6:E
0000oou)
0 cLo
Q
C
CD
L �/� Q r
vJ a
(D
U)
cu
Jmown
I
5
O M O cli 0 0 0 0 0 0 0 0 0 0
r 00 C)� 0 0 0 LO 0 0 0 O O O
U) O 0 0 6 0 0 1- 6 0 0 6 0 0
�� "�toV3U')�K3tfiti9totoEf}
O C? O
w O ti O O
�
�vs 1 �b9
JIWI WIWI I I l0lo
- N,,, N
>
'o
-0
°1a
a
C
N
N
C
m
�_
N
m
U`
C
cm
(5
m
w
O
a
—
w
n
R
J
a)
i-
-
00
O
04
V
(h
N
N
NN
s/euaM N
LO d
N N O
r p r 0 tD
U�Lo
? N N
to 6'-;�
CM
0 0
00
taU�l
CLO
0
0
0
d
a
0
0
0
0
0
0
0
0
00
Q0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
ER
613
ER
EA
to
ER
64
ER
f9
(t?
64
d
i
Q.
3
sjo;ea;uo3gng
0 0 0
O O o
Vi EA to
J
OLo
o
o�
a
OD
a
m
19
v
O 0
z O
Q'
UtL
W
�l O
O Ir
w W
CL CL
C
C1
E
i
0
CL
E
N
L
O
N
CL
E
7
IL
W H
w
Cl) Go
Q' as GO
� c GO
W
w
O N U
LLJ
a LLI
U
Z
_ af o
U a ct�
A7
HLO
D LO LO
-0 � (f'/ (4�
ZO�P-Uuo
U O N N
�00 =W
avQF-LL
`
0
o
0
0
0
C14
V
N
O
a
oCD
o
w
m
�
LO
(fl
h
Cl)
to
tri
a
W
O
l]
O
�
N
N
t`
A
�
fA
E9
ca
g
t(7
(l7
N
H9
Q
d
V
.,
4
a
C r
F`
O
0
r
O N
to
O n
y
'rr N
G>
Q
V W
O
J yj
w tV
C a
O IL
t �-
O
IL
0
N
rn
N
O LO
o —
x M
o
O O
x
N
N
O
x
_ x
� m
o a
� :3
�s w
o N
iD W)
O
O
00 0 0 a0 O
(D O O to m
00
OD
ti
to O O tp W
ti
to
ti
v
e-
N fl) 6.3 N 19t
CO V) ff9
ti
V)
N
M
ce Vi
M
W
F-
Z
a
(U
Z
Q
w
U
Z
W
�
m
Z
X
o
Z
W
m ila
Z
E c
Q
D U Q
°'
w
a o
H
z
06 U H
0
o
N E 7
E
m
D
z
m Y
o
a
0
(D
00o LO
u) O O
N C O
Obi
CD
O
N
LO
(O
co
N
(O
69
I?
W
0
Q
CL
a
000
0
000
000
`�
O
O
O
O
0
0
0
00000`noo
0
0
0
0
N
S
0
Loco)
0
T
CD
(0
O
O
CD
CD
0
0
O
CD
O
CD
CD
COI)o
CCD
606
I�T
U)
(fJ
U)
6g
EA
ER
EPr
ER
U9y
64
69
CO
H-T
N
Efi
Ff3
�}
bg
J
O
L
L
L
L
O
Lo
Q
LO
r—
�O
T
L
L
L
L
L
L
L
L
L
L
L
L
L
d}
EA
K}
Efi
613
H}
d}
S
O
O
O
O
O
O
O
S
O0
0)
U')
LO
00
LO
O
LO
L
O
L
ca
(0
U
C
o
L
4�
co-a.co
0
nm
0
o
�
O
C
V!
O
_I
J
N
O
Y
W
V
(U6
C)
m
v�
/w
,ryVV
v
co
- co U)
ti Lo N r
CV co (D
T co 6
EH EA
Gfi
i
Ao
O
w
(D (D O O T- O N
O N M 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 M I�
O (,) aj OCr0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 r. c
O W V O CM N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 of
qDV( Dd-T (n (fl fr?Efl H)fR ER EH ER ER ER H3 f9 EtT E9 ER N co
� C3 t
O
ui
LO
GO
M
L
L
L
L
L
L
L
L
L
O c O
6
O
(�i
�
L N
FT
V Q
CD
M
O
CD
O
LL M F-
a
L L L L
ti — c4 co 00 CD
O
CDN CC)
O Lo
N
U U)
o 0
m U L
Xm
w U)
:_
2
H
Z
W
2
a_
E5
CY
w
0
0 o 0
o � L6
o N N
� CV
� � r
69
o o 0
0 0 0
0 o p
taUY451).
a
a
O
000000000
00
O6
0
o
o
0
0
0
0
0
SO
0
0
0
O
O
O
O
O
O
66
N
ER
Efl
to
f/?
Eg
EFT
6c9
U9,
[A
EA
V)
d
V
4
0
u�
w
�
j
=
d
Or
�
L
U
O
�
H
sro;er;uo3gnS
0
o Oo 0
O C'5 c i
CO N
N
69
J
0 Lo
w- o
o
a
O
L
N
19
O 0
z O
U�
w
-, O
O cr
of w
a a
C
G1
E
N
O
a
E
N
c
O
N
w
a
E
a
uJ E-
M w
w in w c(o
co
UJ UJ(ti
w
O CD E3
w
W
Q O =
U a w
T
i
Z
O
LO
LO
U-)
N -6 ti u� M
U c H
Oo v�-j
a v ¢ H U-
a
`
0
�
0
o
w
V
�
o
arr
C
O
C.
.0
7
M
M
L
LO
V).
T
O
LO
N
as
W
0
0
0
0
of
rn
N
of
as
�0
tR
cG1
C
O
N
O
N �
tN
N
r
C4 N
T
0
T
4
m
Ot
'C
m
a
W
N
O0
L
y-
m
�
O
Q.
3
c
a
a
O
0
m
Ci
O
N
O
0 ,n
o T
x
o rn
o Q
o 0
7 x
Lq LO
N
co
O
X
_ x
O �
� 3
co
M
` M
O
O
CD 00 co m
0 0 0 0 N'
eP
N
D M
w
M
M O O C4 6
H3
01
V
ti
��3 0d9
�
va
V.:*
eR
co
w
H
r)
Z
o
ZQ
w
U
co
Z
w
m
v
Z
o
z
Z
co
E c
<
Q
aU
0 0 a
Jw
d O J
a
z
U)
c CL
o<
E o
D
E
m
fA
Z
m
O_ J N
0
0 o a o
O
M
O O O LO
LO O O
co
N O O
O
N
O
LO
n
0
Cl)
64
(0
r
W
0
CD
CD
CCD
0
0
0
0
O
O
O
O
O
O
O
O
O
O
O
o
c
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
m
0�00
000
000
000CiornTo
0
T
EFT
ER
EA
E9
EA
6q
ffl
413,
(A
EA
fR
H3
fR
CY
r-
613
CO
EJ3
[f3
Ef3
69
J
L
FQ.
�
O
L
L
�
O
O
C
O
O
N
Y
T
T
T
T
N
L
L
L
L
L
L
L
L
L
ER
EA
Ef3
bq
Efl
V
a)
roO
O
O
O
O
O
O
3
O
O
O
O
O
O
O
Co
0)
LO
ui
Co
Uri
o
r
T
T
r
T
v
LO
0
o
�j
(D
�Cl.`
0
0
`
C
N
m
n
m
'-
vl
O
J
J
CD
C
_
m
Y
cm
0
W
D
U
U
m
m
m
0
u7tiuo N
o o
O 00 N N
N T �
ER � ER r
d�}
o O
0 0 1,::,
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Cl 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 Ln o 6 6 6 6 6 6 6 6 6 6 6 6 6 6 0 w
m cnw cn�(Al(n 611bgts3�UycaUY60, r3UYE»(a�T-
L L L L L
O O O O o
O O O O (O
0 0 0 0 0
L L L
L L
L L L L
Z
ti - D 0O
0 O
O
O CAO O LO
N
N
U)
U w
a 0
o
io U F�-
cu 2 o —
C) OR'F— cu
W m
.E
f1J
Z
W
2
a
73
CY
w
O m m
ID T
ti nj O
Ln
� N
to
00
O o
O 6j
CN
by
Or
04
a
O
O
O
C.
W
x
O
E
O
O
O
O
O
o
0
0
0
00
2
0
0
0
0
0
0
0
0
0
00
o
0
0
6
0
0
0
0
0
0
0
66i
0
(ii6
646696?669
d
sao;ea;uoogng
Lo i5
O ~
rail
L
cu
En
4
O 0
Z O
Q'
U
w
O of
Ix w
a CL
C
Gl
E
O
n
E
U)
C
O
N
a
a
E
a.
uw r
g cn
w
W N m
co
m o
W N ~
w
O � U
UJ a U af
W
Z
c
U a �
~ LO
L�
d N
Ui oLO
nUM
ZOr-�u')
NX
QD~�nLo
u') - X
it C) w X
av< U-
N
0
O
CD
L
W
�
Q
%i
R
O
%i
in
c
CM
M
co
co
,Q.
Otr
u,
N
O
N
O
co
O
Go
O
Efi
eo
!co
C
6
N
O
N
M
N
M
N
O
4
N
u
C
O
w
I
o
U
O
d
Nl
y
l
N
R
O
0
a
w
O
C
O
R
w
h
c
0
O
O
o r-
X *_
O rn
0
0
0 0
m
Q>
` X
U')
�
C')N
O
X
x X
z0 N
O
U
U)
a O
"i w
O
O
LL-) 00 Ln
0 00 0U')
w
Ln
A
ri
N
O
fH
N
r
e»
va
ets
Xw
Q
Z
(U
ZQ
�
W
U
U
a
w
Z a
w
w
m
z
o
z
w
ca
g
o
Z
Q
a U n
a
J
to
w
U
m m E
a o
N U J
a
Z
� �a
o
it
3
C�,Eo
?
(A
aJ�co
0
o a o
C)
O
CDCDO LO
tI') O O
O
N O O
OD
O
O
O
N
O
LO
O
O
69
,z.
a
a
DCDD
000
000
O
O
O
O
O
O
CD
cmw.
O
050
coo
000509000
~
Oo
OLr)
O
O
O
O
O
O
0
0
0
0
0
LO
0
6
W
E9ce
E!T
fR
EH
613
EA
E9
EH
64
EH
ffi
ffi
69
Efi
f
lA
O
O
YC
L
L
L
L
L
L
L
Q1
b—�
(�)
z4
i � iU
O
O
O
O
O
O
O
O
O
O
O
O
O
O
�0)
oLO.0
LO
CD
0
c
c
(
k
c°Qn
0
2
c
m
m
m
c
-
H
_
O
J
J
N
fQ
Y
uj
cn
m
w
00 CD 0 N CD Cl
N O C'i M
N — — N
EA � b9 T
'IOD
Iulto �IQI�I�I0I�I6IQI I0I�I�IQI0I�I�I
cr? 69 fA
L L L
0 0 0 0 0
0 0 0 0 0
lo O O O
L L L L
fRfR�fH�
O N O
O . O
Lo
CD
N O o N
U aL o
m ,z � F-
X m Q' ~
W U)
Z
W
2
a
C1
w
O ao
Lq O�
N O
cfr �
co
C']
Cl)
00
6R
@ o
Q
0� f0
T O
LL fl 0 F—
U a
M N O e—
N O (� 0 0 C 01010 C 0 0 0 0
O(q0 0 0 0 0 0 0 0 0 0 0
r� O p N 6 6 6 6 6 6 6 0 0 0 0 W"
� U j ff-T c�4 K? ER 64 ff3 cii (�3 cf3 EFJ EFt v
UY 6-1
Lo
NI=IOIN
7
SIOUCI N
0 0
00
0 0
tabl)
F�
0
0
0
44
'
O
o
0
0
0
0
0
0
0
00
O0
0
0
0
0
0
0
0
0
0
co
666666666
66
EA
611
to
ef}
UY
E13
Vy
fA
fR
(A
61)
d
4
w
j
OF
Y
sio;e r;uo3gng
0 0
00
66
,al
0
0
0
L
a
19
v
O 0
Z Of
U
W ❑
3 O
O a�
w w
a a
a�
C
N
E
O
a
E
a
c
O
a�
a
a
E
a
uJ F-
g N
� w
W (n to
m00
ti
w
w
O N U
W
Z � a
Q O
U a w
Qi
Z
O
H
U L
L
N
U% d ti M
0 r CO)
V o X N N
Q❑F Lo
F-
o
p :3 W
aX
vQF-LL
�n
p
p
o
o
0
�r
n
C
O
t)
3
Cl)
o
0
M
M
O,
W
N
N
co
M i
+
,W
EH
aa)
to
d
a
N
o•
N
Cl)
C%j
M i
N
�
O
a
d
is
T
O
C
10
ea
J
N
C
F-
O
�
m
M
o
c
y
o,
m
N
m
N K
d'
k
i0
w
O
C
O
t9
N
c
0
p
M U')
o
X
T
am
p o
p
X)
O
= X
LO
Uh
N
O
X
_ X
O Q
� 3
I*
O
O O O O M
eV
b
ai
co
rn O p Oi —
EA E9 fR M fA
O
r
U)
w
H
Z
m
Z
Q
O
E
W
0
Q
a
N
U
Z
w
m
z
O
Z
LU
Z
NW
E C
Q
N N
O U O-
Jw
a- O J
Hz
C: c a
o
of
a�i E '
❑
�O
E Y Y
m
z
in
z>
N
IL
a
o a a o
O O
N
LO
LO
N O O
O
O
p
cfl
w
CD
Q
d
Q
O
CD
O
O
CD
O
0
000
0
0
O
0
O
0
O
0
O
0
O
0
O
0
O
0
CD
0
CD
CDCD
OD
O
r
O
O
O
O
O
O
0
0
0
0
0LC)
0
0
Co
t�
ffi
d3
H3
fR
iR
6H
6-3ffl
ff3
64
ff3
V)
iR
fR
co
b4
Ef-J
fR
J
L
ti
O
L
L
L
L
.0
�
O
O
O
O
O
O
(N
L
L
L
L
�
�f»691
6�
cq
U'Y
O
O
O
O
O
O
O
Cl
O
O
O
O
O
O
00
O
l0
LO
00
LO
O
r
r
r
r
r
'IT
LO
L
O
C
L
L
a)
m
O
O
o
m
C:
N
O
J
J
a)C
a)
d
Y
W
m
0
. N N
O "i CM
r r N
ID
VI
OI�ICIOIOIOIOIOIOIO1OIOIOI6 0 CDIC5 CD CDIo o o
fR � w EF> w to to w 69 w EFT H} Ef3 ER
i
L L L L L
0 0 0 0 0
0 0 0 0 0
000
L L L L
Z,7j
Mcn CD O
N � CD
CDT CD O O N
a
a
0
w
z
w
2
_a
5
Cy
w
CD
_ ti
co4
O
c�
Cl)
tq
O
O N
0
N
Ef3 69
IC)
N
o o 0
0 0 0
0 0
�V)�
z
x
U
0
0
0
0
0
0
0
0
o
co
a
O
O
O
O
O
O
O
O
O
00
o
0
0
0
0
0
0
0
0
0
0
Vol
fA
EiT
Efl
ff)
EA
fR
(fi
ffT
fR
fR
d
a
w
C
sio;ea;uoognS
0
0
0
03,
�
/
a
0 0
2 0
LL
0 g
w
E ƒ
�
E
CL
E
)
�
CL
E
2
kj
cn 2q3
■062
mew
o§�
■
wUJ
/m
<0
3ƒJ
&
§
L) Gi
qLO
Z«/�/
§�FG®
Qqx 2
�c�L�
0LO
w 2 = w
a -It <RE
La
$
cm
CD
0
2
2
;
k
k
■
g
a
i
It
C,.
�
k
r
�
w
Ul
U,
a
\
2
m
2
R
\
§L
�k
§`
\\
W)
£
k
f
�
\
�
�
0
m
U)
t
U)
ƒ
2�
k
2 �
3 �
/
�
2
I
O
2
k
q
x\
c7
§
CDx
� C)
\\
\
�m
§ q
q
7RSg7q
k
n
6aamwo
k
2--Q2cm
2
2
w
/
c
0
<
2
E
Q
<
w
§
m
/
LLI
cl
kED
<
IL
w
t
k
ƒ 2
.9
k
E2\�\
2
/
/2I
2
f22 $
0
000 2
wog
w/o
\
C
Cl
C
C
o
O
Q
0
M
0
M
O
O
O
O
O
O
o
O
O
o
o
Lo
O
0
0
CD
C
O
0
0
O
0
0
0
O
O
O
O
O"I�
CD
N
O
M
C)
0
0
O
O
Cl
O
O
O
O
O
LO
V
O
w
(O
6c3
LO
U>
64
fH
69
Hi
ul
fH
ER
69
ER
ER
co
ua
Ef?
EA
ER
r
Eg
M
tf}
tFT
J
O
O
L
L
L
-r-
L
CD
C)
0
O
rD
LO
LO
O]
Cl)
Cl)
Cl)
3
L
L
d
d3-mac
0
0
0
0
0
O
O
O
O
O
O
O
O
O
CO
O
U-)
fl-
Co
U7
O
r
r
r
r
r
T
LO
0
-
N
Q
L
O
C
O
O
O
Vl
_CL
00
J
O
L
a,w
C
cn
v
cu
cu
❑
n7
w
w
OD LO
cn °D c•)
CD� V
(n CD
eq Vt Lf)
to
0
LO
N o
(9 OO
LO
a v 5
MC 0
VJ LL
C
L
L
00
a
0
w
N o 1':,
0
O N N 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
O L,.) O �j �j 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
O f— m O V N 6 0 0 0 6 6 6 6 6 6 6 6 6 660
EFJ M to M r- ff3 64 EF? 69 fA ER va Ef? <{t ff3 64 69 4f3 w Uzy ul
ER Ef3 Hi d}
IDIkq � o 0
c00amo
V- LO , 0 o 0
0
N o0 LO
N
Q7
M
U
`o O
m U L
w m E
F-
z
w
2
a
Cat
w
0
rn rn rn m
N
I'II
O M B ID 0 0 0 0 0 0 0 0 0
o O O O O O O O O O
f- O (O (O M O O O O 0 0 O O O
V fti r N EA U) 69 H4 69 to to 64Y H9
� � �
(C' O r ti O
O
Mti4(('0
LSH9�V�
N (0 (0 0 0 C
W W W W W
O O O 00
0 0 0 N
r N 'IT a
rx
m00m
>
Q
a
-�ouIVX�>
�C
(nFu
ca
CD
g
CN
9
-�
C
- co
W
O
U
N
A
N
N
N
sfeua;eml
0 0
00
0 0
60, t
O
O
O
d
a
O
w
w
a-
o
0
0
0
0
0
0
0
0
0
0
000000000
00
0666666666
~
000000000
66
69
69
61)
61)
64
64
H9q
64
6q
64
69
a
w
Or
sio;ej;uoogns
O
L
N
19
V�'
O 0
z of
Uw
w
3 O
O w
of w
a. a_
C
W
E
a)
O
a
E
c
O
N
w
a
E
a
W r
M w
D
Wco
co
00
a N ti
W
.3 w
O N C.3
c) w
Z —)
o
U a �
U
Z
z
O
H
LO LO
N
U) a M
OZ� coLo
fU w x
o
O 'O X
CO v¢H IL iQi
`
0
o
0
d0
V
O
O
�
O
t6
C
tN>
O
c.�
7
N
N
(O
N
N
y
O
O
�
01
O
,4
e
W
O
O
O
O
A0ca
ti
Ef>
to
d
0
0
O
m
O
T
M
CO
a�s>
4
a�
C
O
VE
m
0
L
y
V
in
d
d
V
C
O
U
o cn
O r
X *_
O m
o
O �
O O
(O
X
N
ch
O
X
_ X
i
O �
ch 3
N
O
U') 0 0 In O)
•f
0 N
O
N CD O N Cl)w
w
I-
d' � 6c4 It M
m
w
m
N N V>
N
t
v>
w
H
z
Q
�
Z)
w
U
z
Q
m
WX
m
¢
¢
c
o
U)
z
Z
W
H
c
ro ib
❑
Z
w
c
a
Q
t c a
J
w
� O J
a
z
rn
CL
0
z.Eo
E
m
?
mEn Y
cn
a- co
0
0 0 0 0
O
N
O O OLO
� O O
(�O
N 00 O
co
O
O
O
CV
cD
r
W
Q
d
L
0
0
0
0
0
0
0
000
00000
0
0
0 COR
0
o
o
Q
o
0
0
o
0
0
0
0
0
0
0
0
0
0
o
0
0
0
0
C)
O
c
o
o
0
0
0
0
o
pop
O
o
0
d3
fl3
0
fA
H3
ti3
va
6q
61Y
try64
69
E9
H3
6 T
lot6s
0
J
In
�
O
L
L
L
G
o
0
`r
o
3
L
L
L
L
L
L
�
psi
d3
603
f!?
d3
�
La
0
o
0
0
0
0
p
3
0
0
o
O
C)
0
C)
OD0)LO�01)
�a
�LO
°
c
m
a)
a)
ca
0
°o
aa)
0
y
m
L
J
Cl
N
C
to
a
_Ic
Ucm
cl
w
U
C
m
:D
U)
w
'w
0
0 0 0
0 0 0
�
C �
6o � 6h
0
0
0
N
G�
M
40
0
LO
m o
LO
m 0,
FTo
� o ~
ovIL`
C
C
i
O � O O
O O 0 0 0 IO 0 0 IIIOIOIO 0 0 0 0 0 0 0 0 0
ap Il'O M O Lrj 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(DO O N O O O O O O O O O O O O O O O O
40 d3 r "T - 69 69 64 69 69 64 e9 64 [A 64 col)69 69 69 6`i 693
-�I�i-�Irls
LI�I�ILI�
6q61Y
O LO LO 00
N r V O O
V rl UO O 0
•-N .;T -N
L
C�
C
R.■■P
a
Z
W
2
_a
5
Cy
w
N
N
w
O
tf�
CD
O o O
P�-
X
0 0
0 0
0 0
60� U!s
0
0
O
a
O
00
o.00000000
0
00000000
0
0
0
6
6
6
6
6
00
66
p
�
d}
fA
EA
fA
64
EA
ffi
ER
ER
E9
fA
d
V
ap
c
CD
Or
U
O
�
F
sro}ea}uo3gnS
..2
O .0
z Ir
Uw
w
3 O
O ir-
I' w
EL a
.4
C
4)
E
0
a
E
U)
C
O
a9
U)
a
a
E
a
w F-
g N
� w
U) n to
n
w
w
0 N 0
LLI C)
(7 w
Z - a
ao
U a �
Z
0
N LO
LO
N U.)
M 0 Cl)
Z R- OD Cl)
Ln
O rn I,-N
U O H r
C LO �v(
0' CD
O w X
CL .* LL
`
0
o
a
CD
V
C
0
L7
a
m
C
M
M
M
d'
�
m
d9
4
C
W
M
�
M
r
ti
h
M
M
V
�
fA
a-
69
g
U')
N
Lt7
N �
N
cV i
C
ID
M
4
ar
J
�
o
O
m
c
Q
a
a
O
o uO
o r
x *_
o �
0
0
0 0
~
ti
` x
Ln LO
CV) C)
C)
x
x
-iaF
0 6
U)
er
u r.-
cm
Cr
0 0 0 0 0
CD CDo CDao
C>
N
co
M
r -
ao
���
-e �
vs Ass
h
vs
va
ess
w
Z
a�
Z
¢
E
W
p
�
U
Q
co
w
co
Z
�
g
z
LU
z
a
¢
�rz a
IL
a)J
w
d J
a
z
«s a
o
�Mo'
LL
0
o a o 0
LO
u�ioo
r LO
N C)O
co
O
O
N
O
C
0
0
O
0
O
0
0
00
O
O
O
CD
O
O
b
0
0
0
•..
0
0
0
O
O
O
O
O
O
O
O
O
O
N
0
C
0
0
0
0
0
O
O
o
0
0
0
0
0
00
O
O
W
69
69
69
69
69
69
69
69
69
63
69
69
69
69
69
N
69
J
ti
a
�
Z
L
t
tx
O
O
v
v
L
L
L
41
64
to
O
3
O
O
O
00
LO
O
c
O
`
C
L
(0
w
ro
U
n
a
C'J
CD 0
o O N N
V) LO ti N
CD
ta Eq M
EA
cc
r c(D M
o
LC)
ti CY)
c i
Cl)
T
M
T
to
LO
O
02
n
t`
w
O
W
O O
O O
0 0
U�l 6q
O
O
O
a
0
0
0
0
0
0
0
0
0
00
0
6
6
6
6
6
6
6
6
0
6
�
fR
Ei-}
U3
EA
EA
fA
EA
d3
eH
b4
fA
d
a`
L
3
sao;er;uo3gnS
0 0
66
d3 ER
0
0
O
e/a
J
Q 7-
0 N f0
o
a
a
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
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
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2019-499409
Prota Construction Inc and Prota Inc, JV
Austin, TX United States
Date Filed:
06/03/2019
2 Name of governmental entity or state agency that is a party to the contract for which the form is
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.
0000
Change Order for "Southeast Ground Storage Tank and South 81 Elevated Storage Tank Pump Station Improvements" project.
4
Nature of interest
Name of interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
Acosta, Ricardo
Mayaguez Puerto Rico, USA
X
Prota Construction, Inc.
Mayaguez Puerto Rico, USA
X
Prota, Inc.
Austin, TX United States
X
Tamboer, Cornelius
Austin, TX United States
X
X
Borg, Michelle
Austin, TX United States
X
X
5 Check only if there is NO Interested Party. o
6 UNSWORN DECLARATION
My name is Michelle Borg and my date of birth is
My address is 7102 Greenshores Drive Austin TX 78730 Travis
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in Travis ty, e
Coun ,State of T'xa" ___........._.__� on the 31 _ day of June 201.9
(month) (year)
Sgnat a agent of contracting business entity
(Declarant)
' M--..r fiuns�wn www.etnics.state. tx.LIS version V1.1.39f8039C
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1of1
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
Certificate Number:
12019-499409
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Prota Construction Inc and Prota Inc, JV
Austin, TX United States
Date Filed:
06/03/2019
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Round Rock
Date Acknowledged:
06/12/2019
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.
0000
Change Order for "Southeast Ground Storage Tank and South 81 Elevated Storage Tank Pump Station Improvements" project.
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
Acosta, Ricardo
Mayaguez Puerto Rico, USA
X
Prota Construction, Inc.
Mayaguez Puerto Rico, USA
X
Prota, Inc.
Austin, TX United States
X
Tamboer, Cornelius
Austin, TX United States
X
X
Borg, Michelle
Austin, TX United States
X
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 Iexas Ethics Commission www.ethics.state.tx.us Version VIA-*1PfRf139c