Contract - Chasco Constructors - 6/27/2019 Page l of 3
Contract Quantity Adjustment/Change Order
AROUND ROC}C.7DCA5
runMr.r»w<xr rmm�wm.
rev,08/12
Department: Transportation Department
Project
Name: McNeil Extension Phase 1 Date: 4/30/19
City Project Change Order/Quantity
ID Number RC1804-001 Adjustment No. 2
Justification
CO 2
SUMMARY Amount % Change
Original Contract Price: $1,744,147.00
Previous Quantity Adjustment(s): $4,000.00
This Quantity Adjustment: -$192,879.50
Total Quantity Adjustment(s): -$188,879.50✓
Total Contract Price with Quantity Adjustment(s): $1,555,267.50
Previous Change Order(s): $89,902.00 0.06
This Change Order: $244,596.55 0.16
Total Change Order(s)To Date: $334,498.55 0.22
Adjusted Contract Price [Original Contract Price Plus
Quantity Adjustment(s) Plus Change Order(s)]: $1,889,766.0
Difference between Original and Adjusted Contract Prices: $145,619.05
Original Contract Time: 240
Time Adjustment by previous Quan.Adj./Change Order: 25
Time Adjustment by this Quan.Adj./Change Order: 60
New Contract Time: 325
Submitted for Approval
t �
Prepared By: Kellin Neiman, Sr. PM Chasco Constructors 4/30/19
Signature Printed Name,Title, Company Date
Contractor: Kellin Neiman, Sr. PM Chasco Constructors 4/30/19
Signature Printed Name,Title, Company Date
City Project (� -p, I16
Manager: lX�L, �.J��\ Q�j��l In.d
Sign ure Printed Name,Title Date
Mayor/CityM �j�U ,
Manager �, (� VAA '
Sign ure Printe Name,Ti urDate
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Page 2 of 3
Contract Quantity Adjustment/Change Order
�RUUND ROCK,TCJCAS
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rev,08/12
Project Name: McNeil Extension Phase 1
Quan. Adj./Change Order No.: 2
Change Order Data
Contract
Time
Adjustment
Item # Item Description Unit Qty. Unit Price Amount Adjusus(Das
CP 004 WATERLINE&VALVES-T&M REPAIR LS 1 $13,570.00 $13,570.00 15
CP 005 LAMPASAS DUCTBANK LS 1 $97,510.00 $97,510.00 15
CP 007 BACKFILL ONCOR BORE PIT LS 1 $5,600.00 $5,600.00
CP009 SEAL COAT PARKING LOT LS 1 $8,723.00 $8,723.00 30
CP 010 REVISED CROSSING UNDER LAMPASAS LS 1 $33,523.00 $33,523.00
CP 011 TYPE C HMAC IN LIEU OF TYPE D TON 702 $90.00 $63,180.00
CP 12 REFL PAV MRK TY I W 4" SLD LF 293 $0.85 $249.05
CP 12 REFL PAV MRK TY I W 8" SLD LF 57 $1.75 $99.75
CP 12 REFL PAV MRK TY I W 12" SLD LF 0 $5.75 $0.00
CP 12 REFL PAV MRK TY I W 24" SLD LF 74 $11.50 $851.00
CP 12 REFL PAV MRK TY I W ARROW EA 2 $144.00 $288.00
CP 12 REFL PAV MRK TY I W WORD EA 2 $230.00 $460.00
CP 12 REFL PAV MRK TY I Y 4" BRK LF 380 $0.85 $323.00
CP 12 REFL PAV MRK TY I Y 4" SLD LF 2455 $0.85 $2,086.75
CP 13 SEWER TIE-IN AT SALON LS 1 $4,533.00 $4,533.00
CP 14 ONCOR BORE ASSISTANCE LS 1 $13,600.00 $13,600.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS: $244596.55 60
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Page 3 of 3
Contract Quantity Adjustment/Change Order
~ROUND ROCK T[7CAS
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rev,08/12
Project Name: McNeil Extension Phase 1
Quan.Adj./Change Order No.: 2
Quantity Adjustment Data
Contract
Time
Bid Item # Item Description Unit Qty. Unit Price Amount Adjustment
260-6006 OVERRUN LIME MATERIAL TON 33 $170.00 $5,610.00 0
340-6011 D-GR HMA TY B PG 64-22 TN 115 $68.00 $7,820.000
340-6122 D-GR HMA TY D PG 70-22 TN -577 $84.00 -$48,468.00
416-6002 24" DRILL SHAFT(LIGHT POLE) LF 6 $220.00 $1,320.00
530-6004 CONC DRIVEWAYS SY 453 $64.00 $28,992.00
666-6170 REFL PAV MRK TY II W 4"SLD LF -2690 $0.55 -$1,479.50
666-6178 REFL PAV MRK TY II W 8" SLD LF -60 $1.05 -$63.00
666-6180 REFL PAV MRK TY II W 12" SLD LF -75 $4.75 -$356.25
666-6182 REFL PAV MRK TY II W 24"SLD LF -68 $10.00 -$680.00
666-6184 REFL PAV MRK TY II W ARROW EA -2 $68.00 -$136.00
666-6192 REFL PAV MRK TY II W WORD EA -2 $100.00 -$200.00
666-6205 REFL PAV MRK TY II Y 4" BRK LF -385 $0.65 -$250.25
666-6207 REFL PAV MRK TY II Y 4" SLD LF -2370 $0.55 -$1,303.50
672-6009 REFL PAV MRK TY II-A-A EA 22 $11.00 $242.00
672-6010 REFL PAV MRK TY II-C-R EA 2 $11.00 $22.00
1122-2037 TEMP SEDMT CTRL FENCE INSTALL LF -5360 $2.50 -$13,400.00
BIOGRD EROSN CONT LOGS 12" DIA
1122-2048 INSTALL LF -2460 $4.25 -$10,455.00
402-1 CLSM - FLOWABLE FILL CY -384 $90.00 -$34,560.00
505-1 24" STEEL ENCASEMENT PIPE LF -60 $125.00 -$7,500.00
510-1 8" DR14 C900 PVC ALL DEPTHS LF -90 $46.00 -$4,140.00
510-7 10"SDR26 ALL DEPTHS LF 10 $42.00 $420.00
510-8 AC TO PVC ADAPTOR EA -4 $1,100.00 -$4,400.00
510-11 CLEANOUT EA 1 $630.00 $630.00
7000-1 PRECAST CONC FENCE LF -1316 $84.00 -$110,544.00
$0.00
TOTALS: -$192,879.50 0
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, rEQ-rIFICATION1 OF FILIN G
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2019-497875
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 05/30/2019
being filed.
City of Round Rock-Transportation Date Acknowledged:
E
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.
RC1804-001
McNeil Extension Phase 1-Change Order No.02 .
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary f'
i°
r
5 Check only if there is NO Interested Party.
0
6 UNSWORN DECLARATION
G
(/
VA
W--S141
M address isic
(street) (city) (state) (zip code) (country)
i'.
I declare under penalty of perjury that the foregoing is true and correct.
S 1
Executed in A County, Stayf ._._ ,on the ay of ,20
/► (month (year)
ti�A�pia AIMEE C REISWIG
x Notary ID#130241816 k
s My Commission Expires
elf of t�+ May 28,2023
Signature of authorized agent f ontracting business entity y:
(Declaran
Forms provided by Texas Ethics Commission www.ethics,state.tx.us Version V1.1.39f8039c '`
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. 2019-497875
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 05/30/2019
being filed.
City of Round Rock-Transportation Date Acknowledged:
06/27/2019
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.
RC1804-001
McNeil Extension Phase 1 -Change Order No. 02
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 V1.1.39f8039c