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Contract - Chasco Constructors - 7/11/2019 Page l of 3 .,� Contract Quantity Adjustment/Change Order rev,01/16 Department: Transportation Project Name: Harrell Pkwy&Brushy Creek Plant Road Date: 6/17/19 City Project Change Order/Quantity ID Number Adjustment No. 2 Vendor Chasco Constructors PO Box 1057, Round Rock,TX 78680 512-244-4600 Company Name Address Phone No. Justification 1) Railpros invoices for flagger&observer for 24"&30"bores from Salt Lick side 2)Inland Geodetics invoices for track monitoring for 24"&30" bores from Salt Lick side 3)Add 18"gate valve with Poster adapter at tie in of new 16"WL to existing 18"WL at Salt Lick side SUMMARY Amount %Change Origins!Contract Price: $3,549,994.41 Previous Quantity Adjustment(s): This Quantity Adjustment: $0.00 Total Quantity Adjustment(s): _$0.00 Total Contract Price with Quantity Adjustment(s): t $3,549,994.40 Previous Change Order(s): $86,069.00 2% This Change Order: $100,367.00 3% Total Change Order(s)To Date: $186,436.00 50/0 Adjusted Contract Price (Original Contract Price Plus Quantity Adjustment(s)Plus Change Order(s)]: $3,736,430,40 Difference between Original and Adjusted Contract Prices: $186,436.00 Original Contract Time: - 242 Time Adjustment by previous Quan.Adj./Change Order: 20 Time Adjustment by this Quan.Adj./Change Order: 31 New Contract Time: 293 Submitted for Approval Prepared By: 'SILL AM44 t 6R., P/4 CAWZO i —/7—/? Signature Printed Name,Title, Company Date Approvals Contractor: City Project Signature Printed Name,Title,Company Date Manager: 13 6-17 -11 Signa re Printed Name,True Date Mayor/City Manager t 001 0- - -•Il -lei Sig torePrinted Na e,Title Date Page 2 of 3 Contract Quantity Adjustment/Change Order rev Qsi6 Project Name: Harrell Pkwy&Brushy Creek Plant Road Quart.Adj./Change Order No.: 2 Change order Data Contract Time Adjustment Item# Item Description Unit Qty. Unit Price Amount (Davs) 1 Railpros Inv. #CC1244991904 LS 1 $6,706.00 $6,706.00 4 2 Railpros Inv. #CC1244991905 LS 1 3 Railpros Inv, #CCR1904, 5-13-19 LS 1 $16,800.00 $16,804.00 8 $26,675.00 $26,675.00 10 4 Railpros Inv. #CCR1945,5-29-19 LS 1 $23,450.40 $23,450.00 9 5 Inland Geodetics Inv. #2342,4-3-19 LS 1 $876.44 6 Inland Geodetics Inv. #2355,4-26-19 LS 1 $462 00 0 $3,462.44 $3,462.00 0 7 Inland Geodetics Inv. #2384, 6-7-19 LS 1 $4,791.00 $4,791.00 0 8 Add 18"gate valve with Foster adapter LS 1 $17,607.00 $17,647.00 0 $0.00 $0.00 $0.40 $0.00 $0.00 $0.00 $0.00 $0.00 $0.44 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Page 3 of 3 Contract Quantity Adjustment/Change Order ROS, mv,ou16 Project Name: Harrell Pkwy&Brushy Creek Plant Road Quan. Adj./Change Order No.: 2 Quantity Adjustment Data Contract Time Bid Item# Item Description Unit Qty. nit Price Amount Adjustment t $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 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 I $0.00 S0.001 0 RAILPROS 12449 o412sr201 s V° t - t t .: E." t=om: V i <_r t.- ;h-; CC 124491904 I N V 0 1 C E SERVICES PROVIDED TO: Rai(Pros invoice# CCI 24491904 Chasco Constructors Invoice Date 04/26/20319 RP Task Order No. 12449 PO# 18132 Terms Due on Receipt Location Round Rock TX Resod Services from 4/1/2019 through 4/26/2019 Description Quantify Rate Amount RWIC Perkins,Timothy Regular(Days) 5 998.40 4,990.00 Overtime 13 132.00 1,716.00 PLEASE PAY THIS AMOUNT>> Balance Due 6,706.00 Please remit payment to: RailPros Field Services, Inc. 1705 W. Northwest Hwy. Suite 150 Grapevine, TX 76051 Phone: 682-223-6897 Pax: 866.762-7619 Email: accounting.fs@railpros.com Aging Summary Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120 CC124491903 04.1/10/2019 2,994.00 2,994.00 00124491944 04/26/2019 6,706.010 6,706.00 Total 9,700.00 9,700.00 0.00 4.00 0.00 0.00 6 W-46/- 0//0 12449 .0!.�'�RAILPROS 06fO4/2019 ..... i_- 3� 'V i c.�_ L- i-, CGI 24491905 1 N V 0 1 C E SERVICES PROVIDED TO: RaiiPros Invoice# CC124491905 Chasco Constructors Invoice Date 06/04/2019 PO Sox 1057 RP Task Order No, 12449 Round Rock,TX 78660 PO# 18132 Terns Due on Receipt Location Round Rock TX Period Services from 4/27/2019 through 5131/2919 Description Quantity Rate Amount KWIC LOPEZ SENIOR,SAMUEL Regular(Days) 12 998.00 11,976.00 Overtime 27 132.00 3,564.00 Night I Weekends 1 1,260.00 1,260.{}0 PLEASE PAY THIS AMOUNT>> Balance Due 16,800.00 Please remit payment to: RailProS Field Services. Inc. 1705 W. Northwest Hwy. Suite 150 Grapevine,TX 76051 Phone: 652-223-6897 Pax: 866-762-7519 Email: accounting.fs@)ra1lpros.com Aging Summary Invoice Number Invoice Date Outstanding Current Over 30 Over 60 Over 90 Over 120 CC124491904 04/26/2019 6,706.00 6,706.00 CC124491905 06/04/2019 16,800.00 16,800.00 Total 23,506.00 16,800.00 6,706.00 0.00 0.00 0.00 Statement RailPros Field Services, Inc. 1705 W Northwest Hwy Suite 150 Grapevine,TX 76051 Chasco Constructors Statement date:6114/2019 PO Box 1057 Round Rock,TX 78680 Invoice Number Invoice Date Amount Chasco Constructors 1244912449 CC124491904 4126/2019 6,706.00 CC124491905 6/4/2019 16,800.00 Project Outstanding 23,506.00 U3070-91 P1 Chasco Constructors-Round Rock TX CCR1904 5/13/2019 26,675.00 CCR1905 5129/2019 23,450.00 Project Outstanding 50,125.00 Client Outstanding 73,631.00 Chasco Constructors Outstanding Current 31-60 Days 61-90 Days 91-120 Days 121+Days Prepayment 73,631.00 40,250.00 33,381.00 0.00 0.00 0.00 000 Inland Geodetics LLC Invoice 1504 Chisholm Trail Rd. 2342 Ste: 103 Round Rock, Tx. 78681 GEODETICS 4/3/2019 Plione# 512-238-1200 Fax# 512-238-1251 TBPLS Firm No. 10059 100 Bill To Chasco Constr-Lictors PO Box 1057 Round Rock,Tx. 78680 Description {quantity Rate Amount [US 79 Harrell Nirkway Turn Lane-Cross Highway Utility Bores, SuR,-e.ying Suivices through March 31,2019 Project Setup 1Z.P.L.S. 2 135.00 270.00 Technician 3 102.00 306.00 2) Person Crew 2150.00 300.00 Thook You For Your Bushim,q! Balance Due $876.00 Total $876.00 1111cauld Geodetics LLC Ir'll v 0[1 1504 Chisholm Tr6ail Rcl, 2355 Ste: 103 Round R.ock' Tx. 78681 F., 0) 4/26/2019 Phone It 512-238-1200 Fax # 512-238-1251 T13PLS Firm No. 10059100 Bill To Ch'ISCO C011SU'LICtOlS PO Box 1057 Round Rock,Tx. 78680 � � . }� ;�i Description x._ J _. F Quantity P%at C. AmOUnt LIS, 79 U1,11.1'eff Pai-hway Tuna Lane-Cross HfajjAvay Utility Surveying Services throtwh April 21,2019 13�5 4-1 r .00 Technician 3 102,00 Person cr"-W 3.Person Crew 4.5 170.00 765.00 Balance Due Thank You For Your Busill"s! 11 Total S-31,462.00 ......... Inland Geodetics LLC Invoice 1504 Chisholm Trail Rd. A 2384 Ste: 103 Round Rock, Tx. 78681 G E 0 E T I'�,»S 6/7/2019 .Phone 512-238-1200 Fax# 512-238-1251 TBPLS Finn No. 10059100 Bili To Chasco Constructors PO Box 1057 Pound Rock, Tx. 78680 Description Quantity Rate Amount US 79 Harrell Parkway Turn Lane-Cross Highway Utility Bores Saurveyim,Sem ices throe-h June 2,2019 Project Manager 1 140.00 140.00 R.P.L.S. 3 135.40 405.00 Technician 6.5 102.00 663.00 Clerical Support 1 58.00 58.00 'Person Crew150.003,525.00 5.40 Thank You For Your Business? Balance Due $4,791.00 Total 54.7101.00 Pf"). Box. 1057 Round Rock, 1'X 78680 Tel: 512-2144-0600 CONSTRUCTORS Toll free: 1-8-5.5-441-4109 Fa,x: 5 12)-.244-0489 mail(chast:o,com Harrell Pkwy 5/22/2019 Change Proposal 02-Add 18"gate valve to existing 18"waterline at 16"tie in Item # description -- UOM Qty unit price subtotal I Add 18"gate valve at existing 18"waterline EA 1 $17,175.00 $17,175.00 subtotal $17,175.00 1%insurance $171.75 $17,346.75 1.5%Bond $260.20 total $17,606.95 AIM bRA,AN SOCIEn Of CO\'CRr-TF CON"MAM" 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. 2019-506999 Chasco Constructors r Round Rock,TX United States Date Filed: 2 Name of governmental entity or stateagency that is a party to the contract for which the form is 06/19/2019 being filed. City of Round Rock,Texas 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. 18132 Railpros invoices for flagger&observer and Inland Geodetics for track monitoring and add 18"gate valve w/Foster adapter at tie in of new 16"WL for 24"&30"bores from Salt Lick side 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Chuck,Glace Round Rock,TX United States X Charles,King Round Rock,TX United States X f i 5 Check only if there is NO Interested Party. ❑ 6 UNSWORN DECLARATION My name is 1�ti'`l 1 My address is (street) (city) (state) (zip code) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in ( + G�3 J County, State of ,on the/�_aay of`� "''X,,20 ...... (month) (year) 4c/o Sign Are of author�(Declarant)ed agent of contracting business entity Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.391`8039c 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. 2019-506999 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 06/19/2019 being filed. City of Round Rock,Texas 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. 18132 Railpros invoices for flagger&observer and Inland Geodetics for track monitoring and add 18"gate valve w/Foster adapter at tie in of new 16"WL for 24"&30" bores from Salt Lick side 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling Intermediary Chuck, Glace Round Rock, TX United States X Charles, King 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 V1.1.39f8039c