Contract - Texas Materials - 5/14/2020 Page 1 of 3
Contract Quantity Adjustment/Change Order
/ AROUND ROCK.7F�C.LS
rev,0a/12
Department: Transportation Department
Project CORR 2019 SMP Arterials-University,Old
Name: Settlers,Su n rise &Red Bud Lane Date: 4/29/20
City Project Change Order/Quantity
ID Number 20-402 Adjustment No. 1
Justification
Added scope per City of Round Rock officials.
SUMMARY Amount %Change
Original Contract Price: $3,680,000.37 `
Previous Quantity Adjustment $s}: 0,00 Y
This Quantity Adjustment: $93,414.10
Total Quantity Adjustment(s): $93,414.10
Total Contract Pdce with Quantity Adjustment(s): $3,773,414.47
Previous Change Orders):
0.00
This Change Order: 0.00
Total Change Orders)To Date:
$0.00 OAO
Adjusted Contract Price [Original Contract Price Plus
Quantity Adjustment(s)Plus Change Orders)]:
$3,773,414.47
Difference between Original and Adjusted Contract Prices: $93,414.10
Original Contract Time: 120
Time Adjustment by previous Quan.Adj./Change Order: 0
Time Adjustment by this Quan.Adj./Change Order: 0
New Contract Time: 120
IM UNION,, Nil
OEM
i
Prepared Br,,' -�`�' ♦ ,
`� Travis King, Project Manager,Texas Materials 4/29/20
Signature Printed Name,Title,Company Date
+ N<
7r �r" a
Contractor: Travis King, Project Manager,Texas Materials 4/29/20
Signature Printed Name,Title,Company Date
City Project _ _
Manager. a��4611 — a I/v"t&Ivn o� sy r a��. C ;,��t, q-Za � ZO
Sig re Printed Name,Titl Date
Mayor/City �/,•
Manager
Sig ture Printed Name,Title Date
Page 2 of 3
Contract Quantity Adjustment/Change Order
RDLIND ROCK.7tx.LS
rev,08/12
Project Name: CORR 2019 SMP Arterials-University, Old Settlers,Sunrise &Red Bud Lane
Quan.Adj./Change Order No.: 1
F Ct'hange, Order Data WIN-MM 7
�f �`�'Yjr{`.��7 •s��� �'�it� .;4 �"t�
T
Contract
Time
Insj tem #.F It:...e, m Description
escription Unit Qty-
Unit Price Amount
mount (Days)
�iQr, s_,x; r3s7i.w Adjustment
djustment
,R. AMRM: €1-t{-,f'r Da s
A ^,.
R"j kKf
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.0a 0
$0.0a 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00. o
$0.00 0
$0.00 a
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$o.0a 0
$0.00 0
$0.00 0
$0.001 0
$0.001 o
$0.00 a
$0.00 0
$0.00 0
�'���,�
S+wls`.:»t"
TOTALS: $0.00 0
Page 3 of 3
Contract Quantity Adjustment/Change Order
„kOt�ND ROCK.TElx4
rev,081'12
Project Name: CORR 2019 SMP Arterials-University, Old Settlers,Sunrise &Red Bud Lane
Quan.Adj./Change Order No.: 1
Quantity Adjustment Data ¢
w 01'
M
y
Contract
Time
Adjustment
Bid Item # Item Description Unit Qty. Unit Price Amount
2�t?ii .'t p.. `f, 1 a ii.t ..:'�+ 1 z ..i .rp}... yy.;,•, ., y1• 1". S i k ii: 5rn
Y IMP
' i
s't§�y t 4 ^v
�.. �� �n..n c4{;•.w..;g.. .�i.._'`..��:..i tltl..S ...:...t�' •„s ..t{:Iq�� �.;. .y.)�;-, �.w�b�- ) it Tx��° ,ap��r e+. ���tt5���n i� �j,��rt'�� �tA.y bv,...` ,"3��14t�..tk
i�"�1021111 x ;ori; a'fVys4
..��.. ... Y.i.Jf5n�1'�8�.�.,. � � ...usys��F�.<r'�;4:��. •��it�?c�.x•'.09-0-7m,ME
s.: .�. '�,�`±l+_`3it���1ltt�#;r�'Li �12itt.F:.v'A2"�.�.'T�/!ri4�lt�`_is.3'is�;:`1�1t?�`3`�".} ��a�1 t'��ti. 1� �n
1 Pav Repair(12" DEPTH) TON 176 $101.00 $17,776.00 0
2 R&R Conc Curb and Gutter LF 130 $55.00 $7,150.000
3 R&R Sidewalk SF 360 $11.50 $4,140.00
5 R&R Sidewalk Ramp EA 2 $1,750.00 $3,500.00
6 Surface Mill (2" DEPTH) SY 4976 $2.50 $12,440.00
9 TY-D HMAC SURFACE COURSE TON 547 $78.00 $421666.00
10 Valve Can Adjustment EA 2 $52.00 $104.00
11 Manhole Admenjustt EA 4 $180.00 $720.00
REFL PAV MRK TY 1 (W)47(BRK)(100
13 MIL) LF 243 $0.33 $80.19
14 REFL PAV MRK TY 1-C LF 47 $4.35 $204.45
15 REFL PAV MRK TY 1 (Y)4"(SLD)(100 MIL) LF 972 $0.33 $320.76
16 REFL PAV MRK TY 1 (Y)4"(BRK)(100 MIL) LF 25 $0.33 $8.25
17 REFL PAV MRK TY II-A-A LF 47 $4.35 $204.45
REFL PAV MRK TY 1 (W)8"(SLD)(100
18 MIL) LF 680 $0.75 $510.00
REFL PAV MRK TY 1 (W)12"(SLD)(100
20 MIL) LF 528 $3.50 $1,848.00
REFL PAV MRK TY 1 (W)24"(SLD)(100
22 MIL) LF 36 $9.50 $342.00
REFL PAV MRK TY 1 (W)(ARROW)(100
23 MIL) EA 6 $130.00 $780.00
REFL PAV MRK TY 1 (W)(WORD
24 "ONLY")(100 MIL) EA 4 $155.00 $620.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
W
R H $0.00
OW
Lam
is w a 3�5.. -
TOTALS: S93,414.10 0
CERTIFICATE INTERESTED PARTIES FoRm 1295
OFFICE USE ONLY
Camptete Nos,1-4 and 6 it there are Interested des- CETIF[ AT1QN OF RUNG
COMPlete Nos,1,2,3,s,and tt it there are no interested pantie%
of tl iaaasir is antra placo Certificide Number.
1 Name of business entity tiling form,anda dly.stMA"d+��� 2020-609621
of business.
Texas Materials Group,Inky Oate Filed:
cedar Pa*,Tx united States � e (A/2012020
*me of governmen en t,ui;tom emy _ u
being filoct. Date Ackr�wtodged:
City of Round Rock
Provide vide a id+r t €on number tier u� "the i"rtt+�rttai erttityt or state eoencY to U"k or Identify the comm t,,and provide a
description of the services,Vis,41'00W property to 1w prodded under the cantr+ t~
212
20-402 CO#1-2010 SMP AftedalS-U niversitY,Old Settlers,Sunrise&lied Bud Lane
Nature of Interest
Nie of Interested# Cad,ate,Country(place of business) (check applicable)
Cantroliing intermediary
H Atlanta,(3A United Statim
CR ,Inc-
M 11
...
t
\ f
Check only if there is NO Interested Parn�
y
6 UNSWORN DECLARATION
ION
David Reese
My nate is tinct MY date of birthis
Myaddressis
1320 Arrow ,Point Drive #600 Cedar Park TX 78613 LSSA
(streeti ---------""`'
tri } + (country)
I declare under pertain of pedury that the foregoing is true and correct.
Williamson
eo in county, state of Texas �� Air�1
on � 2Q.L1
(year)
ignalure of authorized agent
of CoMaeftbusting e"
Forms provided by TextE#ksCommissionWM-etfiiMstalelcus
j3a6—a 'Y
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. 2020-609621
Texas Materials Group, Inc.
Cedar Park,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 04/20/2020
being filed.
City of Round Rock Date Acknowledged:
05/01/2020
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.
20-402
20-402 CO#1-2019 SMP Arterials- University, Old Settlers, Sunrise&Red Bud Lane
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
CRH, Inc. Atlanta, GA 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 V1.1.3a6aaf7d