Contract - PM Construction and Rehab - 7/23/2020Page I of 3
Contract Quantity Adjustment/Change Order
f?iP-WND ROCK
rev, 01/ 16
Department:
Project
Name: Wastewater Collection System Pipe Bursting Rehabilitation 2020 Date: 6/24/20
City Project Change Order/Quantity
ID Number RHB20 Adjustment No. 1
Vendor PM Construction & Rehab, LLC 131 North Richey Road - Pasadena, TX 77506 (832) 252-4811
Company Name Address Phone No,
,justification
UES
Change Order No. 1 is needed to improve a wastewater line in Anderson Street from 8-inch to 12-inch. This pipe enlargment is needed for
additional wastewater flows in the Northeast Downtown area. A new 8-inch wastewater line will replace a damaged existing 6-inch concrete
wastewater line in Lewis Street from Milam Street northward 450 feet.
SUMMARY
Amount
% Change
Original Contract Price:
$1,443,120.25
Previous Quantity Adjustment(s):
This Quantity Adjustment:
$0.00
Total Quantity Adjustment(s):
$0.00
Total Contract Price with Quantity Adjustment(s):
$1,443,120.25
Previous Change Order(s):
0%
This Change Order:
$186,098.00
13%
Total Change Order(s) To Date:
$186,098.00
13%
Adjusted Contract Price [Original Contract Price Plus
Quantity Adjustment(s) Plus Change Order(s)]:
$1,629,218.25
Difference between Original and Adjusted Contract Prices:
$186,098.00
Original Contract Time:
180
Time Adjustment by previous Quan. Adj./Change Order:
Time Adjustment by this Quan. Adj./Change Order:
30
New Contract Time:
210
Submitted for Approval
Prepared By;==
Eddie Zapata, Senior Project Manager, City of Round Rock
6/24/20
Signature
Printed Name, Title, Company
Date
Approvals
._ ,
wtu ®
Contractor.
Emily High, Project Manager, PM Construction
& Rehab, LLC
rrVi1�
S" t re
Printed Name, Title, Company
Date
City Project
Manager:
Eddie Zapata, Senior Project Manager
Signa re
Printed Name, Title
Date
Mayor/City
/� � 21)2o
Manager
9
Craig Morgan, Mayor
9 g ,
S na re
Printed Name, Title
Date
e2-o,02AU
Page 2 of 3
Contract Quantity Adjustment/Change Order
�7) N n R OCAK 1
rev, 01/16
Project Name: Wastewater Collection System Pipe Bursting Rehabilitation 2020
Quan. Adj./Change Order No.:
Change Order Data
Item #
Item Description
Unit
Qty.
Unit Price
Amount
Contract
Time
Adjustment
(Davs)
CO 1 - 1
Barricades, Signs, & Traffic Handling
EA
2
$3,500.00
$7,000.00
CO 1- 2
Burst existing 8" wastewater line to 12"
HDPE wastewater line
LF
800
$80.00
$64/000.00
CO 1- 3
Post TV Inspection after rehabilitation
LF
800
$5.00
$4,000.00
CO 1 - 4
12" Wastewater line point repair (8' - 12'
deep)
EA
2
$4,830.00
$9,660.00
CO 1-5
Wastewater service lateral reconnect
EA
17
$920.00
$15,640.00
CO 1-6
Install 8" wastewater line by open cut (0 -
8' deep)
LF
450
$75.00
$33,750.00
CO 1-7
Wastewater service lateral reconnect up
to 5'
EA
7
$920.00
$6,440.00
CO 1-8
Extra length service connection over 5'
LF
65
$40.00
$2,600.00
CO 1 -9
Remove & replace end of line cleanout
EA
1
$1,840.00
$1,840.00
CO 1 -10
Install new 4' dia. Manhole 0 - 6' deep
EA
1
$4,500.00
$4,500.00
CO 1 -11
Repair/Rehab 2" Asphalt pavement
SY
250
$46.00
$11,500.00
CO 1-12
Flowable Fill
CY
170
$140.00
$23,800.00
CO 1 -13
Cement stabilized sand
TN
36
$38.00
$1,368.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL
186,098.00
0
Page 3 of 3
Contract Quantity Adjustment/Change Order
rmo
c
rev, 01/16
Project Name: Wastewater Collection System Pipe Bursting Rehabilitation 2020
Quan. Adj./Change Order No.:
Quantity Adjustment Data
Bid Item #
Item Description
Unit
Qty.
Unit Price
Amount
Contract
Time
Adjustment
$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
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS:
$0.00,
0
CERTIFICATE OF INTERESTED PARTIES FORM 1295
10fl
Complete Nos., 1- 4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos,, 1, 21 31 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. 202Ow639607
PM Construction & Rehab, LLC dba IPR South Central
Pasadena, TX United States gate Filed:
2
Name ---- of governmental entity or state agency that is a party to the contract for which the form is 07/02/2020
being filed.
Round Rock, TX 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.
000000
Basin 2 & 3, Cycler 3-Wastewater P13 Buyboard Contract # 555=18 Change Order
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
IPR AcquisitionCo, Inc.
Conyers, GA United States
X
5
Check only if there is NO Interested Party. ❑
6
UNSWORN DECLARATION
My names Jamee Bedingfield ,and my date of birth is
address is 1510 Klondike Rd, Suite 400 Gnu Conyers G A , 30013 ,USA
nm�
(street) (city) (state) (zip code) (country)
declare under penalty of perjury that the foregoing is true and correct.
Executed in Gwi*nneft County, State of GA , on the 2ndday of J U 1Y 20 20
(month) (year)
Ja ee Bedingfield (Jul 2, 2020 14:38 EDT;
----------- ------------ ---- ORION --------- ---------------
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www,ethics,.statetx.us version vi.i.;3abaaTta
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
10fl
Complete Nos. i - 4 and 6 if there are interested parties. OFFICE USE ONLY
Complete Nos,, i, 21 31 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. 2020-639607
PM Construction & Rehab, LLC dba IPR South Central
Pasadena, 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 07/02/2020
being filed.
Round Rock, TX Date Acknowledged:
07/14/2020
g
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.
000000
Basin 2 & 3, Cycler 3-Wastewater 1313 Buyboard Contract # 55548 Change Order
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
Intermediary
IPR AcquisitionCo Inc.
Conyers, 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 - - I - ---- -9 -
(street) (city) (state) (zip code) (country)
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