Loading...
R-2023-162 - 5/25/2023 RESOLUTION NO. R-2023-162 WHEREAS, the City of Round Rock has duly advertised for bids for the Meadow Lake Dock Improvement Project; and WHEREAS, AgH2O Holdings, LLC has submitted the lowest responsible bid; and WHEREAS, the City Council wishes to accept the bid of AgH2O Holdings, LLC, Now Therefore BE IT RESOLVED BY THE COUNCIL OF THE CITY OF ROUND ROCK,TEXAS, That the Mayor is hereby authorized and directed to execute on behalf of the City a contract with AgH2O Holdings, LLC for the Meadow Lake Dock Improvement Project. The City Council hereby finds and declares that written notice of the date, hour, place and subject of the meeting at which this Resolution was adopted was posted and that such meeting was open to the public as required by law at all times during which this Resolution and the subject matter hereof were discussed, considered and formally acted upon, all as required by the Open Meetings Act, Chapter 551, Texas Government Code, as amended. RESOLVED this 25th day of May, 2023. — /-.,, A / CRAIG R AN, Oayor City of R and Roc V xas ATTEST: MEAGAN SOIKS, Ci Clerk 1)1 12.20232:4864-6133-3(N)3 PARKS&REGREATION DEPARTMENT BIDS EXTENDED AND CHECKED 301 West Bagdad BY: kab Round Rods, Texas 78664 DATE: 4/5/2023 (512)218-5540 BID TABULATION SH EET: 1 of 1 CONTRACT: Meadow Lake Dock I mprovanent Pr ed LOCATION:City Hall Chambers AgH2O Holding LLC Dalrymple Gravel& Jerdon Enterprise,LP DATE: April 4,2023@ 10am Cont.Ca,Inc APPROX. UNIT UNIT UNIT UNIT UNIT UNIT # ITEM UNIT CITY. PRICE COST PRICE COST PRICE COST PRICE COST PRICE COST PRICE COST 1 Mobilization LS 1 $18,000.00 $18,000.00 5,000.00 25,000.00 $20,000.00 $20,000.00 2 Barricades,Signs,and Traffic Handling MO 1 $800.00 $1300.00 $2,000.00 $2,000.00 $1,850.00 $1,850.00 3 Concrete Sidewalk(4") SY 140 $140.00 $19,600.00 $140.00 $19,600.00 $125.00 $17,500.00 4 Silt Fence LF 250 $15.00 $3,750.00 $8.00 $2,000.00 $8.00 $2,000.00 5 Stabalized Construction Entrance EA 1 $2,500.00 $2,500.00 $4,000.00 $4,000.00 $4,000.00 $4,000.00 6 Concrete Dods Bulkhead LS 1 $28,000.00 $28,000.00 $65,000.00 $65,000.00 $63,000.00 $63,000.00 7 Excavation and Haul Off CY 130 $75.00 $9,750.00 $50.00 $6,500.00 $53.00 $6,890.00 8 Embankment CY 30 $125.00 $3,750.00 $200.00 $6,000.00 $14.00 $420.00 9 Demolition and ranoval of concrete sidewalk LS 1 $7,500.00 $7,500.00 $2,000.00 $2,000.00 $1,600.00 $1,600.00 10 Concrete washout LS 1 $2,000.00 $2,000.00 $2,000.00 $2,000.00 $1,300.00 $1,300.00 11 Rev ion SF 38400 $0.15 $5,760.00 $0.20 $7,680.00 $0.11 $4,224.00 12 TemporaryIrrigation LS 1 $4,500.00 $4,500.00 $10,000.00 $10,000.00 $17,500.00 $17,500.00 13Purclimeand install offloating dock LS 1 $194,000.00 $194,000.00 $305,000.00 $305,000.001 $205,000.00 $205,000.00 TOTAL BASE BID: I $Z19,910.001 $4ffi,780.001 1 $345,2KO01 $0.001 1 $0.00 1 $0.00 Indicates discrepen y between unit price and unit price BID FORM JOB NAME: Meadow Lake Dock Improvement Project 2023 JOB LOCATION: Round Rock, Williamson County, Texas OWNER: City of Round Rock, Texas DATE: March 2023 Ladies and Gentlemen: Pursuant to the foregoing Notice to Bidders and Instructions to Bidders, the undersigned bidder hereby proposes to do all the work, to furnish all necessary superintendence, labor, machinery, equipment, tools, materials, insurance and miscellaneous items, to complete all the work on which he bids as provided by the attached supplemental specifications, and as shown on the plans for the construction of Meadow Lake Dock Improvement Proiect 2023 and binds himself on acceptance of this proposal to execute a contract and bond for completing said project within the time stated, for the following prices, to wit: Any addenda issued will be posted with the Project Manual and/or Contract Documents on the City's website at h!lps://www.roundrocktexas.gov/businesses`/solicitationsi by the close of business on March 31, 2023. Prior to submitting a bid, the bidder is responsible for determining if any addenda have been issued and for following any instructions in any addenda issued. Bidder acknowledges receipt of the following Addenda by listing Addendum "number" and "date". Addendum: Date: The Owner reserves the right to award any combination of bid items in the Base Bid. Page 1 0200-9-2015 Bid Form BID BOND THE STATE OF TEXAS § § KNOW ALL BY THESE PRESENTS: COUNTY OF WILLIAMSON § That AGH2O Hodings, LLC _ of the City of Round Rock 4 County of Williamson State of Texas as Principal, and FCC[Insurance Company authorized under the laws of the State of Texas to act as surety on bonds for principals,are held and firmly bound unto the CITY OF ROUND ROCK,TEXAS("Owner's, in the penal sum of Five Percent(5%)of the total amount of the Bid of the Principal submitted to the Owner, for the Work described below;for the payment whereof,well and truly to be made,and the said Principal and Surety do herby bind themselves and their heirs, administrators, executors, successors and assigns, jointly and severally,as follows- In no case shall the liability of the Surety hereunder exceed the sum of( Five Percent of Bid Amount Dollars($ 5%of B!d Amount THE CONDITIONS OF THIS OBLIGATION ARE SUCH that,whereas,the Principal has submitted the above-referenced Bid to the Owner, for construction of the Work under the "Specifications for Construction of Meadow Lake Dock Improvement Project 2023 for which Bids are to be opened at the office of Owner on the 4th day of April 20 23 NOW,THEREFORE,if the Principal is awarded the Contract,and within the time and manner required under the"Instructions to Bidders,"after the prescribed forms are presented to her/him for signature,enters into a written Agreement substantially in the form contained in the Bid Documents, in accordance with the Bid, and files the two (2)bonds with the Owner, one to guarantee faithful performance and the other to guarantee payment for labor and materials,then this obligation shall be null and void;otherwise,it shall be and remain in full force and effect. If, however,Principal fails to enter into a written Agreement with the Owner in accordance with the Bid or Principal and Surety fail to timely deliver to Owner the performance and payment bonds required by the Bid Documents, Surety within five(5)business days after receipt of a written demand from Owner shall pay to Owner the full penal sum of this Bid Bond,sub;ect to the limitation described herein. In the event that suit is brought upon this Bond by the Owner and judgment is recovered, said Surety shall pay all costs incurred by the Owner in such suit including a reasonable attorney's fee to be fixed by the Court. IN WITNESS WHEREOF, the said Principal and Surety have signed this instrument on this the 4th _ day of the month of r,�,jI 20 23 AGH2O Holdings, LLC FCCI Insurance Company Principal Surety James R Lesko Sally Lorden Prin Name Printed Mame B .. Byr— tie Managing Member Title- Attorney-ln�-Fact ress: 3817 Bent Brook D Address- 6300 Un,versity Pkwy Round oc 786U4-Z26T Sarasota FL 34240 00200 4-2020 Face 1 Bid Bond 00443638 Resident Agent of Surety: G4c��v SignatureV Sally Lorden-Donegan insurance Agency Printed Name 314 N Camp Street Address Seguin,TX 78155 City,State,Zip i s 3 3 i j l Page 2 00200 4-2020 Bid Bond 00443638 i FCCI.R.,INSU . CF r GENERAL POWER OF ATTORNEY Know ail men by these presents That the FCCI Insurance Company, a Corporation organized and existing under the laws of the State of Florida (the"Corporation')does make, constitute and appoint: Bruce Barnard; Gwen Crouch; Debbie Hay; Tom Hewitt; Sally Lorden Each, its true and lawful Attorney-In-Fact, to make, execute, seal and deliver, for and on its behalf as surety, and as its act and deed in all bonds and undertakings provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed the sum of(not to exceed $20,000,000.00): $20,000,000.00 This Power of Attorney is made and executed by authority of a Resolution adopted by the Board of Directors. That resolution also author zed any further action by the officers of the Company necessary to effect such transaction. The signatures below and the seal of the Corporation may be affixed by facsimile, and any such facsimile signatures or facsimile seal shall be binding upon the Corporation when so affixed and in the future with regard to any bond, undertaking or contract of surety to which it is attached. In witness whereof, the FCCI Insurance Company has caused these presents to be signed by its duly authorized officers and its corporate Seal to be hereunto affixed this 23rd day of July 2020. Attest: °" ae&— �? ,r.P � .'q- 6�p: " . .._ Christina D Welch, President �'. SEALe `. '_ Christopher Shoucair, FCCI Insurance Company 19W - EVP,CFO,Treasurer, Secretary R�oR1aP:' FCCI Insurance Company State of Florida .. County of Sarasota Before me this day personally appeared Christina D We'ch, who is personally known to me and who executed the foregoing document for the purposes expressed therein My commission expires: 2/27/2023 I'"f. .s�S"'°`F °, SOS Notary Public State of Florida County of Sarasota Before me this day personally appeared Christopher Shouca r who is personally known to me and who executed the foregoing document for the purposes expressed therein My commission expires 2/27/2023 yo% ig am. 35" Notary Public CERTIFICATE 1, the undersigned Secretary of FCCI Insurance Company, a Florida Corporation, DO HEREBY CERTIFY that the foregoing Power of Attorney rema;ns in fuli force and has not been revoked, and furthermore that the February 27, 2020 Resolution of the Board of Directors referenced in said Power of Attorney, is now in force. Dated this 4th day of April 2023 Christopher Shoucair, EVP, CFO, Treasurer, Secretary FCCI Insurance Company 1-IONA-3592-NA 04, 712021 BASE BID Bid Approx. Item Description Unit Item Ouantity Unit and Written Unit Price Price Amount 1. 1 LS Mobilization, complete in=1acer plan,for t*#4dollars 00 00 and ND cents. $1 _O�0 $ GLS. i 2. 1 MO Barricades, Signs and Traffic Handling, complete in place per plan, for Mw+a� dollars 4.fZ and AID ----_cents. $ SDD $ $co 3. 140 SY Concrete Sidewalk (4"), complete in place per plan, fordf .otru"dollars 00 Q-0 and No cents. $ $ 0- 4. 250 LF Silt Fence (Install, Maintain And Remove) complete in place per plan, for t'iMVVIJ dollars 00 and Al` cents. $ Ps •� $3 S6 . J 5. 1 EA Stabilized Construction Entrance, complete in place per an, for.M" A44 Ny s 00 00 and Mu cents. $ $SCS 6. 1 LS Concrete Dock Bulkhead/ Abutment, complete in place o forVOAya`� °12 and go cents. &28 oco $m Com � T 7. 130 CY Excavation and Haul Off, complete in place per plan, for$evP,n! Pith dollars Q0 and__,�,�Q - __-_--cents. $?S• $ 9 7•SD' Page 2 0200-9-2015 Bid Form Bid Approx. Item Description Unit Item uanti Unit and Written Unit Price Price Amount 8. 30 CY Embankment, complete in place perlanb for 00 c VWA)60 TY% � t� oO and Aft, _.cents. $ 9. 1 I.S Demolition and removal of Concrete sidewalk, complete in place fo> yw"1 Five qoars N on oc� and I,/o _cents. $ 7.500 10. 1 LS Concrete Washout Pad, complete in place per plan, for'vAD 9I04VO dollars 00 00 and No cents. $ $ 2. OCO 11. 38,400 SF Re-vegetation using Bermuda hydroseed of all disturbed areas, complete in place, per plan. for O dollars j s' OV and f)Ff4 _cents. $ O $ -5 tz 12. 1 LS Temporary irrigation for the Establishment and hydroseed re-vegetation of all disturbed areas, complete in place, per Ian. forfon1.Fwr uu~ as od and_ N 0 cents. S5*00 S S00 Page 3 0200-9-2015 Bid Form Bid Approx. Item Description Unit Item uanti Unit and Written Unit Price Price Amount 13. 1 LS Purchase and install of Floating Dock as manufactured by Floatation Systems, Inc. (Ph.: 800.711.1785) or approved equal per plans and specifications, complete in place, per for Ok M�R^ U a A:2-o 00 and ___..h(jo__ cents. $ 1 gL/G0 $_t 9# xo . c� y OM TOTAL BASE BID (Items 1 thru 13): l STATEMENT OF SEPARATE CHARGES: C4 Materials: 200 .00o ,- All $ o© o0o ,-All Other Charges: $ *Total: $ • Note: This total must be the same amount as shown above for "Total Base Bid" If this proposal is accepted, the undersigned agrees to execute the contract and provide necessary bonds and insurance certification as per the Instructions to Bidders and commence work within ten (10) days after written Notice to Proceed. The undersigned further agrees to complete the work in full within one hundred twenty (180) calendar days after the date of the written Notice-to-Proceed. The undersigned certifies that the bid prices contained in the proposal have been carefully checked and are submitted as correct and final. The Owner reserves the right to reject any or all bids and may waive any informalities. Page 4 0200-9-2015 Bid Form Respectfully Submitt d, 2 1 Ylature .� q n��s tZ_ c.EskU_ 2A l � S�aor- DRIVE )2�2 1�C Print Name Address -78 UP G FN E"L n1A#J4,(aE2 (3)z) yB V- 76!l Title Telephone X1920 gotbjrOA.5 LLC- Na4 o7 Firm y z3 Date Secretary, if Bidder is a Corporation Page 5 0200-9-2015 Bid Form 00410 STATEMENT OF BIDDER'S SAFETY EXPERIENCE Page 1 00410 5-2014 Statement of Bidder's Safety Experience 00090654 Solicitation Requirements, Contract Forms & Conditions of Contract Statement of Bidder's Safety Experience Section 00410 Bidder must submit a signed Statement of Bidder's Safety Experience form with his Bid; failure to do so will constitute an incomplete Bid that may be rejected. In order to make a responsive Bid, Bidder must provide evidence that it meets minimum OSHA construction safety program requirements, has not been fined by OSHA for any willful safety violations in the past three years, and has a lost time injury rate that doesn't exceed the limits established below. All questions must be answered and data given must be clear and comprehensive. If necessary, questions may be answered on separate attached sheets. Company Name: Agb0 g0L01r'J GtS LLC. Address: 30 Q Raj—% aio& K RhA Rai 714(vY Phone:(`y] AV V Completed by: J AYKeS Lin)LO Date: 5r1_3/Z 3 1. Does the company have a written construction Safety program? Utes ❑No 2. Does the company conduct construction safety inspections? 9?cs ❑No 3. Does the company have an active construction safety-training program? GKes ❑No 4. Has the company been fined by OSHA for any willful safety violations in the past ❑Yes GKo three years? 5. Does the company have a lost time injury rate of 7.8 for SIC IS,or 7.6 for SIC 16, Q)Kes ❑No or less over the past three years? Attach the company's OSHA 200/300 logs for the past three years. 6. Does the company or affected subcontractors have competent persons in the following Areas? A. Scaffolding QVes []No ❑N/A B. Excavation CaYes [-]No ❑N/A C. Cranes GKes ❑No ❑N/A D. Electrical [!}'�'es ❑No ❑N/A E. Fall Protection G'�//(es []NoE]N/A F. Confined Spaces (R'Yes []No ❑N/A I hereby certify that the above information is true and correct. Signature Q-0 Title A?Aiv/4V& Page 1 00410 8-2014 Statement of Bidder's Safety Experience 00090654 OSHA's Form 300A (Rev.04!2004) Note.You can type Input Into this form and save It. Year 20 Because the forms in this.ecotdkeeping package are'fillable/writable' 22 PDF documents,you can type into the input form fields and — Summary of Work-Related Injuries and Illnesses then save your inputs using the free Adobe PDF Reader. U.S.Department of Labor Oc"paaona/Safety and Health•dWafabadon Fan apptovcd OMB m.1218-0176 AN establishments covered by Part 1904 must complete this Summery page,even if no work-related injuries or illnesses occurred during the year. Remember to review ft Log to verify that the entries are complete and accurate before completing this summary Using the Log,count the individual entries you made for each category. Then write the totals below,making sure you've added the entries from every page of the Log.If you had no cases,write'0." Establishment information Employees,fonner employees,and their representatives have the right to review the OSHA Form 300 in its entirety.They also have limited access to the OSHA Form 301 or Its equivalent.See 29 CFR Pan 1904.35,in OSHA's recordkeeping rule,for further details on the access provisions for y—astaba nit nine AGH2O Holdings, LLC these forms. street 3817 Bent Brook Drive NumberofCases city Round Rock state TX Zip 78664 Total number of Total number of Total number of cases Total number of deaths cases with days with job transfer or other recordable Industry description(e.g..Manufacture ofmotor heck rrnikrs) away from work restriction cases 0 0 Q Q Construction (G) (H) (1) (J) North American Industria Classification(NAICS),if known(cg.,336212) 236200 of Days Emrploymerrt information(If you don't have these figures,see the Total number of days Total number of days of Worlaheet on the new page to esnmate.) away from work job transfer or restriction Q Q Annual average number of errlployxs Z' (K) Total hours worked by all employees last year Sign here Knowingly falsifying this document may result in a fine. Total number of. (M) 1 certify that 1 have a fined this document and that to the best of m owledge the es true,accurate,and complete. (1)Injuries Q (4) Poisonings Q /�• (2)Skin disorders 0 (5) Hearing loss Q piny executive `Title (3)Respiratory conditions Q (9) All other illnsscs Q up ...(512)484-7611 DH1e12/31/2022 Post this Summary page from February 1 to April 30 of the year following the year covered by the form. Reset Public Irrposthg burden for thu eol1wim of mfnnnar n it Mon esed to avaagir 58 manta per reapone,mchditg Curr to rrvicw the wsvw iotr,seenh and ptbn the dui ncodod.tad complete and my the colkgiom of inforvslioo.Perm arc not rcgmred w rcgood w the w1ketion of infonrmam unless a displays•canny valid OMB control numb".If you have any coma nu about Them atirrrates a any other aspom of thn din ooaedwp wain-us Depanraem er Labor,OSHA Office of St*a"tet Analysis,Room N-7644.=00 Cm daabn Avaaue,NW. Washingtm DC 20210.Do rot seed the conplewd forms w this ofrtx OSHA'S Form 300 (R.., 04/2004) Note.You can type Input Into this fort and save IL Attention:This form Contains information re(atiny to Log of Work-Related Because the forts in this recordkeeping package are Ydlebsle/wntable' employee health and must be used in a manner that PDF docurrtents,you can type into the input form fields and protects the Confidentiality of employees to the extent Year 20 22 then save your inputs using the free Adobe PDF Reader.In addttlon, possible while the information is being used for U.S. Departm- 0 ent of Labor Injuries and Illnesses the forms are programmed to auto-caicutate as appropriate. occupational safety and health purposes. oc.,,p.tlonat s.s rt, twos"Ad.r.ratnow, Plea"Record: Reminders: Fara,.M.-doMem 12194176 tnformaran about every work-related death and about every work-rebted lnfuryor Rios that InvoNtt loss of •Complere an Ltjury and pLrns tridde nr Report(OSHA Form 301)or egWwtmt cansdouvx34resbiaedwork activityor/obtransfer,days away from wodik or medical treo&nmrbeyond first aid form tot eodrin)toyorM?Ye recorded on this fort.ifyou'renot sure watdwra F ye. , ,e AGH20 Holdings, LLC -Wn#kantwork-retatedIniudesand ttfnemesthat are dlognosedbyaphysklonorkeenedleakcare prolesslonal cine krecordable,callyourbcdOSHA ofACefor help. Work-rdored injuries and dk)eues(hot meet any of the WedAc recording uirewfisted in 29 CFR Part Y904.8 Fed bre to use two lines for a wVk case if you need to. through 1904.11. •Cotnpktedw5steps for each case. Ce, Round Rock sun TX (A) (B) (C) (0) (E) (F) Emr.tlr mmnbar or days d*kite d of W Salact ono Cowan; Cue Employees name Job dile Date of injury Whert The event occurred Describe bnjary or mora,pun of body worker wan: no• (e g,Welder) or onset of (e.g..loading dark north end) affected•and objecilsubsnace that .gyp IDom dhwtty injured or nide person ill(e g. Rmraraa rt Wont t leg..1/101 Strood a tore bums on right farrarm from arerylrne torch) Wes may .toe rraaatar Oltur sowers• �Y On)Ob (M) Daata eros.owl «+..moue. .sin caaaa tram bsnatar (G) (H) (I) (J) ((K))t (r..trLl)cuon 5 � - -� t (t) (2) (3) (4) (5) (e) I) „O.,� 0 0 0 0 _�. , 000000 I 0 0 0 0 �tdit 000000 —/— 0 0 0 0 000000 =�t � my 0 0 0 0 000000 o 0 0 0 000000 moan t d.Y �,� 0 0 0 0 000000 te�et 0 0 0 0 _a.� 000000 maanrap' / 0 0 0 0 _, _- 000000 tet o 0 0 0 1 000000 t e,nna,,d., rese / 0 0 0 0 001—A-.) 00 n�ae,t�; ,c r.paona tradrn for sm cv+tacoon a mfomrtw�n eu.,.soa m..sr.Q!♦mmue.or.rt+rw.e msl,6.�ne:n re xw•die , 0 0 0 0 0 0 ona�e...racb..d�.row d.o a.r6rl.ad o°valee me��rhe cal,era or sromn.oe re„oax�m mama u, Pana ror� 0 0 0 0 0 0 v,a.,.rt -.h-hew Add a Fenn Page as sum to tnensror these taan a the s„m�ary pace norm.pow)b.k�t.you post Pt sow o<.ntenet.Hurn fence°r s,r��a=tr.x area, M4,700 Cpm A•taeC NW.W W.oywm.nC 7Qt 10,tb ool iad'Ar amyiczd f b Feu O? (t) (2) (3) (4) (5) (6) OSHA's Form 300A (Rev.0412004) Note:You can type input Into this form and save It. Year 20 Because the forms in this recordkeeping package are'filiable/writable' 21 PDF documents,you can type Into the Input form fields and -- Summary of Work-Related Injuries and Illnesses then save your inputs using the free Adobe PDF Reader. U.S.Department of Labor 0ccoyatlon.1 S.My.nd NNtth Ad,%1W.&,ston Form.ppmvcd OMB m.12 ta4116 All establishments covered by Pan 1904 must complete this Summary page,even ff no work-related injuries or Illnesses occurred during the year. Remember to review the Log to verify that the entries are complete and accurate before completing this summary. Using the Log,count the IndWual entries you made for each category.Then write the totals below,making sure you've added the entries from every page of the Log.If you had no cases,write'0. Establishment Informatlon Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its entirely. They also have limited access to the OSHA Form 301 or Its equivalent.See 29 CFR Part 1904.35,in OSHA's recordkeeping rule,for further details on the access provisions for Yew..pbarewmr,.m. AGH2O Holdings, LLC these forms. srrat 3817 Bent Brook Drive city Round Rock state TX Zip 78664 Total number of Total number of Total number of cases Total number of deaths cases with days with job transfer or other recordable Industry description(e.g.,Manufacture of motor truck trailers) away from work restriction cases 0 0 0 Q Construction (G) (ti) (I) (J) North American Industrial Classification(NAICS),if(mown(e.g.,336212) 236200 NomberofDays Employment Information(If you don't have these figures,see the Total number of days Total number of days of Worksheet on the nut page to estimate.) away from work job transfer or restriction Annual average number of employes 0 0 Total hours worked by all employees last year 107+4 Injury and illnoss Tyjres Sign here Knowingly falsifying this document may result ins fine. Total number of.. (M) l certify that 1 have examined this document and that to the best of my owledge the es are true,accurate,and complete. (1)Injuries 0 (4) Poisonings 0 (2)Skin disorders Q (5) nearing loss 0 o pany executive Title (3)Respiratory conditions Q (6) All other illnesses Q 00C(512) 484-7611 Date 12/31/2021 Post We Summary pays from February 1 to April 30 of the year following the year covered by rite form. Reset Public nom%burden for this coltactim of iafoneaton is otheucd to­V 5a mum"pc,rnp,inrhsimg time m,tk imar-wo,notch s W pd-U-dsu seeded,std coepkre and review the collection of ial♦tnoatioo.Person,ore mt mq—d to respow lo the collection of mfonmeion twku d displays s anemly valid OMB conwl n mba.I f you hove say comments abosa these ot=3ws m ary other ssp"U of ihn dais eo1kaio4 ewmaec US DcPadmcm of tAbor.OSHA Office of Statistical Ami W"ngim DC 20210.Do not send she mM4c ed forms a tts office. ysif.Raom N-3614.200 CoasUnaioa Avpnrc,NW. OSHA's Form 300 (R.,,. o4(2o04) Now You can" into this form and save IL tYPe input P Attention:This form contains information relating to Loof Work-Related Because the fotmts in this recordkeepmg package are'fillablelwritable' employee health and must be used in a manner that gPDF documents,you can type into the input form fields and protects the confidentiality of employees to the extent Year 20 21 then save your inputs using the tree Adobe PDF Reader.in addition, possible while the information is being used for U.S. Department of Labor Injuries and Illnesses the forms are programmed to auto-calcutate as appropriate. occupational safety and health purposes. o'—p.11„e,S.nty rid M.e,m Ad.,1M.Ersid— Please Record: RernIndars: F—stipn+-doMaoo 11194116 Inforrnation about every worli4eiated drath and about ewry work-refated injury or Illness thor Involves Joss of •Canpleteaninjuryand UlnessIncident Report(OW Form 3011ofequivalent AGH2O Holdings, LLC consciousness,restricted work activity or job transfer days away from work.or medkol treatment beyond first cid form for eoch Injury or 91nem recorded on this form.Ifirw*nor sure whedwr a Eu.oua v eve 9 Signllkant work-related/nprries and phrases that are diagnosed by a phys/dan or licensed hoafth can professional case is recordable,call your kcal OSHA office for help. •Wak-related iryuries and ifMasa that meet any of tar sped&recording afteio listed in 19 CFR Part 19D4.8 •Fed free to use two ilnes for a single case if you need ro. tluosrgh 1901.11. •Complete tbe5stepsfor eaclscase p1.Round Rock , TX eStop 2.Describe'he case (A) (13) (C) (D) (E) (F) Enos te..mwnber of Cam Emptover's natty Job title Date of injury Wbere the event orearred Describe Injury or(Oness,parts of body ways w r w Me�or k Select one coivan: no. (e.g..Wilder) or onset of (e.g..Loading dock north end) effected,tad object/sabstasce tbat Wom dbwtfy injured or malt pertoa W(e. at War* 111 e (e.g,.1/10) Second degree bums on nght forearm from aeerylme lomh) bare Job tnmr.. Olfrr nws- Are y On)ob (M) Death hose.w� or reaulason M.carne hart vwbr or 3 1 f8t%pf j <A (G) (H) 10 W) «. (. .wsctson s ae _ Reset / 0 0 0 0 (t) (2) (3) (4) (5) (6) e Jday _�. .. 000000 _ 0 0 0 0 —_'. 1 000000 mole/deY �esat �,1day 0 0 0 0 _�, —Ge" 000000 =�t 0 0 0 0 000000 0 0 0 0 000000 ttveh l"Y wontil I"Y 0 0 0 0 _a., _�. 000000 rrlinth day � __._ tetI 0 0 0 0 -_ . .ter 000000 _/_ 0 0 0 0 N _681. _dl. 000000 rtv rdey reset _ 0 0 0 0 _ y. _..1. 000000 north ra" reset ;� 0 0 0 0 _�. 000000 Ir ey.rePape roMls , 0 O O 0 0 0 0 0 0 0 0 0 ume�amaW dm—6.&-A .m t��sonecuoo df,ofa,eeuon.rr„ae,.�oar�a ! Add a Form Page -- --- o.d w na oottecuoe o(mforwstro uNeta a dupic"a c uredy.W OMB mord. *m If y.,,hear,uy mmrouu sbem Lbm ! �r- 5e � ot s a q her rope of eadeb u oofk .oc conact:0%Deprtmmx i or Labor.MHA Orf nt.S a xsl AwhrY Naso Be Be sure to Vanees r me lomb 10 the$+urinary pegs(Fane 30124)befara you post'i cidd Sad.200 Cmem.ro.A.ewc.Nur W.&.V—DC 20210-Do ear­dd me m+olccd foot m con orf T < A lt) (2) (3) (4) (s) (s) OSHA's Form 300A (Rev.0412004) Note:You can type input into this form and save It. Year 20 Because the forts in this recardkeeping package are'filhbletwntable' 20 PDF documents,you can type Into the Input form fields and U.S.Department of labor Summary of Work-Related Injuries and Illnesses then save your inputs using the tree Adobe PDF Reader. occnp.tlonus.D pa tme"Ith�4dn.f a o Form wp—d OMS m.121$41 All establishments covered by Part 1905 must complete this Summary page,even if no work-related injuries or dlnessas occurred during the year. Remember to review the Log to verily that the entries are complete and accurate before completing this summary Using the Log,count the IndiWdual erltdes you made for each category.Then write the totals below,making sure you added the entries from every page of the Log.ff you had no cases,write'0.' Establishment Information Employees,former employees,and their representatives have the right to review the OSHA Form 300 in its enbrely.They also have limited access to the OSHA Form 301 or Its equivalent.See 29 CFR Pert 1904.35,in OSHA's recordkeeping rule,for further details on the access provisions for Y~.x eaoam-tn AGH2O Holdings, LLC these!bans. street 3817 Bent Brook Drive city Round Rock state TX zip 78664 Total number of Total number of Total number of cases Total number of deaths cases with days with job transfer or other recordable Industry description(e.g.,Manufacture ojmotor truck trailers) away from work restriction cases 0 0 0 Q Construction (G) (H) (I) (,1) North American indusaial Classification(NAICS),if(mown(e.g..336212) 23s2o0 Employment Information(If you don't have these figures,see the Total number of days Total number of days of Worksheet on the next page to estimate.) away from work job transfer or restriction Annual average number of employees O 0 Total hours worked by all employees last year 137 Sign here Knowingly falsifying this document may result in a tine. Total number of... I certify that I have examined this document and that to the best of (M) owledge the es are true,accurate,and complete. (t)injuries 0 (4) Poisonings 0 1!14L?eN . 4'7bd2. (2)Skin disorders 0 (5) Hearing loss 0 rft..7512) executive Title (3)Respiratory conditions 0 (6) All other illnesses Q 484-7611 Datc 12/31/2020 Pow this Summarypage from Febmary 1 to April 30 of rhe year following tris year covered by the form. Reset Pubik mvmTog Medea for iW coliettim of infweuew is estimated to 4vmgc St minter pump—,mhdina rime to nvi the rttt t tam,wteh and pibcr the data seeded,and compktc sod review,the oolloamn of mfer don Pertain uu not tequitod to mpaad to the w1kction of mformwm uA—it daplays a=ffCfflty.slid OM8 trosaml munba.If you have ury —woo Abm shoe atimors w nay obu"Pru of this data eolketion conuhm IIS Departmem of tsbor,OSHA Office of sLowseal Awhy m Room N-7644,'X0 Coosda.i Av ,NW, wruhngtim DC 20210.Do rot Bead the cumr acd form to this ours. OSHA's Form 300 (Rev. oarzooa, Note:you can type input Into this form and save itAttention:This form contains information relating to Log of Work-Related Because the forms in this recordkeeping package are'FtttaMe/wrttable' employee health and must be used in a manner that — 0 PDF documents,you can type into the input form fields and protects the confidentiality of employees to the extent Year 20 20 then save your Inputs using the free Adobe PDF Reader.In addition, possible while the information is being used for U.S. Department of Labor Injuries and Illnesses the forms are programmed to auto-calculate as appropriate. occupational safety and health purposes. Ooeuperlonu Safety and Hosith Aaab"is"Oon Pope Record: Reminders: Fon„.pp,a d OMB m 1.'19-0176 Information about every work-misted death andabewt evuy wok-miated ln/ury or Wriess that lnvohrs loss of •Coapfrte an Injury and Illness Incident Report(OW Form 30 t)a equMaknr AGf720 Holdings, LLC consdousness,makfed work act rity or job fromfer,days away from work or medktnal hentrif beyond first aid torm for each h)ury aWneu recorded on th(s bone ff youlm not sure whether a fsdpwnnsry nems •Si0ficant wok-related Injuria and IWxsses that arc diagnosed health cam a physkian or lkrnsed heacarr professfonat case is recordable,cog your koml OSM office for hdp. Work•rNored intipies and iRnessa that meet arty of the sped6c recording criteria listed in 29 CFR Parr 1904E Feel free to we two lines for a single case d you need to. through IW412 Cornpktethe 5steofor each c:ase. Say Round Rock S7rr. n( (A) (B) (C) (p) (E) IF) Enter M n—bar of --- _ .-.......,.. drys the lribsnnid a M Select one wisest: case En1P1o)ee'a naax Job due Due of tojery Wsets the even oce-Ttd Describe injury or Woes, parts of bode n—*w waa: ISO. (r.g..Weider) or ower of (e.g.,laodingdwk north md) affected.and objecilsebntaace that aer�e�erttaats MOVES =Ujsued or mask person M of wars 111110111111 C.g."10 degree burns on right forearns�rom g ) acetylene wry Jae s vt veer Outer casoe rY On t" (M) r ac er)e torch) Deals hai.�eni w�sv+cuen wb ease from tato or y pp (K1 (f) 3 ' E 3 < 2eset ! 0 0 0 0 (1) (2) (3) (4) (5) (6) ,� �, 1. 000000 _�. �r 000000 , �� 0 0 0 0 _ _ 0 0 0 0 _�. 000000 , eery r tet ; 0 0 0 0 —36" _ , 000000 _/_ 0 0 0 0 d, _ 000000 norm r day 0 0 0 0 _d-" 000000 tenet �;� 0 0 0 0 _�, _�. 000000 0 0 0 0 _ _�. _�. 000000 0 0 0 0 _�. _�. 000000 e�t ;� 0 0 0 0 ��. 000000 r.pero�h.rdrn a r milamo.ar mronew�n n es.s.ed m.,ane i.m.am oer omr m rc�. Pape totals lot' 0 0 0 0 0 0 0 0 0 0 0 0 at...a. -h red Sather air arra—&at ere o pwe are Jonorao¢ra,om �Add a Form Page -- — md m too colt-two of mdonrm „elan u dupava a can=dy yard OMB formal aomher.If you Mw any c,�+roma de,o r ma or a odea atpeca of mu dao cdimaa,c000cr 1:5 Dcp.--of labor.OSI 1A Orr or Simim--i A-h -Rmm 8e aun to(renslsr fosse roteu m theStmrrt.ry peep(Fon JOR4)Wore you Dost K .tor,200 Coammaaoa A.nuc.Nw weapon DC M10.Oo oa=W arc mmpk ed roma w ma utr _ E _ (tl (2) (3) (4) (5) (6) � r •yam:... - �,� ii'. �,l Cr�f g, /s t e a 0 '� t r *44 " ilk 41 - * y • as to � J� � �• � � - 'I iAW ti `moi , OWN . t. IkA., 1 Ale a JW to vt • I, Ik w 40 � R ' s AL '1w.AVE. I 0 Mr-AIM ADA FISHING P'X=RAU,M RW I.INBS BIDI('AM PR= NOTE: 9'-4" ----- --�— ---- 9'-4" POST J. HEIGHT ```% HIP SHAM/ / -� i00 00, 1' 1 s� 6'x35'ADA V C=7 RAMP W/GRABAR POLlBIP &KICK PLATE 14'x8' EQUAL= INGE ADA RAIPWAMLAIAR 6'x 18'DROP «ZIICK PLA'2 DOWN PLATFORM 12"±OFF THE WATER M4W10E F1 2700FLOTATION SYSTEMS,INc: CUSTOMER• DEALER• Drawing Date: 2-14-21 • Revision#: CUL ALABAMA HIGHWAY17 SOUTH Meadow Lake Park FSI CULLMAN.AL. 1800-711-1785 1 aluminumboatdocks.com Revision Date: Scale:NTS L U C K11 DESIGN TEAM May 4, 2023 Ms. Katie Baker Park Development Manager City of Round Rock 301 W. Bagdad Avenue, Suite 250 Round Rock, Texas 78664 Re: Meadow Lake Dock Improvement Project 2023 —Recommendation to Award Dear Ms. Baker, On April 4, 2023,the City of Round Rock received bids for the Meadow Lake Dock Improvement Project 2023. In total, three (3)bids were received with amounts that ranged from$299,910.00 to $456,780.00. Based upon our review of the bids,we recommend the City of Round Rock accept the lowest Base Bid as submitted by AgH20 Holding LLC in the amount of$299,910.00. If additional information is required,please advise. We appreciate the opportunity to be of service and look forward to assisting you in the development of this project as it moves into the construction phase. Respectfully submitted, Brent Luck, PLA Park Planner/Landscape Architect