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CM-12-05-084ROUND ROCK, TEXAS PURPOSE PASSION. PROSPERITY Item Caption: C/1/1-11.- oS -08 '-1 RECEIVED MAY 0 2 2012 City Manager Approval Form Consider executing Quantity Adjustment / Change Order No. 3 with Patin Construction for the Buck Egger CDBG Park Development Phase II Project. Approval Date: May 4, 2012 Department Name: Parks and Recreation Department Project Manager: David Buzzell, Park Development Manager Assigned Attorney: J. Kay Gayle Item Summary: This item will approve change order/quantity adjustment number 3 to the contract with Patin Construction for the Buck Egger Park Project. This deduct change order accounts for $2,625.00 in testing charges for work related to repairs that were performed on the project as a result of the contractor failing to construct the parking lot to plans and specifications. The City had an existing contract with the testing lab and therefore paid for the additional charges. This change order deducts the total amount of additional testing charges from the contractors contract (-$2,625.00). No. of Originals Submitted: 3 Project Name: Cost: Source of Funds: Buck Egger CDBG Park, Phase II Improvements Project - $2,625.00 CDBG HUD Entitlement Grants Source of Funds (if applicable): Select Source Fund Account Number: bg02egg13 Finance Director Approval: Cheryl Delaney Department Director Approval: -. Date: 5/1/12 Date: **Electronic signature by the Director CIP I I r7 Budget N/A OK ❑✓ ❑ N/A OK is acceptable. Please Purchasing only submit ONE approval form per item. ** N/A OK Accounting ❑ ❑ N/A OK ITEMS WILL NOT BE PLACED ON THE COUNCIL OR CM AGENDA W/OUT PRIOR FINANCE AND/OR LEGAL APPROVAL REV. 6/20/11 Contract Quantity Adjustment/Change Order ey I.1JC µ_NRA: rev, 06/11 Department: Parks & Recreation Department Project Buck Egger CDBG-Park Development, Name: PH II City Project ID Number Justification Date: 20 -Apr -12 Change Order/Quantity Adjustment No. 3 Geotechnical Engineering work and testing back charged to the Contractor. SUMMARY Original Contract Price: Previous Quantity Adjustment(s): This Quantity Adjustment: Total Quantity Adjustment(s): Total Contract Price with Quantity Adjustment(s): Previous Change Order(s): This Change Order: Total Change Order(s) To Date: Adjusted Contract Price [Original Contract Price Pius Quantity Adjustment(s) Plus Change Order(s)]: Difference between Original and Adjusted Contract Prices: Original Contract Time: Time Adjustment by previous Quan. Adj./Change Order: Time Adjustment by this Quan. Adj./Change Order: New Contract Time: Prepared By: Signature Printed Contractor C For Contractor: Signature 120 13 0 133 Antonio A. Prete, P.E., Principal $34,124.00 ($2,625.00) $31,499.00 0.10 (0.01) 0.09 $363,964.50 $31,499.00 0 0 0 Printed Name, Title /fes?/54(' `.- Printed Name, Title For City o „ Iv .�Q �iV �V1 wUVd Round R• .��/�/i� Signature Gm- IL- OS Printed Name, Tide Date 20 -Apr -12 /pZ Page 1 of MT" u� rev, 06/11 Page2ofk Contract Quantity Adjustment/Change Order Project Name: Buck Egger CDBG-Park Development, PH II Quan. Adj./Change Order No.: 3 Item # CO3-D1 Item Descri • tion PSI Testin. Back Cha .e Unit LS . 1 Unit Price -$2,625.00 Amount $2,625.00 Contract Time Adjustment Da s _-- $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