CM-12-06-100ROUND ROCK, TEXAS
PURPOSE. PASSION. PROSPERITY
Item Caption:
Cwt, -(1- -'061 -WO
VW RECEIVED
MAY 31 7012
City Manager Approval Form
Consider executing Quantity Adjustment/Change Order No. 1 with Insituform Technologies, Inc. for the
Onion Branch 21" Wastewater Line Rehabilitation Project.
Approval Date: June 1, 2012
Department Name: Utilities and Environmental Services Department
Project Manager: Eddie Zapata
Assigned Attorney: Steve Sheets
Item Summary:
This project rehabilitated 410 linear feet of the Onion Branch wastewater interceptor line that extends southerly from US
Highway 79. This work was completed ahead of a drainage channel rehabilitation project that is scheduled for the channel next
to 615 East Palm Valley (the old Police Department Building that was located on US Highway 79). The work corrected a defect in
the wastewater line as well as removed a wastewater manhole that would have otherwise interfered with the drainage channel
work. Insituform Technologies was awarded this wastewater rehabilitation project for $53,523.
Quantity Adjustment/Change Order No. 1 is necessary to make adjustments to the bid quantities. An additional eighteen linear
feet of cured -in-place pipe (CIPP) was installed and by-pass pumping was deleted from the contractors scope of work. This
Quantity Adjustment/Change Order No. 1 reduces the contract by $3,464, which brings the total contract amount down to
$50,059.
No. of Originals Submitte
Project Name:
Cost:
Source of Funds:
Onion Branch Wastewater Line Rehabilitation 2011 Project
($3,464.00)
Self -Financed Wastewater Construction
Source of Funds (if applicable): Select Source Fund
Account Number: WW02ONION
Finance Director Approval: Cheryl Delaney
Date: 5/30/12
Department Director Approval: Michael Thane Date: 5/22/12
**Electronic signature by the Director is acceptable. Please only submit ONE approval form per item. **
CIP F--1 r--1 Budget El I I Purchasing n n Accounting n n
N/A OK N/A OK N/A OK 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
!MVO ROCK. 7F.%AS
rev, 09/10
Department: Utility and Environmental Services Department
City Project WW02Onion
ID Number
Justification
Gheftgefirdtr/Quantity Adjustment
No.
Page 1 of 3
1
Quantity Adjustment/Change Order No. 1 is needed to add 18 L.F. of CIPP Liner and delete By -Pass Pumping.
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:
Original Contract Price Pius Change Order(s) Plus Quantity
Adjustment(s):
Original Contract Time:
Contract Time Prior to this Change Order:
Contract Time with All Approved Change Orders:
Prepared By:.
Signature
Contractor
Approval:
Signature
City Staff
Approval:
Sig
City Official
Approval:
Signature
CM -L2— a -10o
Amount
$53,523.00
$0.00
-$3,464.00
-$3,464.00
$50,059.00
$0.00
$0.00
$0.00
0/0 Change
0.00%
0.00%
0.00%
$50,059.00
30 calendar days
30 calendar days
30 calendar days
Eddie Zapata, Project Manager, CORR
Printed Name, Title and Company
H. Douglas Thomas, Vice President, Insituform Technologies, Inc.
Printed Name, Title and Company Date
, Pt:,
^ _ Da
d(ey2
uttpl-
Printed Name, Ttacttt at
David Freireich, P.E.,
Printed N itlP
ORR
rev, 09/10
Contract Quantity Adjustment/Change Order
Chan
Page 2 of 3
Bid Item #
Item Descri • tion and Chan .e
Unit
• .
Unit Price
Amount
$0.00
Contract Time
Adjustment
(Days)
$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
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS:
$0.00
0
.......r#11P-."'--
POUND ROM TEXAS
wow ....ow mnsPoere
rev, 09/10
Contract Quantity Adjustment/Change Order
uantity Adjustment Data
Page 3 of 3
Bid Item #
1
Item Descri • tion and Chan . e
21 CIPP Linner comp ete in p ace per Linear
Foot
Unit
LF
Q
18
Unit Price
$102.00
Amount
$1,836.00
on ra
Time
Adjustment
(Days)
2
By -Pass Pumping
LS
-1
$5,300.00
-$5,300.00
$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
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS:
-$3,464.00
0