Contract - Cash Construction - 4/14/2016Contract Quantity Adjustment/ Change Order
Department: Transportation
Project
Name: CORR SWDT Ph 5A
City Project
ID Number SWDT5
Justification
za�
Date: 3/15/16
Change Order/Quantity
Adjustment No. 3
Additional quantities for concrete items (curb ramps, valley gutters, sidwalke, & ect), water, & wastewater. Change order items for Demo inlet top & repour,
hand rail at Tavern, water line leaks, and other misc items.
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 Plus 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:
Amount % Change
$629,321.00
$190,947.40
$820,268.40
$189,755.00 1%
$162,295.00 1%
$352,050.00 2%
E::;;:;AII=
$1,172,318.40
720 CalenclK_Rffs,
35 Calendar Days
0 S2lendar Days
755 Calendar Days
Prepared By: t<\.x c- &J� %-- B.I. Cash, Cash Construction
Signa &a — Printed Name, Title, Company Date
Contractor: B.I. Cash, Cash Construction f sl/U-
T,g-na& Jr Printed Name, Title, Company Date
City Project
Manager: RN Bill Stablein, Project Manager, CORR
ure Printed Name, Title Date
Mayor/City
Manager Alan McGraw, Mayor, CORR U&
§i—gnature Printed Name, Title Date
F- -ZOt
ORKE
Contract Quantity Adjustment/ Change Order
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Project Name: CORR SWDT Ph 5A
Change Order Data
NUNN
Item # Item Description Unit
Contract
Time
Adjustment
Qty- Unit Price Amount (Davs)
'711'e7glzll
ggfl
316
g;
Demo New Inlet Top, and Repour Inlet Tops with
Manholes on Mays EA 7
$10,075.00
MINE
$70,525.00
317
Remobilization for Gateway Arch (North East Shaft)
EA
1
$2,270.00
$2,270.00
318
Move Gas Line for WW Line C
LS
1
$5,675.00
$5,675.00
319
Gravel for Tavarn Bar
LS
1
$800.00
$800.00
320
TTY 2R Curb Inlet on Main Street
EA
1
$6,850.00
$6,850.00
321
Galvinized Hand Rail at Round Rock Tavern
LS
1
$5,400.00
$5,400.00
322
White Limestone Rock Fagade at Round Rock Tavern
LS
1
$1,890.00
$1,890.00
323
Liberty and Mays Leak Repair
LS
1
$6,065.00
$6,065.00
324
Concrete FND for Turndown Mortared Rock Wall
LF
175
$82.00
$14,350.00
325
Double Grate Inlet Apron
LS
1
$2,935.00
$2,935.00
326
Tapping Sleeve at Reids Cleaners
LS
1
$3,960.00
$3,960.00
327
Riprap for Median and 221 Rail at Bagdad and Mays
LS
1
$1,220.00
$1,220.00
328
Cast in Place 10' Ty IIR Inlet SL F
LS
1
$25,595.00
$25,595.00
329
Plug 12" Well 180' Deer) at Jorge's
LS
1
$6,435.00
$6,435.00
330
Additional Colored Concrete at Traffic Circle
SF
1665
$5.00
$8,325.00
$31.62,2 u
J Contract Quantity Adjustment/Change Order
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Project Name: CORR SWDT Ph 5A
Quantity Adiustment Data
Bid Item #
Item Description
-Unit
---Qty. -------Unit
Price
Amount
Contract
Time
Adjustment
(Davs)
Effiffiffilly,111
LIELM
L100 �71471�
91
261
CURB RAMPS (TY 1) (TXDOT-531)
EA
30
$1,300.00
$39,000.00
234
New P.C. Concrete Sidewalks, 5 in Thick
SF
1123
$11.00
$12,353.00
163
Concrete Valley Gutters
SF
568
$12.00
$6,816.00
260
ICONC CURB & GUTTER (TY II) (TXDOT-529)
LF
84
$24.00
$2,016.00
162
P.C. Concrete Driveways
SF
943
$13.00
$12,259.00
156
Hot Mix Asphaltic Concrete Pavement, (Type B) (PG 64-
22) Base (8 in) (Waterline Black Base on Mays)
SY
467
$47.00
$21,949.00
67
Pipe, 6" Dia. PVC ASTM D2241 SDR26 WW (all depths),
including excavation and backfill
LF
102
$160.00
$16,320.00
70
Clean Out Assembly for Pipe, 8" Dia. PVC ASTM D2241
SDR26 WW (all depths), including Excavation and
EA
2
$400.00
$800.00
68
Pipe, 8" Dia. PVC ASTM D2241 SDR26 WW (all depths),
including excavation and backfill
LF
40
$140.00
$5,600.00
11
Asphalt StaBilized Base: Hot Mix Asphaltic Concrete
Base (10.5®° Thick), TxDOT Item 340, Type B (Black
Base) (Method A) under, and 1.5 feet behind roadway
SY
554
$63.60
$35,234.40
15
P.C. Reinforced Concrete Valley Gutter
SY
39
$100.00
$3,900.00
24
P.C. Reinforced Concrete Steps
LF
25
$136.00
$3,400.00
236
Tree Well (8'x8') No Grate
EA
2
$24,000.00
$48,000.00
21
TTrR_eTa_-in_erCurb with Mortared Rock Limestone —STo-cT_
(6"x6"xup to 24") Wall, with mortared joints up to 3 -
feet tall, including foundation, (measured square feet of
face of block) complete in place per square foot) ADDIT
WALL @ LIBERTY
SF
226
$83.00
$18,758.00
314
Concrete Coating Base Coat for Conc, Bridge Wall
(Traffic Side Only Including Top of Wall)
SF
5900
$1.00
$5,900.00
51
Thermoplastic Pavement Mar kings-Reflectorized Type I,
12 inches in width (SLD) (W) cross walks, 100 Mils in
Thickness
LF
69
$8.00
$552.00
52
Thermoplastic Pavement Markings-Reflectorized Type I,
4 inches in width (SLD)(Y), 100 Mils in Thickness
LF
327
$4.00
$1,308.00
53
Thermoplastic Pavement Markings-Reflectorized Type I,
4 inches in width (SLD)(W), 100 Mils in Thickness
LF
695
$4.00
$2,780.00
59
Thermoplastic Pavement Markings-Reflectorized Type I,
WORD (W), 100 Mils in Thickness
EA
1
1 $300.00
$300.00
204
WK ZN PAV MRK NON REMOV (W) 24" (SLD)
LF
78
$9.00
$702.00
177
8" C-900 SDR 14 PVC Pipe
LF
65
$200.00
$13,000.00
203
Portable Changeable Message Sign
EA
3
$20,000.00
-$60,000.00
$0.00
$0.00
$0.00
$0.00,
TOTALS:
....... ...
$190,947.40
.. .
CERTIFICATE OF INTERESTED PARTIES
FORM 1.295
loll
Complete Nos. l - 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
Certificate Number:
1 Name of business entity tiling form, and the city, state and country of the business entity's place
of business.
2016-26594
Cash Construction Company, Inc
Pflugerville, TX United States
Date Filed:
03115!2016
Name of govemmental entity or state agency that Is a party to the contract for which the form is
being filed.
City of Round Rock
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 goods or services to be provided under the contract.
CORR SWDT Ph 5A
Additional quantities for concrete items (curb ramps, valley gutters, sidwalke, & ecl), water, & wastewater. Change order items for
Demo inlet top & repour, hand rail at Tavern, water line leaks, and
4
Nature of interest
(check applicable)
Name of Interested Party
City, State, Country (place of business)
Controlling
Intermediary
Gentry, Nathan
Pflugerville, TX United States
X
Cash, BJ (Bruce Jr)
Pflugerville, TX United States
X
Cash, Bruce
Pflugerville, TX United States
X
5 Check only If there is NO Interested Party. ❑
6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
�;Ikf,, STACY SMALL
P 4y„ State of Texas
o`r s Notory Public.
034034-2020
COMM. Expires
Signature of authorized agent of contracting business entity
`rr ID 11068934
o: NotorY
AF EAL ABOVE,"
J
Sworn to and subscribed before me, by the said k this the / day of
20_ILI,,,„ . to certify which, witness my hand and seal of office
� W
`iz,L
ignature of er administering oath Printed name of o er administering oath Title of officer administering oath
Knrms nrnvirfprf by Tpxac Ethins Commissinn www.ethics.state.tx.us Version V1.0.312
CERTIFICATE OF INTERESTED PARTIES
FORM 1.295
lofl
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
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2016-26594
Cash Construction Company, Inc
Pflugerville, TX United States
Date Filed:
03/15/2016
2 Name of governmental entity or state agency that is a party to the contract for which the form is
being filed.
City of Round Rock
Date Acknowledged:
03/16/2016
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 goods or services to be provided under the contract.
CORR SWDT Ph 5A
Additional quantities for concrete items (curb ramps, valley gutters, sidwalke, & ect), water, & wastewater. Change order items for
Demo inlet top & repour, hand rail at Tavern, water line leaks, and
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest (check applicable)
Controlling
Intermediary
Gentry, Nathan
Pflugerville, TX United States
X
Cash, BJ (Bruce Jr)
Pflugerville, TX United States
X
Cash, Bruce
Pflugerville, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said this the day of
20 , to certify which, witness my hand and seal of office.
Signature of officer administering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.312