Contract - CP&Y - 8/11/2016STATE OF TEXAS §
COUNTY OF WILLIAMSON §
SUPPLEMENTAL CONTRACT NO.1
TO CONTRACT FOR ENGINEERING SERVICES
FIRM: CP&Y, INC. ("Engineer")
ADDRESS: 13809 Research Boulevard, Suite 300, Austin, TX 78750
PROJECT: Southeast GST Pump Improvements & S81 Elevated Tank Pump Station
This Supplemental Contract No. 1 to Contract for Engineering Services is made by and between
the City of Round Rock, Texas, hereinafter called the "City" and CP&Y, Inc., hereinafter called
the "Engineer".
WHEREAS, the City and Engineer executed a Contract for Engineering Services, hereinafter
called the "Contract", on the 12th day of November, 2015 for the Southeast GST Pump
Improvements & S81 Elevated Tank Pump Station Project in the amount of $149,833.00; and
WHEREAS, it has become necessary to amend the Contract to modify the provisions for the
scope of services and to increase the compensation by $332,629.00 to a total of $482,462.00;
NOW THEREFORE, premises considered, the City and the Engineer agree that said Contract
is amended as follows:
I.
Article 1, City Services and Exhibit A, City Services shall be amended as set forth in the
attached Addendum To Exhibit A.
II.
Article 2, Engineering Services and Exhibit B, En in�ng Services shall be amended as set
forth in the attached Addendum To Exhibit B. Exhibit C, Work Schedule shall be amended as
set forth in the attached Addendum To Exhibit C.
III.
Article 4, Compensation and Exhibit Q. Fee Schedule shall be amended by increasing by
$332,629.00 the lump sum amount payable under the Contract for a total of $482,462.00, as
shown by the attached Addendum to Exhibit D.
IN WITNESS WHEREOF, the City and the Engineer have executed this Supplemental
Contract in duplicate.
Supplemental Contract
0199.1552; 00360586
azaWs%W4
Rev.06/16
84275
CP&Y, INC.
By: -1455,
D 71g-5 Zo/G
Date
Supplemental Contract Rev.06/16
0199.1552; 00360586 84275
CITY OF ROUND ROC AP VEDAS FORM:
By:
Alan McGraw, Mayor Stepl1n L. Sheets, City Attorney
Date
Supplemental Contract Rev.06/16
0199.1552; 00360586 84275
ADDENDUM TO EXHIBIT A
City Services
The City will continue to furnish the following information to the Engineer and/or perform the following
tasks:
1. Provide existing reports or data the City has on file concerning the project, if available.
2. Provide any available as -built plans for previous facility projects impacting the project.
3. Provide any available as -built plans for any water lines that are near to, tie into or might affect
the design of the project.
4. Provide any available utility, parcel and/or topographic mapping information of the project area.
5. Assist the Engineer, as necessary, in obtaining any required data and information from the State,
County, neighboring Cities and/or other franchise utility companies.
6. Assist the Engineer by requiring appropriate utility companies to expose underground utilities
within the right-of-way, when required.
7. Give prompt written notice to the Engineer whenever the City observes or otherwise becomes
aware of any development that affects the scope of the Engineer's services.
8. Meet on an as needed basis to answer questions, provide guidance and offer comment.
9. Pay all fees associated with approvals and/or permits from entities when such approvals and/or
permits are necessary as determined by the City.
10. Assist with property owner coordination for Right -of Entry.
11. Secure easements (using documents prepared by Engineer) as required for construction of
improvements described in Engineer's final design plans.
12. Obtain necessary permits, including TxDOT permits, as required for performing work and
installing water lines in the state right-of-way.
13. Provide modeling information for hydraulic review through City staff and others.
14. Pay for costs associated with newspaper public notice for bid advertisement.
15. Secure easements (using documents prepared by Engineer) as required for construction of
improvements described in Engineer's final design plans.
16. Provide construction inspection and construction testing services including coordination and
scope of services.
17. Review the Application for Payment and supporting documentation submitted by the Contractor.
18. Provide SCADA Programming services including local and top end configuration.
ADDENDUM TO EXHIBIT B
Engineering Services
GENERAL
In addition to the scope outlined in the Preliminary Engineering Scope of Services Proposal for the Southeast (SE)
Ground Storage Tank (GST) and South 81 Elevated Storage Tank (EST) Pump Station Improvements project, dated
November 17, 2015, the engineer shall provide design, bid and construction phase services for the improvements
recommended in the final Preliminary Engineering Report. The South 81 Pump Station Improvements will be
accomplished within the existing structure and will not include a new building. The scope of services and tasks are
fully described below.
TASK I
I. BASIC SERVICES
B. DESIGN AND BID DOCUMENT PREPARATION
1. PROJECT MEETINGS
(a) Attend, conduct and document up to eight project meetings. Prepare meeting minutes including
action items to help maintain project schedule.
(b) Coordinate/attend internal meetings and perform project administration.
(c) Perform project coordination/reviews of subconsultant work.
(d) Prepare for and attend up to two site visits.
2. PREPARATION OF CONSTRUCTION PLANS
(a) Cover sheet, sheet index, site locations and general notes.
(b) General abbreviations, drafting symbols and legend.
(c) Civil, architectural, structural, mechanical, electrical, and instrumentation sheets identifying
improvements per facility as generally described and approved in the Preliminary Engineering
Report.
(d) Yard piping plan and profile sheets identifying existing utilities and topographic features for
proposed pipes greater than 6 inches in diameter. Scale will be 1 "=50' horizontal and 1 "=5' vertical.
(e) Construction details.
(f) Erosion and sedimentation control sheets.
(g) Prepare project manual according to City's standard front end documents and technical
specifications.
(h) Perform internal QA/QC prior to each submittal.
(i) Submittal to TCEQ
(j) Prepare Design Plans, Specifications, and Engineer's Opinion of Probable Construction Cost at 60%,
90% and 100% design. Include three half size sets of plans for City's review and respond to review
comments.
(k) Issue Final Plans and Project manual for Advertisement and Bidding of the Project.
C. BID PHASE SERVICES
1. BID PHASE SERVICES
(a) Conduct pre-bid meeting with City for interested contractors. Provide agenda and sign in sheet.
(b) Distribute bid documents and maintain plan holders' list through Document Engine.
(c) Address and respond to questions and interpretation of bid documents.
(d) Prepare and issue addenda to the bid documents if necessary.
(e) Conduct bid opening at City location, tabulate and review all bids for correctness.
1 of 4
(f) Review qualifications of apparent low bidder and others as needed.
(g) Recommend award of contract or other actions to be taken by the City.
D. CONSTRUCTION PHASE SERVICES
1. CONSTRUCTION PHASE SERVICES
(a) Attend one (1) pre -construction conference with the Owner and the Contractor, review the
Contractor's construction schedule and issue meeting notes to the Owner.
(b) Engineer will incorporate addenda items to the bidding document and issue Conformed Set of
documents after the bid opening.
(c) Engineer will attend monthly construction progress meetings at the request of the Owner. Engineer
will attend a maximum of ten (10) meetings; fee is based on this number of meetings.
(d) The Engineer will make periodic visits (typically combined with progress meetings) to the Project
sites at intervals appropriate to the various stages of construction to observe the progress and quality
of the Contractor's work. Engineer will visit the sites up to once a month, two (2) hours per visit,
for a total of ten (10) months. Based on the information obtained during such visits, the Engineer
will endeavor to determine if the Contractor's work is proceeding in accordance with the Contract
Documents. The purpose of such project site visits and such observations is to keep the Owner
generally informed of the progress of the Contractor's work and to determine if the completed work
of the Contractor conforms in general to the design concept indicated in the Construction Contract
Documents. On the other hand, the Engineer shall not, during such visits or as a result of such
observations, supervise, direct, or have control over the Contractor's work nor shall the Engineer
have authority over or responsibility for the means, methods, techniques, sequences or procedures of
construction selected by the Contractor, for safety precautions and programs incident to the work of
the Contractor or for any failure of the Contractor to comply with rules, regulations, ordinances,
codes or orders applicable to the Contractor's performance of the work. The Contractor shall have
sole authority over and responsibility for:
(i) the means, methods, techniques, sequences, and procedures of construction
(ii) safety precautions and programs incident to the construction, and
(iii) compliance with rules, regulations, ordinances, codes and orders applicable to the
construction. The Engineer neither guarantees the performance of the Contractor nor assumes
any responsibility for the Contractor's failure to furnish and perform its work in accordance with
the Construction Contract Documents.
(e) Issue necessary clarifications and interpretations of the Construction Contract Documents as
appropriate to the orderly completion of the Contractor's work. Such clarifications and
interpretations will be consistent with the intent and reasonably inferable from the Construction
Contract Documents. Up to 14 Requests for Information (RFIs) are included.
(f) Make recommendations to the Owner regarding change orders as appropriate and when directed by
the Owner, and prepare up to 4 Change Orders as reasonably required. Preparation of Change
Orders, which result from significant changes in the scope, extent, or character of the Project
designed by the Engineer, is not included in this scope of services.
(g) Review samples, catalog data, schedules, submittals, shop drawings, laboratory, shop and mill tests
of material and test equipment and other data as required by the Construction Contract Documents,
but only for conformance with the design concept indicated in the Construction Contract
Documents. Such reviews will not extend to means, methods, techniques, sequences or procedures
of construction or to safety precautions and programs incident thereto. Up to 48 submittals/O&Ms
are included.
2 of 4
(h) Upon notice from the Contractor that the Contractor's work is ready for its intended use, conduct, in
company with the Owner's representative and the Contractor, an observation to determine if the
work is substantially complete. If the Owner and the Engineer consider the work substantially
complete, issue a certificate of substantial completion containing a list of required tasks for the
Contractor to complete prior to issuance of certificate of final completion. Conduct a final walk
through together with the Owner and the Contractor to determine if the work has reached final
completion so that the Engineer may recommend final payment to the Contractor. If appropriate,
make recommendations to the Owner for final payment to the Contractor.
(i) Receive, review and transmit to the Owner maintenance and operating instructions, warranties and
guarantees, marked up As -built documents received from the Contractor, which reflect field changes
to the bid documents. The Engineer will review the documents to ascertain, to the best of the
Engineer's knowledge and belief, that the reflected field changes are complete and correct.
0) Prepare Project record drawings incorporating compiled change orders and field changes that are
received from the Owner and the Contractor. Three (3) sets of prints of "Record Drawings" will be
submitted by the Engineer to the Owner on 11x17 paper copies.
(k) Submit to the Owner electronic files used for the production of the Record Drawings. The Engineer
shall deliver the electronic files, on CD, to the Owner. Record drawings on electronic files furnished
to the Owner are for the convenience of the Owner only. The Record Drawings shall be sole
documents relied upon by the Owner as a reflection of the condition of the project location after
completion of the construction activities.
II. SPECIAL SERVICES
A. SURVEY SERVICES
Surveyor will provide the professional and technical staff necessary to perform a detailed topographic
survey of sites referenced above. The survey will include at a minimum topography, improvements,
fences, visible utilities, identifiable appurtenances, drainage structures, etc. Surveyor will obtain flow
line elevations & pipe sizes (if ascertainable) for each wastewater and storm drain manhole within the
limits of the survey area. We will also submit a utility locate request to Texas811 for the segment along
the roadway and survey in their markings. We will set two horizontal control points within the limits of
the survey and provide one benchmark. This survey will show property lines with a best fit to found
property corners and record ownership lines. Replacement of missing property corners is not proposed.
2. Surveyor will provide one exhibit and legal for a combined easement/temp easement at the SE GST site.
B. GEOTECHNICAL SERVICES
1. Perform two (2) borings to a depth of about twenty (20) feet at the South 81 EST site only. The borings
will be used to investigate subsurface stratigraphy and to obtain samples for laboratory testing.
2. Laboratory testing will be performed to determine the soil's plasticity and strength characteristics.
Testing will include:
(a) U.S.C.S. Soil Classification
(b) Atterberg Limits Tests
(c) Sieve Analysis
(d) Moisture Content
(e) Unconfined Compressive Strength
3. The Geotechnical Engineer will prepare a geotechnical report that will present recommendations for the
new electrical building, pump pad, and paving improvements. The geotechnical report will include:
(a) General subsurface conditions, discussion of site geology
3 of 4
(b) Boring logs with descriptions of strata and laboratory test results, and water levels obtained at the
time of drilling
(c) Boring location plan
(d) Foundation design recommendations for the proposed improvements.
4. The Engineer will meet with the geotechnical subconsultant on a regular basis to coordinate their work
on the project.
C. PUMP INSPECTION & REPAIRS
1. The pump representative will inspect Pump No. 2 and Pump No. 3 just prior to removal, inspect the
rotating element at removal, and inspect element teardown/clean-up. The pump representative will
remove Pump No. 2 and Pump No. 3, transport to their shop and perform pump repairs. Planned pump
repairs and budget are based on recent Pump No. 1 repairs. After repairs are complete, the pumps will be
re -installed and tested on site. A report of inspection, repair and testing results with color photographs,
measurements, clearances and condition will be provided, along with conclusions.
4 of 4
Task
Notice to Proceed
60% Design
90% Design
100% Design
Bid Phase
Construction
ADDENDUM TO EXHIBIT C
Work Schedule
Duration (Days) Completion Date
N/A
Aug 1, 2016
84
Oct 24, 2016
98
Jan 30, 2017
56
Mar 27, 2017
63
May 29, 2017
305
Mar 30, 2018
ADDENDUM TO EXHIBIT D
Fee Schedule
Attached Behind This Page
Exhibit D Fee Schedule
Southeast GST and South 81 EST Pump Station Improvements Project
City of Round Rock
Task Description
Total Labor Hours
Total Loaded Labor Cost
L BASIC SERVICES
A. PRELIMINARY ENGINEERING
B. DESIGN AND BID DOCUMENT PREPARATION
954
$
104 782.00
C. BID PHASE SERVICES
66
$
9,988.00
D. CONSTRUCTION PHASE SERVICES
392
$
43 252.00
E. EXPENSES
NA S
1,777.00
F. ELECTRICAL DESIGN BID
732
$
76 850.00
G. ELECTRICAL CONSTRUCTION
286
$
25 250.00
SUB -TOTAL BASIC ENGINEERING SERVICES
2,430
$
261 899.00
II. SPECIAL SERVICES
A. SURVEY
$
7,230.00
B. GEOTECHNICAL BY HOLT
$
3,500.00
C. PUMP IMPROVEMENTS BY SMITH PUMP CO.
$
60 000.00
SUB -TOTAL SPECIAL SERVICES
$
70,730.00
TOTAL (BASIC & SPECIAL SERVICES & EXPENSES)
2,430
$
332,629.00
Ill. ADDITIONAL SERVICES
SUB -TOTAL ADDITIONAL SERVICES
$
GRAND TOTAL (BASIC, SPECIAL & ADDITIONAL SERVICES,
EXPENSES)
2,430
$
332,629.00
00360650.XLSX Page 1 of 5
Fwhihit D
Southeast GST and South 81 EST Pump Station Improvements Project
City of Round Rock
Fee Schedule/Budget for CP&Y, Inc.
Task DescriptionE.I.T.
No. of
PS&E
Project
Principal
Project
Manager
Senior
Engineer
Project
Engineer
CADD
Operator
Admin!
Clerical
TotalTotal
Labor
Hours
Direct Labor
Costs
Sheets
$230.00
$165.00
$185.00
$135.00
$90.00
$86.00
$75.00
I. BASIC SERVICES
B. DESIGN AND BID DOCUMENT PREPARATION
1 Project Meetings
a Attend, conduct and document 8 project meetings
b Internal Meetings and Administration
C Coordination Meetings with Subs
Site visit meetings (2)
0
- _ 8
14
6
28
0
8
6
8
6
28
_
0
24
6
8
6
44
16
16
40
42
16
18
116
$ 4,464.00
$ 4,836.00
OO
$ 1,76M
$ 2,316.60-
$ _ _13,384.00
2 Preparation of Construction Plans
a Cover sheet, index, site locations, general notes
4
2
16
8
_
26
$ _ 2,398.00
b General Abbreviations, drafting symbols and_ legend
C Structural and mechanical general notes
d Civil details
e Standards spec, special specs, special provisions prep
f Perform internal QA/QC prior to each submittal
g Prepare OPCC, plans, specs at 60%,90%,& final design
1
3
3
a
a
na
2
2
2
8
12
6
8
32
2
8
2
32
4
12
8
4
12
8
80
6
16
10
34
20
144
46
12
$ 974.00
$ _ 3,522.00
$ 2,008.00
$ 15.200.00
$ 8,360.00
$ 1,506.00
PHASE 1 - SOUTHEAST GST PUMP STATION
$ -
2
4
16
16
a Site layout, demolition and yard piping plan
b Drainage/erosion & sedimentation control (ESC) sheets
c ESC notes and details
d Stormwater Details (SWP3 by contractor)
e Structural plans and details
f Mechanical plans, process, elevations, details
g SCADA architecture and loop diagrams
2
38
20
18
20
76
34
$ 3,686,00
$ --_ 2.008.00
$ 1,836.00
$ - -
$ 2,148.00
$ 8,244.00
$ 3,566.66
1
2
2
8
8
1
2
8
4
6
2
20
8
6
-
8
24
16
2
4
4
8
24
12
h Instrumentation design and details
2
6
12
16
—
34
$ 3,566.00
I Control Narratives
na
6
8
14
$ 1,798.00
PHASE 2 - SOUTH 81 EST PUMP STATION
_ _
$ -
_
a Site layout, demolition, grading, paving and yard piping plan
b Drainage/erosion and sedimentation control (ESC) sheets
c ESC notes and details
d Stormwater Details (SWP3 by contractor)
e Structural plans and details
f Mechanical plans, process, elevations, details
g SCADA architecture and loop diagrams
In Instrumentation design and details
Control Narratives
- --
2
1
1
2
2
2
4
2
2
18
8
8
16
8
6
-...
38
20
18
38
96
34
34
14
1 838
$ 3,686.00
$ 2,008.00
$ 1,836.00
$ -
$ 3,926.00
$ 10.192.00
$ 3,566,00
$ 3,56600
$ 1,79800
1 $ 91,398.00
3
6
16
16
5
4
2
na
2
_. 8
58
-----
6
6
6
86
_ 24_.
- 32
12
32
16
16
8
1 338
1 16
106
12
232
00360650.XLSX Page 2 of 5
Exhibit D Fee Schedule
Southeast GST and South 81 EST Pump Station Improvements Project
City of Round Rock
Fee Schedule/Budget for CP&Y, Inc.
Project
Project
Senior
Project
CADD
E.I.T.
Admin I
Total Labor
Total Direct
Task Description
No. of PS&E
Principal
Manager
Engineer
Engineer
Operator
Clerical
Hours
Labor Costs
Sheets
$230.00
$165.00
$185.00
$135.00
$90.00
$86.00
$7500
.i SERVICES
C. BID PHASE SERVICES
1 Bid Phase Services
a Conduct pre-bid meeting and provide agenda/sign in sheet
4
6
90
$ 1,176.00
to Distribute bid documents and maintain plan holders' list
8
8
$ 688 00
c Address and respond to questions and interpretation of bid documents
4
6
8
18
$ 2,158.00
of Prepare and issue addenda to the bid documents if necessary
4
>
8
1:8
$ 2,158 00
Conduct bid opening at City location, tabulate and review all bids for
e correctness
4
8
12
$ 1,348.00
f Review qualifications of low bidder and others as needed
4
8
12
$ 1,228.00
g Recommend award of contract or other actions to be taken by City
2
2
8
$ 1,232.00
2
18
0
1E
0
48
0
86
$ 9,988.00
00360650.XLSX Page 3 of 5
Frhihit n FPP Srhpcli 1p
Southeast GST and South 81 EST Pump Station Improvements Project
City of Round Rock
Fee Schedule/Budget for CP&Y, Inc.
Task Description
No. of each
Project
Principal
Project
Manager
Senior
Engineer
Project
Engineer
CADD
OperatorClerical
E.I.T.
Admin I
Total Labor
Hours
Total Direct
Labor Costs
$230.0:;
$16500
$185.00
$13500
$90.00
$86.00
$75.00
I. BASIC SERVICES
D. CONSTRUCTION PHASE SERVICES
---.- -
1 Construction Phase Services
_
_
Attend one (1) pre -construction conference, review construction schedule and
a issue meetinq notes.
3
9
$ 1,011.00-
1
b Prepare. Review Project conformed drawings: submit three (3) 11 x17 sets
c Periodic Site Visits: 1 x per month @ 10 months
d Construction Meetings Combined with Site Visits and Admin (10)
' C
':
10
10
34
30
50
$ 3,342.00
$ 3,860.00
S _5,4.70.00
Issue necessary clarifications and interpretations of construction documents
e RFIs
f Make recommendations regardin�chan�a orders _ _
g Review submittept als for conformance with design conc
''
4..
5
5
4.
_3
25
--
4
4
4
t°
f
'.
2
14
8
21
15
115.
20
30
- 16
$ 2,713.00
$ 1,930 00
$ __ 11,808.00
4
4
12
h Structural submittals, RFIs and coordination___
$ 2,132 00
$
i I&C submittals, RFls and coordination
_
$ 1,888.00
Substantial Completion Walk and Punch. List .. —_ _
--_
—_-.
k Receive, review and transmit to Owner bid documents with field changes
4
8
$ -,.. _, 614.00
10
1 Prepare, Review Project record drawings: submit three (3)_11x17 sets_
_ - 2
8
_24
44
$ 4,430.00
_—. _—
m Submit electronic files used for production of Record DrawinqsI
C
45
1 23
_
74
- - -_-48
2
- _--- -192
-
10
2
-_-- -- -392
$ _ 172.00
$-_-- 43,252.00
00360650.XLSX Page 4 of 5
Exhibit D Fee Schedule
Southeast GST and South 81 EST Pump Station Improvements Project
City of Round Rock
Expense Item
Unit Cost
Amount
Total Cost
CADD Plotting
$
1.50
400
$ 600.00
Mylar Plots
$
6.00
$ -
Digital Ortho Plotting
$
2.00
$
11" X 17" Mylar
$
1.00
$
8 1/2" X 11" B/W Paper Copies
$
0.10
5,000
$ 500.00
11" X 17" B/W Paper Copies
$
0.15
2,480
$ 372.00
8 1/2" X 11" Color Paper Copies
$
1.00
$ -
11" X 17" Color Paper Copies
$
1.80
$
Fax Copies
$
0.10
$ -
Film and Development
$
8.00
$
4 X 6 Di ital Color Prints
$
0.50
$
Oversized Digital Color Prints_
$
50.00
$ -
Standard Postage
$
0.44
$ -
Express Mail (Standard)
$
15.00
2
$ 30.00
Express Mail (Oversized)
$
30.00
$ -
Deliveries
$
25.00
$ -
Airfare
$
200.00
$
Rental Car
$
80.00
$
Lodging
$
85.00
S -
Meals _
$
36.00
$ _ -
Mileage
$
0.550
500
$ 275.00
GPS Rental
$
100.000
S -
Cultural Resources Archival Research
$
500.000
0
$ -
HazMat Database Search
$
200.000
$
Miscellaneous Project Related Expenses
at cost
NA
$ -
SUBTOTAL DIRECT EXPENSES
I1,777
00360650.XLSX Page 5 of 5
Forms provided by Tek91--EtWtrs Commission www.ethics.state.tx.us Version V1.0.1021
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1 of 1
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.
2016-78879
Garza EMC, LLC
Austin, TX United States
Date Filed:
06/30/2016
2 Name of governmental entity or state agency that is a party tot the contract for which the f6rrin 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 services, goods, or other property to be provided under the contract.
SCBYP
Civil Engineering Services
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling I
Intermediary
NA, NA
NA, TX United States
X
5
Check only if there is NO Interested Party.
6
A I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
P/+Y
r CHRISTINA MARIE GARZA
My Commleilon Expire$
December 10, 2018
Signature of rized agent of contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said eA1C>)A b 0lyl(A . this the t r'1 day of
20 to certify which, witness my hand and seal of office.
Sign a of t roistering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Tek91--EtWtrs Commission www.ethics.state.tx.us Version V1.0.1021
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.1021
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
lofl
Complete Nos. 1- 4 and 6 if there are interested parties.
Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties.
OFFICE USE ONLY
CERTIFICATION OF FILING
Certificate Number:
2016-78879
Date Filed:
06/30/2016
Date Acknowledged:
07/28/2016
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
Garza EMC, LLC
Austin, TX United States
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
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.
SCBYP
Civil Engineering Services
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
NA, NA
NA, TX United States
X
5
Check only if there is NO Interested Parry. ❑
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 V1.0.1021
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
10f1
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.
2016-88313
CP&Y, Inc.
Dallas, TX United States
Date Filed:
07/21/2016
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:
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
Professional Services
Nature of interest
4 Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
Patel, Pete
Dallas, TX United States
X
Chiang , Walter
Dallas, TX United States
X
Roohms, J.J,
Dallas, TX United States
X
Vergara, Marisa
San Antonio, TX United States
X
Hartzler, Mike
Dallas, TX United States
X
Hays, David
Dallas, TX United States
X
Boswell, Jeremy
Oklahoma City, OK United States
X
5 Check only if there is NO Interested Party,
6 F I AVhn _ —_ I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
REBECCA S MARTINEZ
My Commission Expires
July 1, 2019 %
Signature of authorized agent of contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE
Sworn to and subscribed before me, by the said 1Jli l I I ( jY1 (' t (4t c cc) , this the 2 day of
20��, to certify which, witness my hand and seal of office. 1
via r
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 V1.0.217
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
10f1
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.
2016-88313
CP&Y, Inc.
Dallas, TX United States
Date Filed:
07/21/2016
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:
07/28/2016
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 services, goods, or other property to be provided under the contract.
000000
Professional Services
Nature of interest
4
Name of Interested Party
City, State, Country (place of business)
(check applicable)
Controlling
Intermediary
Patel, Pete
Dallas, TX United States
X
Chiang , Walter
Dallas, TX United States
X
Roohms, J.J.
Dallas, TX United States
X
Vergara, Marisa
San Antonio, TX United States
X
Hartzler, Mike
Dallas, TX United States
X
Hays, David
Dallas, TX United States
X
Boswell, Jeremy
Oklahoma City, OK United States
X
5 Check only if there is NO Interested Parry.
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 V1.0.277