CM-2017-1286 - 1/13/2017Contraot Quantic -Ir Adjustr-len'Llchange Qs -der
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Department: Transportation
Project
Name: Dell Diamond Parking Lot Pavement Repairs
City Project
ID Number
Justification
Date: 12/6/16
Change Order/Quantity
Adjustment No. 1
Parc I of 3
QA/CO #1 is for additional quantities for bid item 1 3 Pavement Repairs (Minor) 2" Type D-HMAC that were found after the project had started.
Quantity totals are as follows, 97 tons Type D-HMAC @ $140.00 for a total of $13,580.00.
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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 Chance Order(s)j:
Difference benveen 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:
i
Submittad for Approval
Amount % Change
$259,337.50
$13,580.00
$13,580.00
$272,917.50
0.00
$0,00 0.00
$0.00 0.00
$272,917.50
513,580.00
2
2
Prepared 5y:
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Randy Crum Project Manager City of Round Rock
12/13/16
---___Signature
Printed Name, Title, Company
Date
AP5-rI t�it
Approvals
Contractor:
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City Project
Signature
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Printed Name, Tide, Company
Date
Manager:
Randy Crum, Project Manager, City of Round Rock
12/13/16
nature
Printed Name, Title
Date
Mayor/City
Manager4X1'11
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Signature
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Printed Name, Title
Date
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� — Contract QuaniiLy Adjus imen'c/Change order
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Project Name: Dell Diamond Parking Lot Pavement Repairs
Quan. Adj./Change Order No.:
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Pact 2 of
ICem # Item Description Unit Qty. Unit Price Amount
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.a0
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
- — -- $0.00
$0.00
TOOTA : $W -OOT
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— Corotract Ouant-ity Adjustmens /Change Orc]er
Project Name: Dell Diamond Parking Lot Pavement Repairs
Quan. Adj./Change Order No,
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Bid Item # item Description UnitAdjustment
Qty. Unit Price Amount:
Contract
Time
Pavement Repairs (minor), 2" Type D-
3 HMAC on 1 47 S140.00 $13,580.00
$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
TA . -$13;580' 00
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