Contract - Underground, inc. - 1/26/2017 Pagel of 3
Contract Quantity Adjustment/Change Order
� ROlJNO ROCK rE%A,
rev,06/15
Department: Utilities and Environmental Services
Project
Name: Lake Creek 2&3 Wastewater Line Upgrades Project Date: 12/30/16
City Project Change Order/Quantity
ID Number LKCK2/ LKCK3 Adjustment No. 2
Justification
Change Order/Quantity Adjustment No. 2 is needed for final quantity adjustments,time extension due to weather delays and fiberglass
manhole fabrication, and additional required services unforseen prior to commencement of construction.
SUMMARY Amount %Change
Original Contract Price: $2,519,182.00
Previous Quantity Adjustment(s):
This Quantity Adjustment: -$2,309.00
Total Quantity Adjustment(s): -$2,309.00
Total Contract Price with Quantity Adjustment(s): r $2,516,873.00
Previous Change Order(s): $80,000.00
0.03
This Change Order: $92,105.15 0.04
Total Change Order(s)To Date: $172,105.15 0.07
Adjusted Contract Price [Original Contract Price Plus
Quantity Adjustment(s) Plus Change Order(s)]: $2,688,978.15
Difference between Original and Adjusted Contract Prices: $169,796.15
Original Contract Time: 360
Time Adjustment by previous Quan.Adj./Change Order: 0
Time Adjustment by this Quan.Adj./Change Order: 123
New Contract Time: 483
Submitted for Approval
Prepared By: Eddie Zapata, Project Manager 12/30/16
Signature Printed Name,Title, Company Date
Approvals
Contractor: Richard Vavro, President,Austin Underground, Inc. G v/
Signaturiet , Printed Name,Title, Company D to
City Project
Manager: Eddie Zapata, Project Manager / 11c-)
Signature Printed Name,Title D to
Mayor/City V,
Manager Y1 w Q ' ��–
Signature Printed Name,Title Date
1,'W(�+— ((2)
Page 2 of 3
Contract Quantity Adjustment/Change Order
ROUND ROCK rLXAS
rev,06/15
Project Name: Lake Creek 2&3 Wastewater Line Upgrades Project
Quan. Adj./Change Order No.: 2
Change Order Data
Contract
Time
Adjustment
Item # Item Description Unit Qty. Unit Price Amount (Days)
Surveying realingment of proposed 36"
CO 2-1 wastewaterline at St. 32+76.91 LS 1 $1,564.00 $1,564.00
Upsize wastewater service lateral from 4"
CO 2-2 to 6" EA 10 $345.00 $3,450.00
Cement Stablized base in Lake Creek Circl
CO 2-3 due to subgrade issues TN 2543 $18.25 $46,409.75
Additional haul-off due to cement
CO 2-4 stablized base displacement CY 1272 $7.50 $9,540.00
Additional HMAC in Lake Creek Circle due
CO 2-5 to subgrade issue TN 126.65 $161.00 $20,390.65
CO 2-6 Sprinkler system repairs LS 1 $3,993.00 $3,993.00
CO 2-7 Concrete encasement for 16"waterline LF 26 $113.60 $2,953.60
CO 2-8 4" PVC LF 7 $510.00 $3,570.00
CO 2-9 Remove existing 10"wastewater line LF 55 $31.50 $1,732.50
CO 2-10 Relocate existing 8"waterline LF 60 $89.70 $5,382.00
CO 2-11 Remove and reset manhole#18 LS 1 $6,034.00 $6,034.00
CO 2-12 Replace damaged boot for manhole #18 LS 1 $577.30 $577.30
CO 2-13 18" PVC&sleeve(material only) LS 1 $1,918.35 $1,918.35
CO 2-14 30" Fernco couplings(material only) LS 1 $1,475.00 $1,475.00
Credit for not installing filter fabric wrap
CO 2-15 around bedding envelope LS -1 $16,885.00 -$16,885.00
Time extension for fiberglass manhole
CO 2-16 fabrication $0.00 90
CO 2-17 Time extension for rain delays $0.00 33
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS: $92105.15 123
Page 3 of 3
Contract Quantity Adjustment/Change Order
ROUND ROCH UXAs
rev,06/15
Project Name: Lake Creek 2&3 Wastewater Line Upgrades Project
Quan.Adj./Change Order No.: 2
Quantity Adjustment Data
Contract
Time
Adjustment
Bid Item # Item Description Unit Qty. Unit Price Amount
Boring 48-inch Steel Encasement- 1/2"
3 Thick Wall LF 15 $810.00 $12,150.00
Concrete Encasement for 36-inch
4 Diameter Pipe LF 100 $220.00 $22,000.00
Remove Existing MH, Replace with 72"
9 Drop Precast Manhole EA -1 $10,000.00 -$10,000.00
11 Trench Safety LF 124 $3.00 $372.00
12 Pipe, 8-inch Dia. PVC SDR LF 4 $610.00 $2,440.00
14 Pipe, 12-inch Dia. PVC SDR LF 6 $510.00 $3,060.00
Abandonment of existing 12"wastewater
16 line LF -1272 $21.00 -$26,712.00
Abandonment of existing 15"wastewater
17 line LF -105 $66.00 -$6,930.00
Abandonment of existing 24"wastewater
18 line LF -3064 $6.00 -$18,384.00
Abandonment of existing 30"wastewater
19 line LF -1673 $6.00 -$10,038.00
23 Remove existing 24"wastewater line LF 598 $34.00 $20,332.00
26 Reconnect service lateral -4" pipe EA -18 $1,000.00 -$18,000.00
28 Native Seeding for Erosion Control AC -1.98 $4,000.00 -$7,920.00
29 Soil Retention Blank Class 1 Type A SY 429 $74.00 $311746.00
30 Protective Fencing Type A Chain Link LF 425 $3.00 $1,275.00
Pipe, 30-inch Dia. SN46 FRPM including
39 excavation and backfill LF 11 $180.00 $1,980.00
Pipe, 36-inch Dia. SN46 FRPM including
40 excavation and backfill LF 2 $160.00 $320.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS: -$2,309.001 0
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
loll
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-151429
Austin Underground Inc
Jonestown,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 0 110 612 0 1 7
being filed.
The 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.
Lake Creek 2&3 WW Upgrade
36"and smaller Wastewater Line upgrade in lake creek
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
-
5 Check only if there is NO Interested Party. ❑
X
6 AFFIDAVIT I swear,or affirm,under enalty ury,that the above disclosure is true and correct.
E'�
� AARON STEVENS Notary Public
STATE OF TEXAS Signature of authorized agent of contracting business entity
�' My Comm.Exp.Oct.22,2019
AFFIX NOTARY STAMP/SEAL ABOVE
Sworn to and subscribed before me,by the said this the lY day of
20 17 ,to certify which,witness my hand and seal of office.
ze�A= A�w �w,5wSAeciuk-M-pr
Signature of officer 6dministering oath Printed name of officer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission wmrw.ethics.state.tx.us Version V1.0.277
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
1 of 1
7-7
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2017-151429
Austin Underground Inc
Jonestown,TX United States Date Filed:
2 Name of governmental entity or state agency that is a party to the contract for which the form is 01/06/2017
being filed.
The City Of Round Rock Date Acknowledged:
01/10/2017
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.
Lake Creek 2&3 WW Upgrade
36"and smaller Wastewater Line upgrade in lake creek
Nature of interest
4
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
5 Check only if there is NO Interested Party.
X
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