Contract - Cash Construction - 12/6/2018 It
Page 1 of 3
Contract Quantity Adjustment/Change Order
RtltIND RM"H.TF.XAS
rev,08/12
Department: Transportation
Project
Name: CORR SWDT Ph 5B Date: 11/5/18
City Project Change Order/Quantity
ID Number SWDT5 Adjustment No. 4
Justification
Additional work for alley paving, parking lot,and other misc items
SUMMARY Amount %Change
Original Contract Price: $4,315,214.00
Previous Quantity Adjustment(s): $139,298.00
This Quantity Adjustment: $35,535.00
Total Quantity Adjustment(s): $174,833.00
Total Contract Price with Quantity Adjustment(s): $4,490,047.00
Previous Change Order(s): $102,132.00 2%
This Change Order: $43,910.00 1%
Total Change Order(s)To Date: $146,042.00 3%
Adjusted Contract Price [Original Contract Price Plus Quantity Adjustment(s)
Plus Change Order(s)]: $4,636,089.00
Difference between Original and Adjusted Contract Prices: $320,875.00
Original Contract Time: 360 Calendar Days
Time Adjustment by previous Quan.Adj./Change Order: 0 Calendar Days
Time Adjustment by this Quan.Adj./Change Order: 0 Calendar Days
New Contract Time: 360 Calendar Days
Submitted for Approval
Qc-Prepared By: cv�� B.J.Cash,Cash Construction
Signature Printed Name,Title,Company Date
Approvals
Contractor: MN clv� B.J.Cash,Cash Construction 1'�
Signature Printed Name,Title,Company Date
City Project 11
Manager: Bill Stablein, Project Manager,CORR 't '
Signa tu Printed Name,Title bate
Mayor/City
Manager Cray hang ayor,CORR to.
Signat re Printed Name,Title Date
F-201b- �P�
Page 2 of 3
Contract Quantity Adjustment/Change Order
�RCN.:ND ROCK.TfliAS
rev,08/12
Project Name: CORR SWDT Ph 5B
Quan.Adj./Change Order No.: 4
Change Order Data
Contract
Time
Adjustment
Item# Item Description Unit Qty. Unit Price Amount Adjusus(Das
TxDOT TY-D with RAP with spot grading, and milling for
Alley Work Ton 100 $300.00 $30,000.00
Additional Handrail at Spanish Academy(18LF at side
entrance&10 LF at front entrance LS 1 $3,055.00 $3,055.00
Tree removal at McNeil Bridge for Oncor Pole Relocation LS 1 $2,000.00 $2,000.00
Trickle Channel Additional Concrete at AT&T Building LF 130 62 $8,060.00
Handrail at Tavarn LS 1 795 $795.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTALS: $43,910.00 0
a
Page 3 of 3
f
Contract Quantity Adjustment/Change Order
�SNDRM`K TF.7iA5
rev,08/12
Project Name: CORR SWDT Ph 5B
Quan.Adj./Change Order No.: 4
Quantity Adjustment Data
Contract
Time
Adjustment
Bid Item# Item Description Unit Qty. Unit Price Amount (Days)
Contract Adds
Barricades, Signs and Traffic Handling,for Contractor
Traffic Control Plan for all phasing throughout the
43 project MO 6 $3,000.00 $18,000.00
Concrete Paver Units for Sidewalk(Paver Section):
Sidewalk Unit(2-3/8"thick)with 1"Sand,6"min. 2 sack
Cement Stabilized Crushed Limestone Flexible Base,and
6" Re-Compacted Moisture Conditioned Subgrade(for
5-528-6004 209 Bagdad) SY 20 $58.00 $1,160.00
P.C. Reinforced Concrete Retainer Curb,Type A,
9-529-6033 Including Tree Wells(for 209 Bagdad) LF 1 46 $75.00 $3,450.00
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 curbs
37 (Small Parking Lot) SY 325 $49.00
$15,925.00
20-506-6020 Stabilized Construction Entrance,maintained thoughout
project per each EA -1 $3,000.00 -$3,000.00
$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: $35,535.00 0
CERTIFICATE OF INTERESTED PARTIES FORM 1295
101`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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2018-427396
Cash Construction Company, INc
Pflugerville,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 11/21/2018
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.
CORR SWDT Ph 5B
Road and Utility Improvements
4 Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling I Intermediary
Cash,BJ Pflugerville,TX United States X
5 Check only if there is NO Interested Party.
6 UNSWORN DECLARATION
My name is and my date of birth (� �
My address is°�0__bi� ' —,r t�.-' Fy +J �t-l.t 4 _ V-6- .- -w� /1
(street) (city) (state) (zip code) (country)
I declare under penalty of perjury that the foregoing is true and correct,
Executed in i�,,,,�;� County, State of Tta`z"S on the ZL9 day of NW. 20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711
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
1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number:
of business. 2018-427396
Cash Construction Company, INc
Pflugerville,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 11/21/2018
being filed.
City of Round Rock Date Acknowledged:
12/05/2018
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.
CORR SWDT Ph 5B
Road and Utility Improvements
4
Nature of interest
Name of Interested Party City,State,Country(place of business) (check applicable)
Controlling Intermediary
Cash, BJ Pflugerville,TX United States X
5 Check only if there is NO Interested Party. ❑
6 UNSWORN DECLARATION
My name is and my date of birth is
My address is
(street) (city) (state) (zip code) (country)
declare under penalty of perjury that the foregoing is true and correct.
Executed in County, State of on the day of 20
(month) (year)
Signature of authorized agent of contracting business entity
(Declarant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.6711