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Contract - G. Hyatt - 10/22/2020 Page 1 of 3 Contract Quantity Adjustment/Change Order mv,06/12 Department: Transportation Department Project City of Round Rock-Streetscapes Name: Improvements Date: 9/24/20 City Project Change Order/Quantity ID Number Adjustment No. 6 Justification Vewr 7,N IWA raw Trai I -7 12do5b.5 IPTI 1. Change Proposal #23: Power for landscape controls: $1580.70 2. Change Proposal # 24: Credit for Dumor benches and torten bridge: ($13,500) 3. Change Proposal # 25: Masonry repairs to staircase outside City hall: $891 4. Change Proposal # 26: Colored concrete curb in Parklet E: $1826.55 SUMMARY Amount _ %Change Original Contract Price: $2,390,391.58 Previous Quantity Adjustment(s): $144,343.72 This Quantity Adjustment: -$13,500.00 Total Quantity Adjustment(s): $130,843.72 Total Contract Price with Quantity Adjustment(s): $2,521,235.30 Previous Change Order(s): $23,025.11 0.01 This Change Order: $54,663.49 0.02 Total Change Order(s)To Date: $77,688.60 0.03 Adjusted Contract Price (Original Contract Price Plus Quantity Adjustment(s)Plus Change Order(s)]: $2,598,923.90 Difference between Original and Adjusted Contract Prices: $208,532.32 Original Contract Time: 275 Time Adjustment by previous Quan.Adj./Change Order: 32 Time Adjustment by this Quan.Adj./Change Order: 43 New Contract Time: 350 Submitted for Approval Prepared By: Signature Printed Name,Title,Company Date Approvals Contractor: Justin Hyatt, President,G. Hyatt Construction, Inc. 9/24/20 Printed Name,Title,Company Date City Project Manager: \ Lc') Sig ture Printed Name,Title I Date Mayor/City Manager 41V �ZZ, Sign ture Printed Ndne,Title V Date i Page 2 of 3 j i Contract Quantity Adjustment/Change Order -?�POUND RFK 71XA5 ner.w.� �vxrvrt rev,08/12 Project Name: City of Round Rock- Streetscapes Improvements j Quan. Adj./Change Order No.: 6 Change Order Data Contract Time Adjustment Item # Item Description Unit Qty. Unit Price Amount (Davs) 1 Change Proposal # 23 LS 1 1 580.70 g p $ , $1,580.70 0 j $0.00 0 i 2 Change Proposal # 25 LS 1 $891.00 $891.00 0 3 Change Proposal # 26 LS 1 $1,826.55 $1,826.55 0 4 Change Proposal # 27 LS 1 $7,541.00 $7,541.00 5 5 Change Proposal # 28 LS 1 $2,750.96 $2,750.96 0 6 Change Proposal # 29 LS 1 $11,733.96 $11,733.96 10 7 Change Proposal # 30 LS 1 $1,683.96 $1,683.96 0 8 Change Proposal # 31 LS 1 $20,740.36 $20,740.36 28 9 Change Proposal # 32 LS 1 $5,915.00 $5,915.00 0 $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 g $0.00 4 rWWW.. TOTALS: $54663.49 43 Page 3 of 3 Contract Quantity Adjustment/Change Order '�R[NIrvU RCN]cRT f n,^ti rev,08112 Project Name: City of Round Rock-Streetscapes Improvements Quan.Adj./Change Order No.: 6 Quantity Adjustment Data Contract Time Adjustment Bid Item # Item Description Unit Qty. Unit Price Amount $0.00 0 1.37 Dumor Benches EA 8 -$1,500.00 -$12,000.00 0 $0.000 $0.000 $0.000 $0.00 0 $0.00 0 $0.000 $0.00 0 $0.00 0 1.36 Corten Plate Bridge EA 1 -$1,500.00 -$1,500.0010 $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 TOTALS: - 13 500.00 0 CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of l 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 1 Name of business entity filing form,and the city,state and country of the business entity's place Certificate Number: of business. 2020-680047 G Hyatt Construction,Inc. Leander,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 10/19/2020 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. Downtown Round Rock Streetscap General Construction Services 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling intermediary Hyatt,Justin Leander,TX United States X 5 Check only if there is NO Interested Party. 6 UNSWORN DECLARATION My name is "a'n and my date of birth is My address is , p / l ��yss (Er✓ ( / 05 (street) (city) (state) (zip code) (country) I declare under penal of per' that the foregoing is true and correct. �y Executed in ff( 'f County, State of on the ay of D 2?-JL (month) (year) Signatureof u ; t of c tracti business entity rant) Forms provided by Texas Ethics Commission www.ethics.state. .us Version V1.1.3a6aaf7d i