Contract - DeNucci Constructors - 10/28/2021Page I of 3
Contract Quantity Adjustment/Change Order
- wuwu auca n ��.
rev, 01/16
Department: Transportation
Project
Name: 13001.01 University Blvd Widening Date: 9/24/21
City Project Change Order/Quantity
ID Number 13001.01 Adjustment No. 5
Vendor DeNucci Constructors LLC 8310 Capital of TX Hwy N Ste 275 Austin TX 78731 512-335-0600
Company Name Address Phone No.
Justification
1. Added install/remove tublar delineators per REV 12 per COP 10 (attached) 2. Added FHs per CoRR directive. (1) —SfA 666+10 University
Blvd. in front of CVS, (2) —STA 661+25 at SE corner of University Blvd. and Sunrise Rd. COP 11 (attached) 3. NW corner of University Oaks
31vd and University Blvd, removal and relocation of BBVA double water service in conflict with University Oaks Blvd proposed cross street
,oadway section. COP 12 REV 1 (attached) 4. (4) added 6" GVs due to failed shutout at FH SfA 652+00 COP 14 (attached)
Item #870. Quantity bust in temp arrows (16 already installed and not billed, 48 remaining = 64)
Amount % Change
Original Contract Price:
Previous Quantity Adjustment(s):
$74,807.01
This Quantity Adjustment:
$9,600.00
Total Quantity Adjustment(s):
$84,407.05
Total Contract Price with Quantity Adjustment(s):
$12,113,320.05
Previous Change Order(s):
$203,091.07 2%
This Change Order:
$58,346.19 0%
Total Change Order(s) To Date:
$261,437.26 2%
Adjusted Contract Price [Original Contract Price Plus Quantity
Adjustment(s) Plus Change Order(s)]:
$12,374,757.31
Difference between Original and Adjusted Contract Prices:
$345,844.31
Original Contract Time:
760
Time Adjustment by previous Quan. Adj./Change Order:
24
Time Adjustment by this Quan. Adj./Change Order:
12
New Contract Time:
796
Prepared By:
Aaron DeNucci, Project Engineer, DeNucci Constructors, LLC 9/24/21
Signature
Printed Name, Title, Company
Date
Contractor:
Aaron DeNucci, Project Engineer, DeNucci Constructors, LLC 9/24/21
Signature
Printed Name, Title
Date
City Project
LW-Manager:
?-�'A1
q _,28 — 21
Sign re
Printed Name, Title
Date
Mayor/City 01
Manager
I MAVOIS,
0-7 pp��
l(9' zlv
Signa re U
Printe Name, TitfeJ
JI i
Date
f"U2q'--)ar
Contract Quantity Adjustment/Change Order
ROUND ROCK i i xn•.
O1!16
Project Name: 13001.01 University Blvd Widening
Quan. Adj./Change Order No
Chance order data
Page 2 of 3
Item #
Item Description
Unit
Qty.
Unit Price
Amount
Contract
Time
Adjustment
1
SW)SZ1(FLX)SRF PER COP #10
LS
1
$95.00
$9,690.95
3
2
PER COP #11
LS
1
$20,741.87
$20,741.87
3
3
BBVA WS COP #12 REV 1
LS
1
$8,332.50
$8,332.50
1
4
ADDED GV COP #14
LS
1
$19,580.87
$19,580.87
$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
Contract Quantity Adjustment/Change Order
- AOUNO
rev, 01/16
Project Name: 13001.01 University Blvd Widening
Quan. Adj./Change Order No
Quantity Adiuctmant nat.
Page 3 of 3
Bid Item #
Item Description
Unit
Qty.
Unit Price
Amount
Contract
Time
Adjustment
870
WK ZN PAV MRK NON-REMOV ARROW
EA
64
$150.00
$9,600.00
3
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.06
$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
$ .00
$o.00
$0.00
TCOYTA 9 600.00 3
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
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2021-809769
DeNucci Constructors, LLC
Austin, TX United States
Date Filed:
10/06/2021
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
description of the services, goods, or other property to be provided under the contract.
the contract, and provide a
13001.01
Change Order #5 to Contract 13001.01 University Blvd Widening
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling
I Intermediary
5 Check only if there is NO Interested Party. ❑
x
6 UNSWORN DECLARATION
My name is P,& Li t n r • "� CA/w Gc-1 and my date of birth is
My address is 1 l D � Al me,/VQ Us T l k rIC 7g�� I �.•�%�
o -r
(skeet) rctty; (state) (zip code) t,conrrtry)
sue"
I declare under penalty of perjury that the foregoing is true and correct.
Executed in ! "T`� ` S County, State of / rh . or, the day of !/ �j • . 20
(month) (year)
• 1
J. Signature of authorize gent of contracting business entity
(D farant)
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.191b5cdc
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, 29 39 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.
2021-809769
DeNucci Constructors, LLC
Austin, TX United States
Date Filed:
10/06/2021
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:
10/08/2021
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.
13001.01
Change Order #5 to Contract 13001.01 University Blvd Widening
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest
(check applicable)
Controlling�i
Intermediary
5
Check only if there is NO Interested Party.
nX
6
UNSWORN DECLARATION
My name is and my date of birth is
My address is ,
(street) (city) (state) (zip code) (country)
I 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 V1.1.191b5cdc