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Contract - DeNucci Constructors - 12/16/2021 Pac I of 3 Contract Quantity Adjustment/Change Order F",01116 Department: Tres tion Project Name: 130O1eOI University Blvd Wls! ni Date,11/11/21 City Project ��Change Order/Quantity ID Number 13D01,01 Adjustment No. 6 Vendor DeNucci Constructors LLC 8310 CaDltai Of TX Hlwy N Ste 275 Austin TX 78731 512-335-0600 Company Name Address Phone No. Justification 1.COP 13 to provide all labor,equipment,and material to completely remove(5)existing 20"valves at University Blvd and remove and replace (1) 12"gate valve.Price also includes(2)thrust blocks, (Per attached material Invoice)(Per COP 913 attached)2.Delta of Valve Direction LLC material invoice(ordered by CORR,paid for by DeNucc!)vs Benmark material invoice(DeNucci's vendor)for the 20" actuator gears. (Per attached material invoices)QUANTITY ADJUSTMENTS:Trench in lieu of bore electrical conduit: ftem(s)318. Add Alternate connector road quantity bust: ftem(s)210,306,340, 430. Added WW Pipe and bypass quantities for bypass plan agreed upon in bypass meeting 10/29/21® 7 (s1 80, 82. (3 NT updated plan sheet attached) Amount 9/b Change Original Contract Price: $12,028,913. Previous Quantity Adjustment(s): $84,407�05 This Quantity Adjustment, =-$30,880.DO Total Quantity Adjustment(s): $53,527.05 Total Contract Price with Quantity Adjustment(s): $12,082 440O Previous Change Or $261,437.26 2% Is Change Order: $61,539-14 1% Total Change Order(s)To Date: 322,976.40 3% Adjusted Contract Price [Original Contract Price Plus Quantity Adjustment(s)Plus Change Order(s)]: E:�$12, 0416.45 Difference between Original and Adjusted Contract Prices: $376,503.45 Original Contract Time: 760 Time Adjustment by previous Quart.Adj4Change Order: 36 Time Adjustment by this Quan,Adj./Change Order: 44 New Contract Time., 840 in MEN Prepa!r By. ron=DeNu91.EPr9oJect �Ei Constructors LLC 11 ?L Printed Date Signature PH Name,fTlFtle,Company City Project Signature Printed Name,Title Date Manager: Mayor/City Manager �2 R,W��2- C) Page 2 of 3 Contract QuantlitV Adjustment/Change Order rew�0 L,16 Project Name; 13001.01 University BiYd Widening Quan. Ad.j./Change Order No. 6 Cha e Order Data i'll ''Ell E'llil 112:111MM RISE= Contract I Order Time Adjustment Item Item Descripa7tionUnit Qtv. 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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 umber: of business. 2021-828622 eucci Constructors,LLC AUSTIN,TX United States Date Filed: 2 Name of governmentWal entity or state agency thaft is tot a contract for whicfi the arm Is 12/02/2021 being filed. City of Round Rock Date cno edged: 3 Provide the identification number used by the governmental entity or state agencyto 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#6 to Contract 13001.01 University Blvd Widening ------------------------ Nature of interest Name of interested Party City,State,Country(place of business) (check applicable) ControllingIntermediary --------------------------------------- --------------------------------- 5 Check only if there is NO Interested Party. X 6 UNSWORN DECLARAMN my name is Paul T. DeNucci and my date of birth is My address is_8310-1 N. Capital of Texas Hwy., Ste.275 Austin TX 78731_ USA (street) {city} (state) (zip e) (country) I declare under penalty of perjury that the foregoing is true and correct. Executed in TRAVIS County, State of TEXAS —on the 2nd day of December ,20 21 (month) (year) t Signature of authorrzer gent of co�ttracting business entity Forms provided by Texas Ethics Commission .ethics.state.tx.us Version V1.1.191b5cdc 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 it there are no interested parties. CERTIFICATION OF FILING n 1 Name of business entity filing form,and the city,state and country of the business entity's place l!erfificate Number: of business. 2021-828622 DeNucci Constructors,LLC AUSTIN,TX United States Date Filed: 2 Name of governmental entity ors a agency Mat Is a party to the contract for is the form is 12102/2021 being filed. City of Round Rock Date Acknowledged: 1 12/10/2021 3 Provide the identification number used by the governmental entity ors 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#6 to Contract 13001.01 University Blvd Widening 4 Nature of interest Name of Interested Party City,State,Country(place of business) (check applicable) Controlling li-ntermadiary 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) (slate) (zip code) (wuritry) I declare under penalty of perjury that the foregoing is true and correct. Executed in County, State of on the..........-day of 2011 (month) (yearn� Signature of authorized agent of contracting business entity (Declarant) Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.1.191b5cdc