Contract - Cash Construction - 2/25/2016Contract Quantity Adjustment/ Change Order
Inx� s
rev, 08/12
Department: Transportation
Project
Name: Sundance Pkwy & Parker Rd Street Reconstruction
City Project
ID Number TX05MNTLF
Justification
Page 1 of 3
Date: 11/30/15
Change Order/Quantity
Adjustment No. 2
Miscellaneous change order items for traffic circle area. Quantity adjustments for additional Type C HMAC, and Deduction in Type B HMAC, and additional
concrete quantities for concrete items.
SUMMARY
Amount % Change
Original Contract Price:
$3,088,927.00
Previous Quantity Adjustment(s):
-$357,431.80
This Quantity Adjustment:
$99,635.00
Total Quantity Adjustment(s):
-$257,796.80
Total Contract Price with Quantity Adjustment(s):
$2,831,130.20
Previous Change Order(s):
$13,096.80 0%
This Change Order:
$38,014.00 1%
Total Change Order(s) To Date:
$51,110.80 2%
Adjusted Contract Price [Original Contract Price Plus Quantity Adjustment(s)
Si a re
Plus Change Order(s)]:
Date
$2,882,241.00
Difference between Original and Adjusted Contract Prices:
-$206,686.00
Original Contract Time: 202
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: 202
Calendar Days
Submitted for Approval
Prepared By: k?j� l�Wr B.J. Cash, Cash Construction
Signature
Printed Name, Title, Company
Date
Approvals
Contractor:
Cwt
B.J. Cash, Cash Construction
2�0
Signatuw
Printed Name, Title, Company
Date
City Project
Manager:
] 1 —
Bill Stablein, Project Manager, CORR
1--27.. (f,
Si a re
Printed Name, Title
Date
Mayor/City/n��1�
0'
L �"J
Manager
� `
Alan McGraw, Mayor, CORR
Signature
Printed Name, Title
Date
Paee 2 of 3
Contract Quantity Adjustment/Change Order
ROUKD ROCK, ryIX nS
rev, oe/iz
Project Name: Sundance Pkwy & Parker Rd Street Reconstruction
Quan. Adj./Change Order No.
Chance Order Data
Item #
Item Description
Unit
Qty.
Unit Price
Amount
Contract
Time
Adjustment
(Days)
75
ITEM - 4434 4 INCH P.C. CONCRETE MEDIAN
(additional concrete 2" at Traffic Circle)
LS
1
$4,580.00
$4,580.00
0
76
ADA Ramp Re -Work at Traffic Circle
LS
1
$5,395.00
$5,395.00
0
77
Mill Out and Remove at Parker Rd and 45 2" to 6"
SY
556
$9.00
$5,004.00
78
Irrigation Repairs (Sundance and Parker Road)
LS
1
$20,000.00
$20,000.00
79
Lower Clean Outs and Concrete Around
EA
3
$695.00
$2,085.00
80
Tree Well at Traffic Circle
LS
1
$950.00
$950.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Page 3 of 3
Contract Quantity Adjustment/ Change Order
ROUNNDPOCK
rev, 08/12
Project Name: Sundance Pkwy & Parker Rd Street Reconstruction
Quan. Adj./Change Order No.:
Quantity Adjustment Data
TOTALS: 1 99 635.00 0
Bid Item #
Item Description
Unit
Qty.
Unit Price
Amount
Contract
Time
Adjustment
(Days)
13
ITEM - R340 HOT MIX ASPHALTIC CONRETE PAVEMENT
TYPE B
TON
-903
$88.00
-$79,464,00
14
ITEM - R340 HOT MIX ASPHALTIC CONRETE PAVEMENT
TYPE C
TON
769
$110.00
$84,590.00
21
ITEM - R432 P.C. CONCRETE SIDEWALK
SF
3,553
$6.50
$23,094.50
22
ITEM - R433 P.C. CONCRETE DRIVEWAY
SF
1,076
$9.50
$10,222.00
23
ITEM - 4434 4 INCH P.C. CONCRETE MEDIAN (Attional
Qty at Island at Traffic Circle)
SF
3103
$17.00
$52,751.00
24
ITEM - R436 P.C. CONCRETE VALLEY GUTTERS
SF
169
$9.50
$1,605.50
42
ITEM - T644 2001 IN SM RD SN SUP & AM TY 10BWG
(1) SA (P)
EA
10
$600.00
$6,000.00
2
ITEM - R104 REMOVE P.C. CONCRETE CURB
LF
38
$7.00
$266.00
15
ITEM - R430 P.C. CONCRETE CURB AND GUTTER (FINE
GRADING)
LF
38
$15.00
$570.00
$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
TOTALS: 1 99 635.00 0
CERTIFICATE OF INTERESTED PARTIES
FORM 1295
lofl
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.
2016-6549
Cash Construction Company, Inc
Pflugerville, TX United States
Date Filed:
01/27/2016
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 the contract, and provide a
description of the goods or services to be provided under the contract.
Sundance Pkwy Change Order #2
Miscellaneous change order items for traffic circle area. Quantity adjustments for additional Type C HMAC, and Deduction in Type
B HMAC, and additional concrete quantities for concrete items.
4
Name of Interested Party
City, State, Country (place of business)
Nature of interest (check applicable)
Controlling
Intermediary
Gentry, Nathan
Pflugerville, TX United States
X
Cash, BJ (Bruce Jr)
Pflugerville, TX United States
X
Cash, Bruce
Pflugerville, TX United States
X
5 Check only if there is NO Interested Party. ❑
6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct.
STACY SMALL
Notary Public, State of Texas
Comm. Expires 03-04-2020
V ° Notary ID 11068434 SiNature of authorized agent of contracting business entity
AFFIX NOTARY STAMP / SEAL ABOVE �i1 �� f� �q
Sworn to and subscribed before me, by the said ^� �K �c'C � this the _ �� / day of tf Q
20to certify which, witness my hand and seal of office.
G a e Ota CJ X da(.r'n
gnature of offs r administering oath Printed name of o icer administering oath Title of officer administering oath
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.34416
CERTIFICATE OF INTERESTED PARTIES
FORM .12,9CJ
1 of 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
Certificate Number:
1 Name of business entity filing form, and the city, state and country of the business entity's place
of business.
2016-6549
Cash Construction Company, Inc
Pflugerville, TX United States
Date Filed:
01/27/2016
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:
02/03/2016
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 goods or services to be provided under the contract.
Sundance Pkwy Change Order #2
Miscellaneous change order items for traffic circle area. Quantity adjustments for additional Type C HMAC, and Deduction in Type
B HMAC, and additional concrete quantities for concrete items.
4
Name of Interested Parry
City, State, Country (place of business)
Nature of interest (check applicable)
Controlling
Intermediary
Gentry, Nathan
Pflugerville, TX United States
X
Cash, BJ (Bruce Jr)
Pflugerville, TX United States
X
Cash, Bruce
Pflugerville, TX United States
X
5 Check only if there is NO Interested Party. ❑
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 V1.0.34416