7413 - Change Order 1 Executed
Docusign Transmittal Coversheet
File Name
Purchasing Contact
Contract Expiration
DocuSign Envelope ID: 8EED7A0C-9747-45FF-8E30-177640407FAE
N/A
Cori Power
7413 - 2019 INtersection Improvements CO#1
Contractor:Quality Excavation, LTD
5580 US-377
Aubrey, TX 76227
Robin Mallon
2019 Intersection Improvements Project CHANGE ORDER NO.1
7413 CIP/ENG#PO #:195342
Contract BID Amount:1,723,400.60$
5% Contingency Amount:86,170.03$
1,809,570.63$
Prior Approved CAA's:-$
Available Contingency:86,170.03$
$25,531.54 21
Contingency Remaining:60,638.49$ 141
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
2 104 - 6001 SY 100 190 14.00$ 2,662.10$
8 104 - 6067 LF 4,661 826 2.00$ 1,651.66$
9 110 - 6001 CY 2,300 85 16.00$ 1,353.44$
12 247 - 6231 FL BS (CMP IN PLACE)(TY A GR 1-2)(10")SY 4,390 -839 20.00$ (16,774.80)$
15 260 -6016 LIME (HYD, COM,OR QK(SLURRY)TN 7 -1 350.00$ (350.00)$
16 260 - 6027 LIME TRT (EXST MATL)(8")SY 4,802 -839 9.00$ (7,548.66)$
18 *340 - 6070 1.5"D-GR HMA (SQ) TY-C SY 7,970 -839 11.00$ (9,226.14)$
20 *341 - 6003 3" D-GR-HMA TY A SY 4,145 -839 19.00$ (15,936.06)$
-$ -$
-$44,168.46
141 NEW LS 1 8,875.00$ 8,875.00$
142 NEW LS 1 500.00$ 500.00$
143 NEW REMOVE & DISPOSE EXSISTNG POWER POLE LS 1 365.00$ 365.00$
144 NEW SSTR RAIL LF 784 59.00$ 46,256.00$
145 NEW 3- GRATE TY C INLET (0'-4')EA 2 6,500.00$ 13,000.00$
146 NEW SY 44 16.00$ 704.00$
$69,700.00
-$
8/29/2021
New Completion Date:
9/19/2021
This CO Days Request:
Total NTE Amount : This CO Other Funding Request:
Project Scope
included in Contract:
Signal Light and traffic improvements at the following locations: Unversity/Nottingham; Sherman/Loop 288;
Hercules/Locust; McKinney/Loop 288; McKinney/Woodrow.
CONTINGENCY ALLOWANCE AUTHORIZED (CAA) CONTRACT CHANGES
QUANTITY CHANGES TO EXISTING ITEMS
TOTAL CAA QTY CHANGES:
NEW ITEMS OF WORK
Description of work
Additional quantities needed due to utility conflicts at Sherman/Loop 288 and McKinney/Woodrow locations. New items needed for the fire
Hydrant assembly, flexbase in lieu of lime, and Franchise utility pole relocation (Woodrow/McKinney); SSTR rail and grate inlet relocation
(Sherman/Loop288). Additional quantities due to existing conditions of pavement at the connection points on Sherman/Loop 288 and a
reduction in quantities due to utility conflicts.
1,723,400.60$
180022-1
Notice To Proceed Issued:
4/1/2021
Current Completion Date:
Dustin Draper, Project Manager
CITY OF DENTON CHANGE ORDER FORM
City of Denton - Capital Projects
401 N. Elm Street
Denton, TX 76201
Project:
New Contract Days:
Total Change Request:25,531.54$
Reason for change:
IFB#
This CAA Request:
PROJECT SCOPE AND REASON FOR CHANGE
Prior Approved Other Funded CO's:-$
Current Contract Amount w CO's:
Orig Contract Days:
Approved CO Days:
120
0
REMOVING CONC (PAV)
REMOVING CONC (SAWCUT)
EXCAVATION (ROADWAY)
FL BS (CMP IN PLACE)(TY A GR 1-2)(6")
FIRE HYDRANT ASSEMBLY W/TAPPPING SLEEVE & VALVE
INSTALL NEW POWER POLE (PROVIDED BY OTHERS)
Contingency funds are used at City's discretion per contract spec language TOTAL CAA NEW ITEMS:
DocuSign Envelope ID: 8EED7A0C-9747-45FF-8E30-177640407FAE
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
$0.00
-$ -$
$0.00
$25,531.54
1,723,400.60$
1,809,570.63$
2019 Intersection Improvements Project 25,531.54$
-$
1,748,932.14$
29.63%
1.48%
0%
Signatory Lines will be updated by Purchasing if required
SUBMITTED BY:_______________________________
ACCEPTED BY CITY ENGINEER/DIRECTOR OF CAPITAL PROJECTS _______________________________
ACCEPTED BY CONTRACTOR: ____________________________________________________________
Name, Title
PURCHASING:_______________________________
TOTAL OTHER FUNDED NEW ITEMS:
THE AFOREMENTIONED CHANGE, AND WORK AFFECTED THEREBY,
Revised Contract Amount:
Percent Changes over NTE:
TOTAL CO AMOUNT:
Total Change Order over Original Bid:
Total CO's:
% of CAA Approved To-Date:
Total CAA's:
Original Total Not To Exceed Amount:
Original BID/Contract Amount:
N/A
OTHER FUNDED CONTRACT CHANGES (CO)
QUANTITY CHANGES TO EXISTING ITEMS
NEW ITEMS OF WORK
TOTAL OTHER FUNDED QTY CHANGES:
Description of work
IS SUBJECT TO ALL CONTRACT STIPULATIONS AND COVENANTS.
Signature
Signature
Signature
Project Manager
]
DocuSign Envelope ID: 8EED7A0C-9747-45FF-8E30-177640407FAE
Rob Mallon Operations Manager
7/12/2021
Project Name
Project Number
Date
Current Contract Amount
Requested Change Order Amount
BID ITEM DESCRIPTION UNIT QUANTITY $/UNIT TOTAL/EXTENSION
New 1
Fire Hydrant Assembly w/ Tapping Sleeve &
Valve LS 1 8,875.00$ 8,875.00$
NEW 2 Install new power pole provided by others LS 1 500.00$ 500.00$
NEW 3
Remove & dispose or surrender existing
power pole LS 1 365.00$ 365.00$
NEW 4 SSTR Rail LF 784 59.00$ 46,256.00$
NEW 5 3‐ Grate Ty C Inlet (0'‐4')EA 2 6,500.00$ 13,000.00$
NEW 6 FL BS (CMP IN PLACE)(TY A GR 1‐2)(6") SY 44 $16.00 $704.00
247 ‐ 6231 FL BS (CMP IN PLACE)(TY A GR 1‐2)(10") SY ‐838.74 20.00$ (16,774.80)$
260 ‐ 6027 LIME TRT (EXST MATL)(8") SY ‐838.74 9.00$ (7,548.66)$
260 ‐ 6016 LIME (HYD, COM, OR QK(SLURRY)) TON ‐1 350.00$ (350.00)$
*340 ‐ 6070 1.5" D‐GR HMA(SQ) TY‐C SY ‐838.74 11.00$ (9,226.14)$
*341 ‐ 6003 3" D‐GR HMA TY A SY ‐838.74 19.00$ (15,936.06)$
104 ‐ 6067 REMOVING CONC (SAWCUT) LF 825.83 2.00$ 1,651.66$
110 ‐ 6001 EXCAVATION (ROADWAY)CY 84.59 $16.00 1,353.44$
104 ‐ 6001 REMOVING CONC (PAV)SY 190.15 $14.00 2,662.10$
25,531.54$
New Item
Descriptions
Total
2019 Denton Intersection Improvements
IFB#7412 / QE#20099
$1,723,400.60
$25,531.54
5/13/2021
1) At the intersection of Audra & McKinney there was a fire hydrant called out for relocation but there was no pay item
provided of that work. Also, the condition of the existing hydrant warranted replacement with a new hydrant. New
hydrant replacement was authorized by the City of Denton.
2&3)At Audra & McKinney there is an existing power pole that is in conflict with the proposed design. Denton requested
a price for QE/Durable Specialties to install a new pole provided by others. This additional work will require 7 additional
days to schedule, coordinate and complete.
4)At Sherman & Loop 288 the plans call out SSTR rail under the bridge but there was not a pay item provided for funding
the SSTR rail.
5)At Sherman & Loop 288, there are two existing grate inlets that are in conflict with the proposed roadway limits. RFI 5
response directed the adjustment of the existing inlets. Cost provided is for using existing inlet grates with new nuts &
bolts.
6) There was no existing lime subgrade quantity allocated to the intersection of Audra & McKinney. Due to the small
area, it was agreed that flexbase could be used in lieu of lime. A 6" flexbase pay items is being added to replace the plan
call out for 6" lime.
DocuSign Envelope ID: 8EED7A0C-9747-45FF-8E30-177640407FAE
Existing Item
Description
Summary
Time Extension Request:
QUALITY EXCAVATION LTD
958 US HIGHWAY 377, SUITE # 200
AUBREY, TX 76227
ALL INVOICES MUST INCLUDE JOB NUMBER AND PURCHASE ORDER
Approved
Printed
SUBMIT ALL INVOICES TO ‐ INVOICE@QUALITYEXCAVATIONLTD.COM
The existing items that are being adjusted are for the Sherman & Loop 288 intersection where there are existing utilities
in conflict with the proposed edge of paving. RFI 5 directed the edge of pavement to be shifted past the point of conflict
at each obstacle. This resulted in a reduction of asphalt paving required for the shoulders. A 14 day time extension is
being requested to make up for time lost while utility conflicts were being reviewed and correction was advised.
For this change order request a total of 21 calendar days
added to the total duration for the project is being
requested.
DocuSign Envelope ID: 8EED7A0C-9747-45FF-8E30-177640407FAE
Certificate Of Completion
Envelope Id: 8EED7A0C974745FF8E30177640407FAE Status: Completed
Subject: ***Purchasing Approval*** Contract 7413- 2019 Intersection Improvements CO#1
Source Envelope:
Document Pages: 5 Signatures: 4 Envelope Originator:
Certificate Pages: 6 Initials: 1 Cori Power
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
cori.power@cityofdenton.com
IP Address: 198.49.140.104
Record Tracking
Status: Original
7/2/2021 1:16:06 PM
Holder: Cori Power
cori.power@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Cori Power
cori.power@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.104
Sent: 7/2/2021 1:24:57 PM
Viewed: 7/2/2021 1:25:12 PM
Signed: 7/2/2021 1:25:38 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Lori Hewell
lori.hewell@cityofdenton.com
Purchasing Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.104
Sent: 7/2/2021 1:25:39 PM
Viewed: 7/2/2021 1:46:56 PM
Signed: 7/2/2021 1:47:38 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Dusty Draper
Dustin.Draper@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 7/2/2021 1:47:39 PM
Viewed: 7/2/2021 2:51:00 PM
Signed: 7/2/2021 2:51:18 PM
Electronic Record and Signature Disclosure:
Accepted: 7/2/2021 2:51:00 PM
ID: d7f25f66-ed34-4b9f-98d6-e3ad97d27663
Rebecca Diviney
Rebecca.Diviney@cityofdenton.com
Director of Capital Projects/City Engineer
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 47.222.11.1
Signed using mobile
Sent: 7/2/2021 2:51:20 PM
Viewed: 7/12/2021 8:50:03 PM
Signed: 7/12/2021 8:50:19 PM
Electronic Record and Signature Disclosure:
Accepted: 7/12/2021 8:50:03 PM
ID: 3a803239-1be3-43fe-ae09-23eb2c249c45
Signer Events Signature Timestamp
Rob Mallon
rob@qualityexcavationltd.com
Operations Manager
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 173.219.29.14
Sent: 7/2/2021 2:51:21 PM
Viewed: 7/2/2021 3:02:33 PM
Signed: 7/6/2021 8:49:17 AM
Electronic Record and Signature Disclosure:
Accepted: 7/2/2021 3:02:33 PM
ID: ce8c4fcf-a0f2-4bc4-b914-de8048a1bac1
Cori Power
cori.power@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 35.135.179.120
Signed using mobile
Sent: 7/12/2021 8:50:22 PM
Viewed: 7/12/2021 9:07:06 PM
Signed: 7/12/2021 9:07:12 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 7/12/2021 9:07:14 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Dusty Draper
Dustin.Draper@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Sent: 7/12/2021 9:07:14 PM
Electronic Record and Signature Disclosure:
Accepted: 7/2/2021 2:51:00 PM
ID: d7f25f66-ed34-4b9f-98d6-e3ad97d27663
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 7/2/2021 1:24:57 PM
Certified Delivered Security Checked 7/12/2021 9:07:06 PM
Signing Complete Security Checked 7/12/2021 9:07:12 PM
Completed Security Checked 7/12/2021 9:07:14 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, City of Denton (we, us or Company) may be required by law to provide to
you certain written notices or disclosures. Described below are the terms and conditions for
providing to you such notices and disclosures electronically through your DocuSign, Inc.
(DocuSign) Express user account. Please read the information below carefully and thoroughly,
and if you can access this information electronically to your satisfaction and agree to these terms
and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of
this document.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. For such copies, as long as you are an authorized user of the
DocuSign system you will have the ability to download and print any documents we send to you
through your DocuSign user account for a limited period of time (usually 30 days) after such
documents are first sent to you. After such time, if you wish for us to send you paper copies of
any such documents from our office to you, you will be charged a $0.00 per-page fee. You may
request delivery of such paper copies from us by following the procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. To indicate to us that you are changing your mind, you must
withdraw your consent using the DocuSign 'Withdraw Consent' form on the signing page of your
DocuSign account. This will indicate to us that you have withdrawn your consent to receive
required notices and disclosures electronically from us and you will no longer be able to use your
DocuSign Express user account to receive required notices and consents electronically from us
or to sign electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or
made available to you during the course of our relationship with you. To reduce the chance of
you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Dusty Draper, Rebecca Diviney, Rob Mallon, Dusty Draper
How to contact City of Denton:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: purchasing@cityofdenton.com
To advise City of Denton of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at melissa.kraft@cityofdenton.com
and in the body of such request you must state: your previous e-mail address, your new e-mail
address. We do not require any other information from you to change your email address..
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
in your DocuSign account by following the process for changing e-mail in DocuSign.
To request paper copies from City of Denton
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an e-mail to purchasing@cityofdenton.com and in
the body of such request you must state your e-mail address, full name, US Postal address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with City of Denton
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your DocuSign account, and on the subsequent
page, select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an e-mail to purchasing@cityofdenton.com and in the body of such request you
must state your e-mail, full name, IS Postal Address, telephone number, and account
number. We do not need any other information from you to withdraw consent.. The
consequences of your withdrawing consent for online documents will be that transactions
may take a longer time to process..
Required hardware and software
Operating Systems: Windows2000? or WindowsXP?
Browsers (for SENDERS): Internet Explorer 6.0? or above
Browsers (for SIGNERS): Internet Explorer 6.0?, Mozilla FireFox 1.0,
NetScape 7.2 (or above)
Email: Access to a valid email account
Screen Resolution: 800 x 600 minimum
Enabled Security Settings:
•Allow per session cookies
•Users accessing the internet behind a Proxy
Server must enable HTTP 1.1 settings via
proxy connection
** These minimum requirements are subject to change. If these requirements change, we will
provide you with an email message at the email address we have on file for you at that time
providing you with the revised hardware and software requirements, at which time you will
have the right to withdraw your consent.
Acknowledging your access and consent to receive materials electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please verify that you
were able to read this electronic disclosure and that you also were able to print on paper or
electronically save this page for your future reference and access or that you were able to
e-mail this disclosure and consent to an address where you will be able to print on paper or
save it for your future reference and access. Further, if you consent to receiving notices and
disclosures exclusively in electronic format on the terms and conditions described above,
please let us know by clicking the 'I agree' button below.
By checking the 'I Agree' box, I confirm that:
• I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF
ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
• I can print on paper the disclosure or save or send the disclosure to a place where I can
print it, for future reference and access; and
• Until or unless I notify City of Denton as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to me by City of Denton during the course of my relationship with you.