8611 - Change Order 2 Executed
DocuSign Transmittal Coversheet
File Name
Purchasing Contact
Docusign Envelope ID: E0BDD9DE-23B1-4C1B-B1F6-A4A9AB11D5C2
Gabby Leeper
8611 Morse St Loop 288- Mayhill
Contractor:JAGOE PUBLIC COMPANY
3020 FORT WORTH DR
Denton, TX 76205-8624
Ben Teconchuk
Proj:Morse St. (Loop 288-Mayhill)CHANGE ORDER NO.2
CSP#8611 ENG/PMO#180012-1 PO#209139
Contract BID Amount:2,398,119.50$ Prior Approved Other Funded CO's:-$
5% Contingency Amount:119,905.98$ Current Contract Amount w CO's:2,417,822.88$
Total NTE Amount : 2,518,025.48$ This CO Non-Contingency Fund Request:-$
Prior Approved CUA's:19,703.38$ Total Change Request:57,977.83$
Available Contingency:100,202.60$
This CUA Request:$57,977.83 Orig Contract Days:This CO Days Request:0
Contingency Remaining:42,224.77$ Approved CO Days:New Contract Days:210
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
18 32 11 02 Lime Treated Subgrade SY 9432 -9432 10.00$ (94,320.00)$
19 32 11 02 Hydrated Lime TN 306 -306 275.00$ (84,150.00)$
-$178,470.00
27 56 00 Cement TN 0 183 400.69$ 73,326.27$
27 56 00 Cement Treatment SY 0 9432 16.92$ 159,589.44$
28 56 00 Cement Series Testing EA 0 1 2,317.19$ 2,317.19$
34 41 05 Aluminum Signs and Signposts- additional signage LS 0 1 1,214.93$ 1,214.93$
$236,447.83
$57,977.83
2,398,119.50$
2,518,025.48$
77,681.21$
-$
2,475,800.71$
65%
3.24%
0.00%
% of CUA Approved To-Date:
Total Changes over Original Bid:
Percent Changes over NTE:
Morse St. (Loop 288-Mayhill)
Total CO's:
Revised Contract Amount:
TOTAL CO AMOUNT:
Original BID/Contract Amount:
Original Not To Exceed Amount:
Total CUA's:
CONTINGENCY USE ALLOWANCE (CUA) CONTRACT CHANGES
TOTAL CUA NEW ITEMS:
Description of work
Contingency funds are used at City's discretion per contract spec language TOTAL CUA EXISTING ITEMS:
NEW ITEMS OF WORK
Reason for change:
- Added Signage for increased visibility.
- Surface Soils testing recommended use of cement in lieu of lime stabilization.
210
0
PROJECT SCOPE AND REASON FOR CHANGE
Description of work included
in Contract:
The Morse St ( Loop 288 and Mayhill Road) project includes the design and construction full depth reconstruction
including replacement of an existing waterline.
Kristine Stewart, Project Manager
Contingency funds are used at City's discretion per contract spec language
CITY OF DENTON CHANGE ORDER FORM
City of Denton - Capital Projects
401 N. Elm Street
Denton, TX 76201
Notice To Proceed Issued:Current Completion Date:New Completion Date:
12/2/2024 6/30/2025 6/30/2025
QUANTITY CHANGES TO EXISTING ITEMS
Docusign Envelope ID: E0BDD9DE-23B1-4C1B-B1F6-A4A9AB11D5C2
Signatory Lines will be updated by Purchasing if required
SUBMITTED BY:_______________________________
Kristine Stewart, Project Manager
ACCEPTED BY CITY ENGINEER/DIRECTOR OF CAPITAL PROJECTS _______________________________
Signature
ACCEPTED BY CONTRACTOR: ____________________________________________________________
Name, Title Signature
PURCHASING:_______________________________
Signature
IS SUBJECT TO ALL CONTRACT STIPULATIONS AND COVENANTS.
THE AFOREMENTIONED CHANGE, AND WORK AFFECTED THEREBY,
Docusign Envelope ID: E0BDD9DE-23B1-4C1B-B1F6-A4A9AB11D5C2
Brian Lee Chief Estimator/Senior PM
Interim director
CONFLICT OF INTEREST QUESTIONNAIRE
CONFLICT OF INTEREST QUESTIONNAIRE - FORM CIQ
For vendor or other person doing business with local governmental entity
This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session.
This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who has a business relationship as
defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a).
By law this questionnaire must be filed with the records administrator of the local government entity not later than the 7th business day after
the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code.
A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code. An offense under this section is a
misdemeanor.
1 Name of vendor who has a business relationship with local governmental entity.
2
Check this box if you are filing an update to a previously filed questionnaire.
(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the
date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.)
3 Name of local government officer about whom the information in this section is being disclosed.
Name of Officer
This section, (item 3 including subparts A, B, C & D), must be completed for each officer with whom the vendor has an employment or other business
relationship as defined by Section 176.001(1-a), Local Government Code. Attach additional pages to this Form CIQ as necessary.
A. Is the local government officer named in this section receiving or likely to receive taxable income, other than investment income, from the vendor?
Yes No
B. Is the vendor receiving or likely to receive taxable income, other than investment income, from or at the direction of the local government officer
named in this section AND the taxable income is not received from the local governmental entity?
Yes No
C. Is the filer of this questionnaire employed by a corporation or other business entity with respect to which the local government officer serves as an
officer or director, or holds an ownership of one percent or more?
Yes No
D. Describe each employment or business and family relationship with the local government officer named in this section.
4
I have no Conflict of Interest to disclose.
5
Signature of vendor doing business with the governmental entity Date
Docusign Envelope ID: E0BDD9DE-23B1-4C1B-B1F6-A4A9AB11D5C2
3/18/2025
N/A
X
Certificate Of Completion
Envelope Id: E0BDD9DE-23B1-4C1B-B1F6-A4A9AB11D5C2 Status: Completed
Subject: ***Purchasing Approval*** 8611 Morse Street Loop 288-Mayhill Change Order 2
Source Envelope:
Document Pages: 4 Signatures: 5 Envelope Originator:
Certificate Pages: 6 Initials: 1 Gabby Leeper
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-06:00) Central Time (US & Canada)
901B Texas Street
Denton, TX 76209
Gabby.Leeper@cityofdenton.com
IP Address: 198.49.140.104
Record Tracking
Status: Original
3/18/2025 12:29:37 PM
Holder: Gabby Leeper
Gabby.Leeper@cityofdenton.com
Location: DocuSign
Signer Events Signature Timestamp
Gabby Leeper
gabby.leeper@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.104
Sent: 3/18/2025 12:40:09 PM
Viewed: 3/18/2025 12:40:17 PM
Signed: 3/18/2025 12:40:53 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: 198.49.140.10
Sent: 3/18/2025 12:40:55 PM
Viewed: 3/18/2025 4:53:33 PM
Signed: 3/18/2025 4:53:38 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Kristine Stewart
kristine.stewart@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Drawn on Device
Using IP Address: 45.24.154.103
Signed using mobile
Sent: 3/18/2025 4:53:40 PM
Viewed: 3/18/2025 6:06:24 PM
Signed: 3/18/2025 6:06:44 PM
Electronic Record and Signature Disclosure:
Accepted: 3/18/2025 6:06:24 PM
ID: 891c83d1-0776-42b5-a22c-0fd0c19e47d2
Brian Lee
Brian.Lee@jagoepublic.com
Chief Estimator/Senior Project Manager
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 174.197.130.225
Signed using mobile
Sent: 3/18/2025 6:06:45 PM
Viewed: 3/18/2025 10:09:13 PM
Signed: 3/18/2025 10:12:23 PM
Electronic Record and Signature Disclosure:
Accepted: 3/18/2025 10:09:13 PM
ID: 7138a668-3220-42ba-b78d-346b16668466
Signer Events Signature Timestamp
Seth Garcia
Seth.Garcia@cityofdenton.com
Deputy Director of Capital Projects
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 12.186.163.4
Signed using mobile
Sent: 3/18/2025 10:12:26 PM
Viewed: 3/18/2025 10:32:39 PM
Signed: 3/18/2025 10:33:54 PM
Electronic Record and Signature Disclosure:
Accepted: 3/18/2025 10:32:39 PM
ID: 6a49ce85-28ec-40b6-bff4-13855a92d254
Gabby Leeper
gabby.leeper@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 47.189.253.137
Signed using mobile
Sent: 3/18/2025 10:33:56 PM
Viewed: 3/19/2025 7:48:23 AM
Signed: 3/19/2025 7:48:41 AM
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
Procurement Administration Supervisor
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 3/19/2025 7:48:42 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Cori Power
Cori.Power@cityofdenton.com
Purchasing Supervisor
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 3/19/2025 7:48:43 AM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 3/18/2025 12:40:09 PM
Envelope Updated Security Checked 3/18/2025 2:20:11 PM
Certified Delivered Security Checked 3/19/2025 7:48:23 AM
Envelope Summary Events Status Timestamps
Signing Complete Security Checked 3/19/2025 7:48:41 AM
Completed Security Checked 3/19/2025 7:48:43 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
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Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Kristine Stewart, Brian Lee, Seth Garcia
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