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6894 - Amendment 1 Executed Docusign Transmittal Coversheet File Name Purchasing Contact Contract Expiration DocuSign Envelope ID: 659F64F6-39CF-4342-B508-D99C57D9CDF0 FILE Crystal Westbrook IFB NA HICKORY CREEK LIFT STATION CONSTRUCTION EJCDC® C-940, Work Change Directive. Copyright© 2018 National Society of Professional Engineers, American Council of Engineering Companies, and American Society of Civil Engineers. All rights reserved. Page 1 of 1 WORK CHANGE DIRECTIVE NO.: 11 Owner: City of Denton Owner’s Project No.: 6894 Engineer: Hazen and Sawyer Engineer’s Project No.: 60702-004 Contractor: Rey-Mar Construction Contractor’s Project No.: N/A Project: Hickory Creek Lift Station Contract Name: Date Issued: 12/2/2020 Effective Date of Work Change Directive: 12/2/2020 Contractor is directed to proceed promptly with the following change(s): Description: Extension of monorail. Attachments: 1. Direct Field Cost by Ray-Mar Construction Purpose for the Work Change Directive: With change to wet well hatch, extending monorail will allow completely removing the wet well access hatch to one side of the wet well and removal of pumps to the other side of the wet well. Directive to proceed promptly with the Work described herein, prior to agreeing to change in Contract Price and Contract Time, is issued due to: Notes to User—Check one or both of the following ☐ Non-agreement on pricing of proposed change. ☒ Necessity to proceed for schedule or other reasons. Estimated Change in Contract Price and Contract Times (non-binding, preliminary): Contract Price: $9,662.68 increase. Contract Time: 21 days increase. Basis of estimated change in Contract Price: ☒ Lump Sum ☐ Unit Price ☐ Cost of the Work ☐ Other Recommended by Engineer Authorized by Owner By: Title: Senior Associate Date: 12/2/2020 DocuSign Envelope ID: 659F64F6-39CF-4342-B508-D99C57D9CDF0 12/22/2020 Senior Buyer DIRECT FIELD COST REV2. Extension of Monorail Change Order material labor rental / sub Unit Total Total Total Unit Sub / Rental Unit MH Loc.Description Qty Unit Mat'l Labor Mat'l Labor Unit Composit Rate Analysis NA Qty Description Extension of Monorail Change Order 1.000 5 ton Monorail I- beam & Angle Iron (freight included)1 LS - 6,000.00 - - 6,000.00 - 2.000 Additional material installation 13 HRS 13.00 88.00 - 169.00 1,144.00 - - - - - - - - - - - - - - - - - - - - - Subtotal - 6,169.00 1,144.00 Burden 35%400.40 Subtotal - 6,169.00 1,544.40 Subtotal - Sub/Rental + Labor + Material 7,713.40 Overhead 10%771.34 Subtotal 8,484.74 Profit 10%848.47 Subtotal 9,333.21 Bond 1.5%140.00 Subtotal 9,473.21 Insurance 2%189.46 Total 9,662.68 Days Extra 21.00 Job:Hickory Creek LS Item:REV2. Extension of Monorail Change Order Sht.1 of 1 Contractor Approval By:________________________________ By:________________________________ Title:_______________________________ Title:_______________________________ Date:______________________________ Date:______________________________ Unit Sub DocuSign Envelope ID: 659F64F6-39CF-4342-B508-D99C57D9CDF0 Project Manager 12/21/2020 12/22/2020 Senior Buyer THIS AGREEMENT HAS BEEN BOTH REVIEWED AND APPROVED as to financial and operational obligations and business terms. _______________ ________________ SIGNATURE PRINTED NAME __________________________________ TITLE __________________________________ DEPARTMENT DocuSign Envelope ID: 659F64F6-39CF-4342-B508-D99C57D9CDF0 Interim Director Water/Wastewater Terrance Naulty Utilities Certificate Of Completion Envelope Id: 659F64F639CF4342B508D99C57D9CDF0 Status: Completed Subject: ***Purchasing Approval*** 6894--1st Amendment Source Envelope: Document Pages: 4 Signatures: 4 Envelope Originator: Certificate Pages: 5 Initials: 0 Crystal Westbrook AutoNav: Enabled EnvelopeId Stamping: Enabled Time Zone: (UTC-06:00) Central Time (US & Canada) 901B Texas Street Denton, TX 76209 crystal.westbrook@cityofdenton.com IP Address: 198.49.140.104 Record Tracking Status: Original 12/21/2020 3:47:20 PM Holder: Crystal Westbrook crystal.westbrook@cityofdenton.com Location: DocuSign Signer Events Signature Timestamp Crystal Westbrook crystal.westbrook@cityofdenton.com Senior Buyer City of Denton Security Level: Email, Account Authentication (None) Completed Using IP Address: 198.49.140.104 Sent: 12/21/2020 3:53:31 PM Viewed: 12/21/2020 3:53:52 PM Signed: 12/21/2020 3:54:42 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Sergio Conchas Jr. sergioc@reymarconstruction.com Project Manager Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 66.169.179.199 Sent: 12/21/2020 3:54:43 PM Viewed: 12/21/2020 6:19:42 PM Signed: 12/21/2020 6:28:47 PM Electronic Record and Signature Disclosure: Accepted: 12/21/2020 6:19:42 PM ID: d72cd517-8df6-4bfd-bb21-c003e02b0e20 Terrance Naulty terrance.naulty@cityofdenton.com Interim Director Water/Wastewater City of Denton Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 149.20.251.196 Sent: 12/21/2020 6:28:49 PM Viewed: 12/22/2020 8:28:00 AM Signed: 12/22/2020 8:28:47 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Crystal Westbrook crystal.westbrook@cityofdenton.com Senior Buyer City of Denton Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 198.49.140.104 Sent: 12/22/2020 8:28:48 AM Viewed: 12/22/2020 8:30:46 AM Signed: 12/22/2020 8:30:55 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 Annie Bunger annie.bunger@cityofdenton.com Contract Control Specialist City of Denton Security Level: Email, Account Authentication (None) Sent: 12/22/2020 8:30:57 AM Viewed: 12/22/2020 8:37:27 AM Electronic Record and Signature Disclosure: Not Offered via DocuSign Cheyenne Defee cheyenne.defee@cityofdenton.com Contract Administrator City of Denton Security Level: Email, Account Authentication (None) Sent: 12/22/2020 8:30:57 AM Viewed: 12/22/2020 9:00:21 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 12/21/2020 3:53:31 PM Certified Delivered Security Checked 12/22/2020 8:30:46 AM Signing Complete Security Checked 12/22/2020 8:30:55 AM Completed Security Checked 12/22/2020 8:30:57 AM 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. 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