6903 - Change Order 1 Executed
Docusign City Council Transmittal Coversheet
File Name
Purchasing Contact
City Council Target Date
Piggy Back Option
Contract Expiration
Ordinance
DocuSign Envelope ID: 4FDDB782-A6F8-4BC7-BC76-BBD8E05EECE6
Not Applicable
HICKORY CREEK WEST CONSTRUCTION - CO#1
Cori Power
IFB 6903
N/A
NOVEMBER 16, 2021
21-2393
Contractor:Jagoe Public
PO BOX 250
Denton, TX 76202
Mike Albert
Hickory Creek Rd PH II (West)CHANGE ORDER NO.1
6903 PO #: 188795
880008 Date Prepared: 02/01/2021
Contract BID Amount:5,320,870.00$
5% Contigency Amount:-$
Prior Approved CAA's:-$
Available Contingency:-$
-$ 360
Contingency Remaining:-$ 720
Item
No.Spec. Section No. UOM BID QTY +/- QTY Unit Price Extended Price
EA ‐$
$0.00
‐$ ‐$
$0.00
Item
No.Spec. Section No. UOM BID QTY +/- QTY Unit Price Extended Price
2 808 LS 1 2 22,000.00$ 44,000.00$
5 808 MO 36 5 2,800.00$ 14,000.00$
10 203.2 CY 7,848 1,000 14.00$ 14,000.00$
54 TX 666 LS 1 1 24,500.00$ 24,500.00$
26 TS‐07 LF 839 427 15.50$ 6,618.50$
$103,118.50
501.6 LF 79 92.00$ 7,268.00$
12" C900 DR 14 PVC Water Line LS 1 34,649.00$ 34,649.00$
TX 110 CY 2,800 5.00$ 14,000.00$
702 EA 2 1,825.00$ 3,650.00$
W7 Lower 12" Water Main LS 1 5,275.00$ 5,275.00$
‐$ ‐$
$64,842.00
$167,960.50
Notice To Proceed Issued:Current Completion Date:New Completion Date:
1/9/2020 1/3/2021 12/29/2021
21" Class III RCP
Embankment Fill for Bridge Headers (Import)
7'X5' Junction Box
OTHER FUNDED CONTRACT CHANGES (CO)
QUANTITY CHANGES TO EXISTING ITEMS
NEW ITEMS OF WORK
TOTAL OTHER FUNDED QTY CHANGES:
Description of work
Portable Changeable Message Signs
Unclassifeid Excavation
Striping and Pavement Markings
Traffic Control Plan and Barricades, Warnings & Sig
Contingency funds are used at City's descretion per contract spec language
Total Change Request:167,960.50$
Description of work
included in Contract:
Widening of Hickory Creek Road from two lanes to four lanes between Teasley (FM-2181) and
Riverpass.
PROJECT SCOPE AND REASON FOR CHANGE
5,320,870.00$
167,960.50$
This CO Days Request:
Dustin Draper, Project Manager
CITY OF DENTON CHANGE ORDER FORM
City of Denton - Capital Projects
901-A Texas Street
Denton, TX 76209
Project:
IFB#
CIP/ENG#
This CAA Request:
Prior Approved Other Funded CO's:-$
Current Contract Amount w CO's:
This CO Other Funding Request:
Orig Contract Days:
Approved CO Days:
360
0 New Contract Days:
Reason for change:Additional time of message boards, embankment fill for bridge headers, water line lowering,
up size in junction boxes and additional barricade time due to utility conflicts.
CONTINGENCY ALLOWANCE AUTHORIZED (CAA) CONTRACT CHANGES
QUANTITY CHANGES TO EXISTING ITEMS
TOTAL CAA QTY CHANGES:
NEW ITEMS OF WORK
TOTAL OTHER FUNDED NEW ITEMS:
TOTAL CHANGE ORDER #1:
4" Schedule 40 Irrigation Sleeve
Description of work
TOTAL CAA NEW ITEMS:
DocuSign Envelope ID: 4FDDB782-A6F8-4BC7-BC76-BBD8E05EECE6
5,320,870.00$
$167,960.50
$5,488,830.50
3.157%
Signatory Lines will be updated by Purchasing if required
SUBMITTED BY:_______________________________
ACCEPTED BY CITY ENGINEER/DIRECTOR OF CAPITAL PROJECTS _______________________________
ACCEPTED BY CONTRACTOR: _______________________________________________________________
Name, Title
CITY MANAGER:_______________________________
ATTEST: CITY SECRETERY _______________________________
PURCHASING:_______________________________
APPROVED AS TO LEGAL FORM:_______________________________
Signature
Signature
Signature
Signature
Project Manager
THE AFOREMENTIONED CHANGE, AND WORK AFFECTED THEREBY,
IS SUBJECT TO ALL CONTRACT STIPULATIONS AND COVENANTS.
Signature
Signature
Hickory Creek Rd PH II (West)
Original BID/Contract Amount:
Revised Contract Amount:
Percent Changes:
Total CAA's & CO's:
DocuSign Envelope ID: 4FDDB782-A6F8-4BC7-BC76-BBD8E05EECE6
Bill Cheek Executive Vice President
SARA HENSLEY, INTERIM CITY MANAGER
Certificate Of Completion
Envelope Id: 4FDDB782A6F84BC7BC76BBD8E05EECE6 Status: Completed
Subject: Please DocuSign: City Council Contract 6903 Hickory Creek West - CO#1
Source Envelope:
Document Pages: 3 Signatures: 7 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
10/19/2021 3:33:21 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: 10/19/2021 3:40:50 PM
Viewed: 10/19/2021 3:42:12 PM
Signed: 10/19/2021 3:43:36 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: 10/19/2021 3:43:38 PM
Viewed: 10/20/2021 4:29:33 PM
Signed: 10/20/2021 4:29:41 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Marcella Lunn
marcella.lunn@cityofdenton.com
Catherine Clifton, Interim City Attorney
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.104
Sent: 10/20/2021 4:29:43 PM
Viewed: 10/21/2021 3:16:01 PM
Signed: 10/21/2021 3:18:10 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: 10/21/2021 3:18:12 PM
Viewed: 10/21/2021 3:27:20 PM
Signed: 10/21/2021 3:27:40 PM
Electronic Record and Signature Disclosure:
Accepted: 10/21/2021 3:27:20 PM
ID: fe7b7334-60d2-482b-9cbd-60cd948b509c
Signer Events Signature Timestamp
Bill Cheek
bill.cheek@jagoepublic.com
Executive Vice President
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 75.139.243.122
Sent: 10/21/2021 3:27:41 PM
Viewed: 10/21/2021 3:59:43 PM
Signed: 10/21/2021 4:00:19 PM
Electronic Record and Signature Disclosure:
Accepted: 10/21/2021 3:59:43 PM
ID: e7cd2ded-e9a5-43a8-8e25-92039c43095e
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: 107.115.5.86
Signed using mobile
Sent: 10/21/2021 4:00:21 PM
Viewed: 10/21/2021 4:02:40 PM
Signed: 10/21/2021 4:03:11 PM
Electronic Record and Signature Disclosure:
Accepted: 10/21/2021 4:02:40 PM
ID: 57ac6346-a2c1-4838-8fec-f37fe2ecedba
Cheyenne Defee
cheyenne.defee@cityofdenton.com
Contract Administrator
City of Denton
Security Level: Email, Account Authentication
(None)
Completed
Using IP Address: 198.49.140.104
Sent: 10/21/2021 4:03:13 PM
Viewed: 11/17/2021 8:10:42 AM
Signed: 11/17/2021 8:11:04 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Sara Hensley
sara.hensley@cityofdenton.com
Interim City Manager
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 11/17/2021 8:11:07 AM
Viewed: 11/17/2021 8:13:59 AM
Signed: 11/17/2021 8:14:04 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Rosa Rios
rosa.rios@cityofdenton.com
City Secretary
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.10
Sent: 11/17/2021 8:14:06 AM
Viewed: 11/17/2021 1:08:37 PM
Signed: 11/17/2021 1:09:07 PM
Electronic Record and Signature Disclosure:
Accepted: 11/17/2021 1:08:37 PM
ID: 6393a8d5-d9e2-48fc-8fef-f15e9183c467
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: 10/19/2021 3:43:38 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Gretna Jones
gretna.jones@cityofdenton.com
Legal Secretary
City of Denton
Security Level: Email, Account Authentication
(None)
Sent: 11/17/2021 8:11:06 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
City Secretary Office
citysecretary@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Sent: 11/17/2021 1:09:09 PM
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 10/19/2021 3:40:50 PM
Certified Delivered Security Checked 11/17/2021 1:08:37 PM
Signing Complete Security Checked 11/17/2021 1:09:07 PM
Completed Security Checked 11/17/2021 1:09:09 PM
Payment Events Status Timestamps
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Electronic Record and Signature Disclosure created on: 7/21/2017 3:59:03 PM
Parties agreed to: Dusty Draper, Bill Cheek, Rebecca Diviney, Rosa Rios
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