7252 - Change Order 3 Executed
Docusign Transmittal Coversheet
File Name
Purchasing Contact
Contract Expiration
DocuSign Envelope ID: 94304CF7-A48C-4393-8F91-713360C360F4
7252 - Hickory Creek Interceptor 1&2 - CO#3
N/A
Cori Power
Contractor:Mountain Cascade of Texas
11729 E. FM 917
Alvarado, TX 76009
Jamie Voris
Hickory Creek Interceptor Phase I & II CHANGE ORDER NO.3
7252 CIP/ENG#880004-1 PO #:196842
Contract BID Amount:7,175,985.00$ Prior Approved Other Funded CO's:-$
5% Contingency Amount:358,799.25$ Current Contract Amount w CO's:7,175,985.00$
Total NTE Amount : 7,534,784.25$ This CO Other Funding Request:-$
Prior Approved CAA's:100,667.63$ Total Change Request:50,000.00$
Available Contingency:258,131.62$
This CAA Request:50,000.00$ Orig Contract Days:This CO Days Request:0
Contingency Remaining:208,131.62$ Approved CO Days:New Contract Days:519
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
-$
$0.00
40 NEW Insurance Deductible LS 1 50,000.00$ 50,000.00$
TOTAL CAA QTY CHANGES:
NEW ITEMS OF WORK
154
PROJECT SCOPE AND REASON FOR CHANGE
Project Scope
included in Contract:
Install approx. 13,000 linear feet of 36", 42", and 54" gravity sewer main, 3-barrel siphon structure, and supporting
appurtenances
To fullfull the 195 Denton Partners indemnity agreement between City, Contractor, and Property Owner. As part of the conditions, City of
Denton agrees to pay Mountain Cascade of Texas their policy deductible ($50,000) if/when needed. The following summarizes the full provision
as agreed to by the City of Denton Project Management Team, Legal review, and Risk review:
As part of the coordination, the following verbiage outlines the agreed provision by the City of Denton and Mountain Cascade of Texas: The
attached “Release, Indemnity and Assumption of Risks” agreement to be execute by and between 195 Denton Partners, LLC and Mountain
Cascade of Texas LLC, is hereby added to the Contract under the following provisions.
No indemnity, hold harmless or defense obligations shall commence related to any claims on the project involving the “Release, Indemnity and
Assumption of Risks” agreement associated with the property recorded in Document No. 2016-33855 of the Official Records of Denton County,
Texas (O.R.D.C.T.) until all deductible amounts have been paid by the City of Denton as such deductibles become due and owing by indemnitor.
In the event that such funds are not paid to indemnitor in time to respond to any legal or other proceedings that damage the indemnitor, all
such costs shall be paid by project owner and/or indemnitees and all obligations shall terminate; provided, however, indemnitor would be
obligated to provide notice to City of Denton within a reasonable period of time to allow the City of Denton to make any required payments.
Mountain Cascade hereby agrees that if a claim on the project involving the “Release, Indemnity and Assumption of Risks” agreement associated
with the property recorded in Document No. 2016-33855 of the Official Records of Denton County, Texas (O.R.D.C.T.) (the “Indemnity
Agreement”) occurs, Mountain Cascade will provide reasonable notice to the City of Denton. After such notice is provided, City of Denton will
pay the applicable deductible to Mountain Cascade not to exceed $50,000 for each policy providing coverage or in the event of no coverage.
Mountain Cascade will then use such funds to pay the relevant deductible to their insurance company or expense arising from the Indemnity
Agreement and will be obligated to act in accordance with the Indemnity Agreement.
CONTINGENCY ALLOWANCE AUTHORIZED (CAA) CONTRACT CHANGES
QUANTITY CHANGES TO EXISTING ITEMS
Description of work
Reason for change:
8/2/2021 1/3/2023 1/3/2023
365
Attn: Tracy L. Beck, P.E./Capital Projects
Project:
IFB#
Notice To Proceed Issued:Current Completion Date:New Completion Date:
CITY OF DENTON CHANGE ORDER FORM
City of Denton - Capital Projects
401 N Elm Street
Denton, TX 76201
DocuSign Envelope ID: 94304CF7-A48C-4393-8F91-713360C360F4
$50,000.00
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
$0.00
-$ -$
$0.00
$50,000.00
7,175,985.00$
7,534,784.25$
Hickory Creek Interceptor Phase I & II 150,667.63$
-$
7,326,652.63$
41.99%
2.10%
0%
SUBMITTED BY:_______________________________
ACCEPTED BY CITY ENGINEER/DIRECTOR OF CAPITAL PROJECTS _______________________________
ACCEPTED BY CONTRACTOR: ____________________________________________________________
Name, Title
PURCHASING:_______________________________
Signature
THE AFOREMENTIONED CHANGE, AND WORK AFFECTED THEREBY,
IS SUBJECT TO ALL CONTRACT STIPULATIONS AND COVENANTS.
Project Manager
Signature
Signature
TOTAL OTHER FUNDED QTY CHANGES:
Percent Changes over NTE:
TOTAL OTHER FUNDED NEW ITEMS:
TOTAL CO AMOUNT:
Original BID/Contract Amount:
Original Total Not To Exceed Amount:
Total CAA's:
NEW ITEMS OF WORK
Total CO's:
Revised Contract Amount:
% of CAA Approved To-Date:
Total Change Order over Original Bid:
OTHER FUNDED CONTRACT CHANGES (CO)
QUANTITY CHANGES TO EXISTING ITEMS
Description of work
Contingency funds are used at City's discretion per contract spec language TOTAL CAA NEW ITEMS:
DocuSign Envelope ID: 94304CF7-A48C-4393-8F91-713360C360F4
Vice-PresidentAndrew McCulloch
2/16/2022
Certificate Of Completion
Envelope Id: 94304CF7A48C43938F91713360C360F4 Status: Completed
Subject: ***Purchasing Approval*** 7252 - Hickory Creek Interceptor 1&2 - CO#3
Source Envelope:
Document Pages: 3 Signatures: 4 Envelope Originator:
Certificate Pages: 5 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
2/15/2022 2:53:09 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: 2/15/2022 2:56:29 PM
Viewed: 2/15/2022 2:56:36 PM
Signed: 2/15/2022 2:56:47 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: 2/15/2022 2:56:49 PM
Viewed: 2/15/2022 2:59:59 PM
Signed: 2/15/2022 3:00:14 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Tracy L Beck
Tracy.Beck@cityofdenton.com
Project Mngr
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 198.49.140.104
Sent: 2/15/2022 3:00:15 PM
Viewed: 2/15/2022 3:00:45 PM
Signed: 2/15/2022 3:01:40 PM
Electronic Record and Signature Disclosure:
Accepted: 2/15/2022 3:00:45 PM
ID: fd46eef1-1031-49db-bc79-3b4b4098c398
Andrew McCulloch
AMcCulloch@mountaincascade.com
Vice-President
Harber Co.Inc. dba Mountain Cascade of Nevada
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 12.219.70.204
Sent: 2/15/2022 3:01:42 PM
Viewed: 2/15/2022 4:03:46 PM
Signed: 2/15/2022 4:19:54 PM
Electronic Record and Signature Disclosure:
Accepted: 2/15/2022 4:03:46 PM
ID: 879718d7-8c6c-4c3e-aac8-76426798e55f
Signer Events Signature Timestamp
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: 47.222.20.2
Signed using mobile
Sent: 2/15/2022 4:19:56 PM
Viewed: 2/16/2022 5:57:10 AM
Signed: 2/16/2022 5:57:41 AM
Electronic Record and Signature Disclosure:
Accepted: 2/16/2022 5:57:10 AM
ID: 4930f87b-af0f-4684-a469-cb4b771f0814
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: 198.49.140.104
Sent: 2/16/2022 5:57:42 AM
Viewed: 2/16/2022 8:26:57 AM
Signed: 2/16/2022 8:27:02 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: 2/16/2022 8:27:05 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 2/15/2022 2:56:29 PM
Certified Delivered Security Checked 2/16/2022 8:26:57 AM
Signing Complete Security Checked 2/16/2022 8:27:02 AM
Completed Security Checked 2/16/2022 8:27:05 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. 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: Tracy L Beck, Andrew McCulloch, Rebecca Diviney
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.