7364 - Change Order 1 Executed
Docusign Transmittal Coversheet
File Name
Purchasing Contact
Contract Expiration
DocuSign Envelope ID: 30478B24-47B9-40AA-8391-6ADBCCBC7CF8
N/A
Cori Power
7364 ROBSON RANCH FORCE MAIN & SEWER - CO#1
Contractor:Mountain Cascade of Texas, LLC
5340 East US Highway 67
Alvarado, TX
Chris Windsor
Robson Ranch Force Main and Sewer CHANGE ORDER NO.1
7364 CIP/ENG#PO #:199363
Contract BID Amount:2,710,806.00$ Prior Approved Other Funded CO's:-$
5% Contingency Amount:135,540.30$ Current Contract Amount w CO's:
Total NTE Amount : 2,846,346.30$ This CO Other Funding Request:-$
Prior Approved CAA's:-$ Total Change Request:43,303.00$
Available Contingency:135,540.30$
This CAA Request:43,303.00$ Orig Contract Days:This CO Days Request:0
Contingency Remaining:92,237.30$ Approved CO Days:New Contract Days:300
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
20 33 14 11; 33 31 10;
33 31 14 Sanitary Sewer Gravity Main (21")LF 1,373 -87 120.00$ (10,440.00)$
-$10,440.00
29 33 14 20 EA 4 7,411.00$ 29,644.00$
30 33 14 11; 33 31 10;
33 31 14 Sanitary Sewer Pressure Rated Gravigy Main (20')LF 87 277.00$ 24,099.00$
$53,743.00
Item
No.Spec. Section No.UOM BID QTY +/- QTY Unit Price Extended Price
$0.00
-$ -$
$0.00
$43,303.00
2,710,806.00$
2,846,346.30$
Robson Ranch Force Main and Sewer 43,303.00$
-$
2,754,109.00$
31.95%
1.60%
0%
New Completion Date:
CITY OF DENTON CHANGE ORDER FORM
City of Denton - Capital Projects
401 N. Elm Street
Denton, TX 76201
Scott Fettig, Project Manager
Project:
IFB#200015-1
Notice To Proceed Issued:Current Completion Date:
QUANTITY CHANGES TO EXISTING ITEMS
3/28/2022 1/22/2023 1/22/2023
300
0
PROJECT SCOPE AND REASON FOR CHANGE
Project Scope
included in Contract:
Robson Ranch Force Main and Sewer project is an agreement between Robson Ranch and the City of Denton to install a new
sewer line to allow them to re-route current flow away from on site treatment plant and into city's collection system.
Reason for change:
Material and labor to install four isolation gate valves in the force main portion of project
CONTINGENCY ALLOWANCE AUTHORIZED (CAA) CONTRACT CHANGES
N/A
Description of work
TOTAL CAA QTY CHANGES:
NEW ITEMS OF WORK
Gate Valve (14")
Contingency funds are used at City's discretion per contract spec language TOTAL CAA NEW ITEMS:
OTHER FUNDED CONTRACT CHANGES (CO)
QUANTITY CHANGES TO EXISTING ITEMS
Description of work
TOTAL OTHER FUNDED QTY CHANGES:
NEW ITEMS OF WORK
N/A
TOTAL OTHER FUNDED NEW ITEMS:
TOTAL CO AMOUNT:
Original BID/Contract Amount:
Original Total Not To Exceed Amount:
Total CAA's:
Total CO's:
Revised Contract Amount:
% of CAA Approved To-Date:
Total Change Order over Original Bid:
Percent Changes over NTE:
DocuSign Envelope ID: 30478B24-47B9-40AA-8391-6ADBCCBC7CF8
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:_______________________________
Date: __________________________
THE AFOREMENTIONED CHANGE, AND WORK AFFECTED THEREBY,
Signature
IS SUBJECT TO ALL CONTRACT STIPULATIONS AND COVENANTS.
Project Manager
Signature
Signature
DocuSign Envelope ID: 30478B24-47B9-40AA-8391-6ADBCCBC7CF8
Vice-PresidentAndrew McCulloch
4/13/2022
Certificate Of Completion
Envelope Id: 30478B2447B940AA83916ADBCCBC7CF8 Status: Completed
Subject: ***Purchasing Approval*** 7364 Robson Ranch Force Main and Sewer CO#1
Source Envelope:
Document Pages: 3 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: 198.49.140.10
Record Tracking
Status: Original
4/12/2022 8:34:23 AM
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
Signed by link sent to cori.power@cityofdenton.com
Using IP Address: 198.49.140.10
Sent: 4/12/2022 8:41:19 AM
Viewed: 4/12/2022 8:41:31 AM
Signed: 4/12/2022 8:42:11 AM
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
Signed by link sent to lori.hewell@cityofdenton.com
Using IP Address: 198.49.140.104
Sent: 4/12/2022 8:42:13 AM
Viewed: 4/12/2022 11:03:48 AM
Signed: 4/12/2022 11:03:57 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Scott Fettig
Scott.Fettig@cityofdenton.com
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Signed by link sent to Scott.Fettig@cityofdenton.com
Using IP Address: 198.49.140.10
Sent: 4/12/2022 11:03:59 AM
Viewed: 4/12/2022 11:10:07 AM
Signed: 4/12/2022 11:10:20 AM
Electronic Record and Signature Disclosure:
Accepted: 4/12/2022 11:10:07 AM
ID: c0f8d902-8010-4bed-9265-95c7c3dd526c
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
Signed by link sent to
AMcCulloch@mountaincascade.com
Using IP Address: 32.132.177.214
Sent: 4/12/2022 11:10:21 AM
Viewed: 4/12/2022 11:10:58 AM
Signed: 4/12/2022 11:16:03 AM
Electronic Record and Signature Disclosure:
Signer Events Signature Timestamp
Accepted: 4/12/2022 11:10:58 AM
ID: e9f7a5be-0583-4b29-9209-44bb637e0a0d
Rebecca Diviney
Rebecca.Diviney@cityofdenton.com
Director of Capital Projects/City Engineer
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Signed by link sent to
Rebecca.Diviney@cityofdenton.com
Using IP Address: 107.115.147.130
Signed using mobile
Sent: 4/12/2022 11:16:05 AM
Viewed: 4/12/2022 6:06:09 PM
Signed: 4/12/2022 6:06:24 PM
Electronic Record and Signature Disclosure:
Accepted: 4/12/2022 6:06:09 PM
ID: 0c2126b9-4fbd-45e3-8668-d0ad928cfb16
Cori Power
cori.power@cityofdenton.com
Senior Buyer
City of Denton
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Signed by link sent to cori.power@cityofdenton.com
Using IP Address: 198.49.140.10
Sent: 4/12/2022 6:06:25 PM
Viewed: 4/13/2022 7:59:18 AM
Signed: 4/13/2022 7:59:49 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: 4/13/2022 7:59:51 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 4/12/2022 8:41:19 AM
Certified Delivered Security Checked 4/13/2022 7:59:18 AM
Signing Complete Security Checked 4/13/2022 7:59:49 AM
Completed Security Checked 4/13/2022 7:59:51 AM
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: Scott Fettig, Andrew McCulloch, Rebecca Diviney
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