08-157.00 Inland Asphalt: Pines-Mansfield Corridor Congestion Relief
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Washington State
W/ Department ot Transportation Change Order - Minor Change
Contrect Number Contract Title Federal Aid Number
TA-2942 Pines-Mansfield Corridor Congestion Relief Project CM-9932(032)
Change Order Number Change Description Date
8 SubQrade Repair - CDF Nov 12, 2008
Region Project Engineer Phone Number I
Eastern Region Steven M. Worley 509-688-0198 j
Prime Contractor I
Inland Asnhalt Company
0 Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications
❑ Change proposed by Contractor
Change Description The General Special Provisions for this project are supplemented as follows:
Description
Pill the void found in the subgrade vicinity Station P 34+00 with controlled density fill.
Payment
The lump sum amount of 335.83 shall be full pay for all labor, equipment and materials [o perfor the work specified.
All work, materials and measurements to be in accordance with the provisions of the Standard Specifications and Special
Provisions for the type of construction involved unless stated otherwise in this document.
Original Contract Amount Current CoMract Amount Est. Net Change This C.O. Est. Revised Contract Amount
$ 3,061,916.95 $ 3,134,217.90 $ 335.83 $ 3,134,553.73
Prime Contractor Signature or
Method of Concurrence: \ (I VS!/1---/..' Date
Project Engineer's Signature for Execution: Date J2
Distnbution: Original wlAttachments - Steven M. Worley
Copy o( page 1 only w/o Attachments - Inland Asphalt Company Page 1
Copy w/o Attachments - ER Construclion Ofice
DOTForm 421-005A EF Copy w/o Attachments - State ConstruMion Ofice
Revised 4/2002 -
I C0$'157