09-056.00 Inland Asphalt: Pines Mansfield Congestion Relief
Adobil Vlfash~ngton StaRe
~ Departtnent of 71rar~ort~ation Chinge Order
Date 4/21 /2009
Page 1 of 4 Pages
Contract Number 08-016 Federal Aid Number CM-9932 (032)
Contract TMe Pines-Manfield Corridor Congeshon Relief Project
Change Order Number 16
Prime Contractor Inland Asphalt
(9 Ordered by Engineer under the terms of Section 1-04 4 of 4he Standard Specifications
❑ Change proposed by Contractor
Endorsed By Surety Consent
C ~ •
Contredffr-- 4/ ~ Attomey on Fact
Dete Date
,
Ongmai Contract Amount 39061,916 95
Current Contract Amount 391559298 13
Estimated Net Change This Order 1186480
Estimated Contract Total After Change 391579162 93
Approval Required ❑ Region ❑ Olympia Service Center Z Local Agency
If the amount authorized m the Local Agency Agreement is exceeded and federal funds are not available for this
change, the Local Agency wnll assume the total cost of this Change Order
F-] Approval Recommended ~ Approved
Ap oved i d-~L
Project Engineer provl utho per C A. Agreement
Dete Date
F-] Approval Recommended F-] Approved Other Approval When Required
8y S(gnature Oate
Date RepreserUng
DOT Form 140-005 EF '
Revised 10/97
C09-056
CHANGE ORDER
Page 2 of 4
Contract No: 08-016 Change Order No. 16
This Contract is revised as follows:
Description of Work
The Contractor shall install Truncated Domes - ADA Tactile Waming tiles at the
locations shown on the attached Plan. The tiles shall be 24 inches by 48 inches and
yellow in color.
Measurement
Truncated Domes - ADA Tactile Wamings shall be measured per each
Payment
Payment shall be made for each of the following items
New contract items:
"Truncated Domes - ADA Tactile Waming", per each.
Contract Time
Contract time will not be adjusted as a result of this Change Order
Attachments
Plan Sheet MD1.
CHANGE ORDER
Page 3 of 4,
Contract No: 08-016 Change Order No.16
Item No Group No. Item Descnption Uni4 Unit Price Est Qty. Est Amt Change
IMeasure Change
NE1N 1 Truncated Domes - ADA Tactde Wammgs EACH $207 20 7 $1,450 40
NEW 3 Truncated Domes - ADA Tacble Wammgs EACH $207 20 2 $ 41440
TOTAL $19864.80
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TA I 9
N~T TO SCAtE Plat 2
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