09-054.00 Inland Asphalt: Pines Mansfield Congestion Relief
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Contract Number Contract Title Federal Aid Number
TA-2942 Pines - Mansfield Corridor Congestion Relief Project CM-9932(032)
Change Order Number Change Description Date 15 Pines/Mansfield Rt. Tum Lane Widening Apr 3, 2009
Region Project Engineer Phone Number
Eastern Region Steven M. Worley , 509-688-0198
Prime Contractor / Design-Builder
Inland Asnhalt ComDanv ,
0 Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications or the RFP
❑ Change proposed by Contractor / Design-Builder
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Change Description
The General Special Provisions for this project are supplemented as follows: '
Description .
Provide additional earthwork to facilitate the lengthening of the right tum lane for eastbound Mansfield Avenue.
Payment
The lump sum ainount of $1556.63 shall be full pay for all labor, equipment, and materiars to perform the work as
specified. Contract Time 1 Working Day will be added as a result of this Change Order.
All work, materials and measurements to be in accordance with the provisions of the Contract for the type of construction
involved unless stated otherwise in this document
Original Contract Amount Current Contract Amount Est. Net Change This C.O. Est. Revised Contract Amount
$ 33,0612916.95 $ 3,1982826.70 $ 1556.63 $ 332003,383.33
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Prime Contractor / Design-Builder "
Signature or Method of Concurrence: Date Oq
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Project Engineer's Signature for Execution: Date
Distribution: Copy w/Attachments - Steven M. Worley Page 1
Copy of page 1 onty w/o Attachments - PrimeContrador / Design-Builder
" Copy w/o Attachments - ER Construction Office
DOTForm 421-005A EF Original w/o Attachments - State Construction Office
Revised 2108
C09-054