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09-100.00 Inland Asphalt: Pines Mansfield Congestion Relief ~ Washington State ~ Department of Transportation Change Order - Minor Change Contract Number Contract Title Federal Aid Number TA-2942 Pines-Mansfield Corridor Congestion Relief Project CM-9932(032) Change Order Number Change Description Date 27 Pull conductors for RR signal interconnection May 21, 2009 Region Project Engineer Phone Number Eastern Region Steven M. Worley 509-688-0198 Prime Contractor Inland Asphalt Company - ~ 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 The Contractor shall pull in conductors in the existing conduit to allow for railroad signal interconnect Payment The lump sum amount of $1,120.31 shall be full pay for all labor, equipment and materials to perform the work specified. Contract Time Contract time will not be adjusted as a result of this Change Order. 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 Contract Amount Est. Net Change This C.O. Est. Revised Contract Amount $ 3,061,916.95 $ 3,256,504.69 1,120.31 $ 3,257,625.00 Prime Contractor Signature or Method of Concurrence: Date • • 0 ' Project Engineer's Signature for Execution: ~ . Date 9 Distribution: Original w/Attachments - Steven M. Worley Copy of page 1 only w/o Attachments - Inland Asphalt Company Page 1 Copy w/o Attachments - ER Construction Office DOT Form 421-005A EF Copy w/o Attachments - State Construction Office Revised 4/2002 ~~0 cDq -