09-096.00 Inland Asphalt: Pines Mansfield Congestion Relief
der
W ~e Change O r
Qep~rtmerrt of T~ansportation Date 5/21/2009
Page 1 of 3 Pages
Contract Number 08-016 Federal Aid Number CM-9932 (032)
Contract Title Pines-Manfield Corridor Congestion Relief Project
Change Order Number 26
Prime Contractor Inland Asphalt
IgJ Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications
❑ Change proposed by Contractor
Endorsed By Surety Consent r ~
~ .
ConVactar Attomey on Facl
\i oQVt 62. 17.061
Date ~ Date
Original Contract Amount 3,061,916.95
Current Contract Amount 3,243,221.12
Estimated Net Change This Order 13,283.29
Estimated Contract Total After Change 352563,504.41
Approval Required ❑ Region ❑ Olympia Service Center N Local Agency
If the amount authorized in the Local Agency Agreement is exceeded and federal funds are not available for this
change, the Local Agency will assume the total cost of this Change Order.
NI Approval Recommended ~ Approved Approved 20
-e ~
`
Project E er A~roving Authortiy per C. . reemerrt
3J„~,o ~ 117
~
ogte - oate i
F~ Approval Recommended F-] Approved Other Approval When Required
By Signeture Date
Date RepresenUng
DOT Form 140-005 EF
Revised 10197
CO~j- O~~
CHANGE ORDER
Page 2 of 3
Contract No: 08-016 Change Order No. 26
This Contract is revised as follows:
Description of Work
The Contractor shall install two (2) full-length and one (1) half-length 4-inch, schedule
80 PVC conduits across Pines Avenue at the UPRR crossing. The Contractor shall
patch back the crossing with HMA
Measurement
No specific unit of ineasure will be made for the lump sum item Additional Conduit for
UPRR Crossing.
Payment
Payment shall be made for the following item:
New contract item:
"Additional Conduit for UPRR Crossing", lump sum.
Contract Time
Contract time will not be adjusted as a result of this Change Order
• ~
CHANGE ORDER
Page 3 of 3
Contract No: 08-016 Change Order No. 26
Item No. Group No. Item Description Unit Unit Price Est. Qfiy. Est. Amt. Change
Measure Change
NEW 1 Additional Conduit for UPRR Crossing L.S. $13,283.29 1 $ 13,283.29
TOTAL $13,283.29