09-083.00 Inland Asphalt: Pines Mansfield Congestion Relief
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~~Swn~o, ~te Change O r
der
Qepartnerrt of Transportation .
Date 5/6/2009
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 11
Prime Contractor Inland Asphalt
0 Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications
❑ Change proposed by Contractor
Endorsed By Surety Consent
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CanUecto ~ U Attomey on Fact
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Date ( Date
Original Contract Amount 3,061,916.95
Current Contract Amount 3,178,521.80
Estimated Net Change This Order 14,300.00
Estimated Contract Total After Change 3,192,821.80
Approval Required ❑ Region ❑ Olympia Service Center (Z 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.
(~0 Approval Recommended L] Approved Approve
Project Englneer Approving uthority e C.A. Agreement
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Date oa'te '
❑ Approval Recommended ~ Approved Other Approval When Required
gy Slgnature Date
Date Representing
DOT Form 140-005 EF
Revised 10/97
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CHANGE ORDER
Page 2 of 3
Contract No: 08-016 Change Order No. 11
This Contract is revised as follows:
Description of Work
In accordance with, and at the direction of Spokane County, the sanitary sewer
system located on the northeast corner of the Pines/Mansfield intersection, and the
sanitary sewer system located at the Perrine Court apartments shall be revised.
Materials
All materials necessary to complete the work shall be approved by Spokane County.
Measurement
No specific unit of ineasure will apply to the lump sum items, Sanitary Sewer Revision
- Pines/Mansfield Intersection and Sanitary Sewer Revision - Perrine Court
Apartments.
Payment
Payment will be made for each of the following new contract items:
"Sanitary Sewer Revision - Pines/Mansfield Intersection," lump sum
"Sanitary Sewer Revision - Perrine Court Apartments," lump sum
Contract Time
One (1) working day will be added to Contract Time as a result of this Change Order.
Attachments
None
s'
CHANGE ORDER
Page 3 of 3
Contract No: 08-016 Change Order No.11
Item No. Group No. Item Description Unit Unit Price Est. Qty. Est. Amt. Change
Measure Change
NEW 6 Sanitary Sewer Revision - Pines/Mansfield Intersection LS $10,380.00 1 $10,380.00
NEW 5 Sanitary Sewer Revision - Perrine Court Apartments LS $3,920.00 1 $3,920.00
TOTAL $14,300.00