09-079.00 Inland Asphalt: Pines Mansfield Congestion Relief
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Washington State
v7AW 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
20 Cold Weather Protection - October May 6, 2009
Region Project Engineer Phone Number
Eastern Region Steven M. Worley 509-688-0198
Prime Contractor
Inland Asphalt Company
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~ 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 protect concrete in accordance with their proposed cold weatber protection plan
Payment
The lump sum amount of $1,624.00 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 provislons of the Siandard 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
$ 390613916.95 $ 3,202,733.99 1,624.00 $ 392049357.99
Prime Contractor Signature or
Date • a°~
Method of Concurrence: ~
Project Engineer's Signature for Execution: Date
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Distribution: Original w/Attachments - Steven M. Woriey
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