09-078.00 Inland Asphalt: Pines Mansfield Congestion Relief
~ Washington State
Department of Transportation Change Order - Minor Change
tract Number Contract Titie ~ Federal Aid Number
~ TA-2942 Pines-Mansfield Corridor Congestion Relief Project CM-9932(032)
ange Order Number Change Description Date
19 Bike Ramp Curb Revisions at Roundabout May 6, 2009
t Region Project Engineer Phone Number
Eastern Region Steven M. Worley 509-688-0198
r Prime Contractor
Inland Asphalt Company
N 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:
f
' Description
Revise the sidewalk bike ramps per the attached plan sheet.
Payment
The lump sum amount of $2,612.96 shall be full pay for all labor, equipment and materials to perform the work specified. .
Contract Time
One (1) additional contract day will be added as a result of this Change Order.
All work, materials and measurements to be in accordance with the provlslons of the Standard Specifications and Special
Provisions for the type of construction involved unless stated otherwise In thls document.
Original Contract Amount Current Contract Amount Est. Net Change This C.O. Est. Revised Contract Amount
$ 35061,916.95 $ 31200,121.03 $ 21612.96 $ 3,202,733.99
Ottachments Prime Contractor Signatu re or Method of Concurrence: Date ~
Project Engineer's Signature for Execution: Date Distribution: Original ven 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
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