09-138.00 Inland Asphalt: Pines-Mansfield Corridor Congestion Relief
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t Washington State Change O e
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Departmerrt of TYansportation Date 8/12/2009
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 31
Prime Contractor Inland Asphalt
~ 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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Contractor t// Attomey on Fact
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0° 4-n I
Date I Date
Original Contract Amount 3,061,916.95
Current Contract Amount 3,278,386.32
Estimated Net Change This Order 5,201.28
Estimated Contract Total After Change 3,2833587.60
Approval Required [I Region ❑ Olympia Service Center ~ 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.
~ Approval Recommended F-] Approved Approved
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ProJect Englneer Approving Authority per C.A. Agreement
2~ ~~v d 9 k' ~ ?~d
Date ~
Date
F] Approval Recommended F-] Approved Other Approval When Required
By Stgnature
Date
Date RepTesent(ng
DOT Form 140-005 EF
Revised 10/97
rCoo) - 13~
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CHANGE ORDER
Page 2 of 3
Contract No: 08-016 Change Order No. 31
This Contract is revised as follows:
Description of Work
The Contractor shall install an additional curb wall along Mansfield Avenue. The
additional curb wall shall extend from the previously constructed curb wall to
approximately Station M 21 +25. The additional curb wall shall be approximately 130
LF.
The work shall include any excavation necessary to complete the additional curb wall.
Payment
Payment shall be made for the following item:
New contract item:
"Additional Curb Wall", Lump Sum.
Contract Time '
Contract tirne will not be adjusted as a result of this Change Order.
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CHANGE ORDER
Page 3 of 3
Contract No: 08-016 Change Order No. 31
Item No. Group No. Item Description Unit Unit Price Est. Qty. Est. Amt. Change
Measure Change
NEUV 5 Additional Curb Wall L.S 5,201.28 1 $ 5,201.28
TOTAL $5,201.28