09-137.00 Inland Asphalt: Pines-Mansfield Corridor Congestion Relief
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Washington State Change Order
~ ~ Qepartmerrt of Twansportation
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Date 8/12/2009
Page 1 of 3 Pages
Contract Number 08-016 Federai Aid Number CM-9932 (032) Contract Title Pines-Ma.nfield Corridor Congestion Relief Project
Change Order Number 30
Prime Contractor Inland Asphalt
IZ 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 ✓ U , Aitomey on Fact
Date 6f ~ Date
Original Contract Amount 33061,916.95
Current Contract Amount 3,263;748.84
Estimated Net Change This Order 14,637.48
Estimated Contract Total After Change 3,278,386.32
Approval Required (~?Region ❑ Olympia Service Center p~l 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 n Approved Approved I
Project Engineer Approving Authority per 1..-ft' Agreement
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Date Date
Q Approval Recommended n Approved Other Approval When Required
gy Signature Date
Date I Representlng
DOT Form 140-005 EF
Revised 10/97
coct_ 137
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CHANGE ORDER
Page 2 of 3
Contract No: 08-016 Change Order No. 30
This Contract is revised as follows:
Description of Work
This Change Order compensates the Electrical Subcontractor for delays incurred by
utilities that were not relocated prior to beginning of electrical work.
Payment
Payment shall be made for the following item:
New contract item:
"Equitable Adjustment - Utility Delay to Electrical Subcontractor", Lump Sum.
Contract Time
Contract time will not be adjusted as a result of this Change Order.
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CHANGE ORDER
Page 3 of 3
Contract No: 48-016 Change Order Na. 30
Item No. Group IVo. Item Description Unit lJnit Price Es#. Oty. Est, Amt. Charrge
Measure Chan-ge
NEIA! 'V Equitable Adjustrnent - Utilit5r Delay to Electrical Subcontrac#or L.S 7,318.14 1 $ 7,318.74
NEW 2 Equitable Adjustment -Utility Delay to Electrica[ Subcontractoc L.S 1,318.74 1 $ 7,318.74
TDTAL $14,$37.4$