09-132.00 Inland Asphalt: Pines Mansfield Congestion Relief
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Washington State
W/ Department of Transportation C h a n g e O rd e r- M i n o r C h a n g e
Contract Number Contract Title Federal Aid-Number
TA-2942 Pines - Mansfield Corridor Congestion Relief Project CM-9932(032)
Change Order Number . Change Description Date
29 1V.Iiscellaneous Signing Revisions Jul 29, 2009
Region Project Engineer Phone Number
Eastern Region Steven M. Worley , 509-688-0198,
Prime Contractor / Design-Builder
Inland Asahalt Companv .
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Z Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications or the RFP
❑ Change proposed by Contractor / Design-Builder Change Description '
The General Special Provisions for this project are supplemented as follows:
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D'escription
This Change Qrder conmpensates the Contractor for costs associated with revisions to Item #69, Permanent
. Signing. _
Payment
The lump sum amount of $2,961.81 shall be fiill pay for all labor, equipment, and materials to perform the work as specifi,ed. .
Contract Time
Contract time will iiot be adjusted as a result of this Change Order.
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. All work, materials and measurements to be in accordance with the provisions of the Contract for the type of construction
involved unless stated otherwise in this document.
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Original Contract Amount Current Contract Amount Est. Net Change This C.O. Est. Revised Contract Amount
$ 3,061,916.95 $ 3,272,245.96 - $ 2,961.81 $ 3,275,207.77
Prime Contractor / Design-Builder
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Signature or Method of Concurrence: ~'Date ~.o
Project Engineer's Signature for Execution: . Date O~ Distribution: Copy w/Attachments - Steven M. Worley .
Copy of page 1 only w/o Attachments - PrimeContractor / Design-Builder Page 1
' Copy w/o Attachments - ER Construction Office
DOTForm 421-005A EF Original w/o Attachments - State Construction Office , (?j2-
Revised 2/08 .