09-148.00 Inland Asphalt: Pines-Mansfield Corridor Congestion Relief r
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Washington State
~ Department of Transportation Change Order - Minor Change
Contract Number Contract Title Federa! Aid Number
~ TA _2942 Nines-Mansfield Corridor Congestion Relief Project a ! CM-9932(032) ~
Change Order Number Change Description Date
34 Fence Tie-in Repairs Aug 21, 2009
Region Project Engineer Phone Number
Eastei•n Kegion Steven M. Worley 509-688-0198
Prime Contractor
Inland Asphalt Company
9 Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications
❑ Change proposed by Contractor
Change Description
The Genera) Special Provisions for this pmject are supplcmented as follows:
Description
The Contractor shall repair existing fence tie-ins that were removed to facilitate construction on Manstield.
Payment
The lump sum amoimt of $4792.12 shall be full pay for all ]abor, equipmcnt and materials to perform the work
specified.
Contract 'T'ime
Contract time will not bc adjusted as a result of this Changc; Order.
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All work, materials and measurements to be in accordance with the provisions of the Standard 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
$ 3,061,916.95 $ 3,348,785.04 4,792.12 $ 3,353,577.16
Prime Contractor Signature or Date 6~ - ~q
Method of Concurrence: Z] ~ ~
Project Engineers Signature for Execution: , Date
Distribution: Original w/Attachments - Steven 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 wlo Attachments - State Construction Office
Revised 412402
609- 1 ~ 9