23-039.04NorthForkEnterprisesSullivanRd Improvementsart aF ��
Spokane
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ENGINEERING DIVISION
CHANGE ORDER NO: 4
CONSTRUCTION CONTRACT NO: 23-039
PROJECT: Sullivan Rd Improvements CONTRACT DATE: 4/25/2023
PRIME CONTRACTOR: North Fork Enterprises CIP NO: 340
Item No. Description
C04.1 Additional Sowcutting
MaB Quentl Unit Price
LS 1 $649.60
ICI
649.60
Sales Tax $ N/A
Total Amount of this Change Order (Incl. Tax): $ 649.60
APPROVALVFRBAL
Independent Justification on File Yes
Verbal Approval __ WA Verbal Approval by.__. N/A
Original Contract Working Days: -_-_I00__
Revisions by Prior Change Orders: ........ 0-.__...
Revision By This Change Order:
Total Revised Contract Working Days:
CHANGES RESULT IN THE FOLLOWING ADJUSTMENTS OF TOTAL CONTRACT AMOUNT:
ORIGINAL TOTAL CONTRACT AMOUNT $
TOTAL PRIOR CONTRACT CHANGE ORDER AMOUNT (through cQn_I _ + _ $
TOTAL CONTRACT AMOUNT PRIOR TO THIS CHANGE ORDER $
NET THIS CHANGE ORDER _ _ _ _ $
TOTAL CONTRACT AMOUNT INCLUDING THIS CHANGE ORDER $
3,820,971.36
0.00
3,820,971.36
649.60
3,821,620.96
CONTRACTOR ACCEPTANCE: �.�L_.'"` DATE:
The contractor hereby accepts this adju tment un er the terms of Section 1-04.4 of the original contract.
RECOMMENDED BY: i DATE: ��Z S 7�3
l 'Project Manager ( J
APPROVED BY: i-f `�' nG'v DATE: 7/ 2. S / �3
CityFEngineer
APPROVED BY: DATE:
City Manager
ATTACHMENTS:
Distdburion: ORIGINAL TO: City of Spokane Valley Clerk's Office
COPIES TO: Contractor, PW Project File, Project Inspector, Finance Department