09-203.00 Inland Asphalt: Pines-Mansfield Corridor Congestion ReliefWashington State
Alli
7 Department of Transportation
Change Order - Minor Change
Contract Number
Contract Title
Federal Aid Number
TA - 2942
Pines - Mansfield Corridor Congestion Relief Project
CM 9932(032)
Change Order Number
Change Description
Date
35
Rock Excavation for Signal Installation
Oct 26, 2009
Region
Project Engineer
Phone Number
Eastem Region
Steven M. Worley
509- 688 -0198
Prime Contractor
Inland Asphalt Company
® Ordered by Engineer under the terms of Section 1 -04.4 of the Standard Specifications
❑ Change proposed by Contractor
Change Description
The General Special Provisions for this project are supplemented as follows:
Description
This Change Order compensates the Contractor to excavate rock encountered during trenching for during installation
of signal and loop lead -ins at the Pines - Mansfield intersection.
Payment
The lump sum amount of $1,905.00 shall be full pay for all labor, equipment and materials to perform the work
specified.
Contract Time
Contract time will not be adjusted as a result of this Change Order.
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
$ 3,321,111.72
$ 1,905.00
$ 3,323,016.72
Prime Contractor Signature or
Method of Concurrence: � _�k
Project Engineer's Signature for Execution:
Distribution: Original w /Attachments - Steven M. Worley
Copy of page 1 only w/o Attachments - Inland Asphalt Company
Copy w/o Attachments - ER Construction Office
DOT Form 421 -005A EF Copy w/o Attachments - State Construction Office
Revised 412002
Date t OS 264
Date 01 ( o1
Page 1
Cog - 203