09-204.00 Inland Asphalt: Pines-Mansfield Corridor Congestion ReliefWashbltgton State
VAf Department of Transportation
Change Order
Date 8/12/2
Page I of 3 Pages
Contract Number 08 -016 Federal Aid Number
Contract Title Pines - Manfield Corridor Congestion Relief Project
CM -9932 (032)
Change Order Number
Prime Contractor Inland Asphalt
32
IZ Ordered by Engineer under the terms of Section 1 -04.4 of the Standard Specifications
❑ Change proposed by Contractor
Endorsed By
- I
Contr�act
Date
Original Contract Amount
Current Contract Amount
Estimated Net Change This Order
Estimated Contract Total After Change
3,061,916.95
3,288,37
22,400.00
3,310,7
Approval Required ❑ Region ❑ Olympia Service Center iZ 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.
(�I! Approval Recommended Approved
Project En9in��
Date
Approved
ApprovMAuthod C.A. Agreement
Data
Approval Recommended Approved
Other Approval When Required
By
Signature Date
Date
Representing
DOT Form 140 -005 EF
Revised 10/97
C 09 -2Dy
CHANGE ORDER
Page 2 of 3
Contract No: 08 -016
This Contract is revised as follows:
Description of Work
Change Order No. 32
This Change Order compensates the Contractor for costs incurred due to utility delays
associated with the Contract.
Payment
Payment shall be made for the following items:
New contract item:
"Project Management Compensation ", Per Day.
Contract Time
Forty (40) Working Days will be added to the Contract as a result of this Change
Order.
c
Contract No: 08 -016
Item No. I Group No.
NEW 1
NEW 5
CHANGE ORDER
Item Description
Project Management Compensation
Project Management Compensation
Page 3 of 3
Change Order No. 32
Unit
Unit Price
Est. Qty.
Est. Amt. Change
Measure
Change
DAY
$560.00 15
$ 8,400.00
DAY
$560.00 25
$ 14,000.00
TOTAL $22,400.00