09-218.00 Inland Asphalt: Pines-Mansfield Corridor Congestion Relief i
Adw
Washington State
~AP Department of Tlransportation
Change Order
Date 12/15/2009
Page I of 3 Pages
Contract Number 08-016 Federal Aid Number CM-9932 (032)
Contract Title Pines-Manfield Corridor Congestion Relief Project
Change Order Number 36
Prime Contractor Inland Asphalt
I] Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications
M Change proposed by Contractor
Endorsed By Surety Consent
Con Attorney on Fact
Date Date
Original Contract Amount
3,061,916.95
Current Contract Amount
3,323,016.72
Estimated Net Change This Order
160,500.00
Estimated Contract Total After Change
3,483,516.72
Approval Required 17 Region ❑ Olympia Service Center MI 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.
n Approval Recommended Approved Approved
Y'
4~~ Zell'
Project E ineer
Approving Authority per C.A. Agreement
Date
U Approval Recommended Approved
Date
Other Approval When Required
By
Signature Date
Representing
DOT Form 140-005 EF
Revised 10/97
Coi - D ~
CHANGE ORDER
Page 2 of 3
Contract No: 08-016
This Contract is revised as follows:
Description of Work
Change Order No. 36
This Change Order compensates the Earthwork Subcontractor for delays incurred by
utilities that were not relocated prior to beginning of earthwork.
Payment
Payment shall be made for the following item:
New contract item:
"Equitable Adjustment - Utility Delay to Earthwork Subcontractor", Lump Sum.
Contract Time
Four (4) days will be added to the contract as a result of this Change Order.
CHANGE ORDER
Page 3 of 3
Contract No: 08-016
Item No. Group No.
Item Description
Change Order No. 36
Unit Unit Price I Est. Qty. I Est. Amt. Change
Measure Change
NEW 1 Equitable Adjustment - Utility Delay to Earthwork Subcontractor L.S
NEW 2 Equitable Adjustment - Utility Delay to Earthwork Subcontractor L.S
80,250.00 1 $ 80,250.00
80,250.00 1 $ 80,250.00
TOTAL $160,500.00