08-059.00 Knife River: Appleway Ave Reconstruction• •
Washington State Change Order 1
Department of Transportation
Date June 5, 2008
4
Contract Number TA-2922 Federal Aid Number STPUL-3842 (002)
Contract Title Appleway Avenue Reconstruction Project
Change Order Number 1
Prime Contractor Knife River
^ Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications
^ Proposed by Contractor
Endorsed i3y
Contras l- ,
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Dale
Surety Consent
Attorney of Fact
Date
OriginaLContract Amount $ 4,565,859.95
Current Contract Amount S 4,565,859.95
Estimated Net Change This Change S 1.875.00
Estimated Contract Total After Change $ 4,567,734.95
Approval Required Region ^ Olympia Service Center ^ 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.
X Apr al Recommended Approved
r
~G~ Approved
Project Engineer
(~~~~08 proving u ' n per C.A. Agreement
D
Date Da
^ Approval Recommended Approved Approved
gy Approving Authority per C.A. Agreement
Date Date
C08-59
• CHANGE 0:12DER •
Date
Contract No: TA-2922
This Contract is revised as follows:
Description of Work
Page 2 of 4
Change Order No. 1
The Contractor shall be compensated for three hundred seventy five (375) cubic yards
of Common Borrow Incl. Haul. The unsuitable material was located at Station 75+31 to
77+00 on the south half of Appleway Avenue
Materials
Common Borrow Including Haul will be imported by the Contractor and shall meet the
requirements of section 2.03.3(14)K and 9-03.14(3) of the Standard Specifications.
Construction Requirements
Work shall meet the requirements of sections 2-03.3(14)C, 2-03.3(14)D, 2-03.3(14)K
and 9-03.14(3).
Measurement
Common Borrow Incl. Haul will be measured per Cubic Yard per sect-03.4.
Payment
Common Borrow Incl. Haul will be paid per Cubic Yard per section 2-03.5.
•
CHANGE ORDER
Date
Contract No: TA-2922
•
Page 3 of 4
Change Order No. 1
Item No. item Description Unit Unit Price Est... Qty. Est. Amt.
Measure Change Change
NIA Common Borrow Incl. Haul CY $5.00 375 $1,875.00
TOTAL $x,875.00
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COlaPArJY
43750•KRCC-GAVYX-08.09 A LIBERTY MUTUAL FIRE INS. CO.
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KNIFE RIVER-SPOKANE DIVISION 8 NIA
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COEUR D'ALENE, ID 83816-ZU47 ccr~PANY
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NOIl'ATHSTANDTh"G ANY R'EOUIREAtENi, TER.1: OR CWIDI1tON OF ANY CONTRACTOR OTHEl3 DDpl1.V.=_hT t'ATH RES?ECT TO 1'A1ICH THE C~1IFDCATE MAY E;£ [5SUE0 OR h1AY
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LTR TYPE Or DISURANCE POLICYNUMBER POLICY EFF£CTNE
DATBIdt«UDDlYY) POLICY EXPIRATIDdI
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q aENERALUAe!uTY TB2841005097-048 01/01/08 01101109
O£NERALAC3r3Rfi(IATE
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OYRVKR•5 6 CON I NACTOR'S PROT EACH OCCUFiH.t'.ItClc $ 1,000,000
FIRE DAt,AtiE or,» nre $ 500,000
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SCHEDULED ALROS (Per peteon)
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WORtCERS COV1P£NSATION IS
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INSURED WORDING
D£SCRI?T{ON OF OPERA710N31LOGATTOKSNEKICLESlSPECtAI. BENS '
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Project No
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Fed Aid No
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Spokano County, Cily of Spokane Valley, and State of Washington are Indudad as additional Insured as required by written contract Coverage is primary
and non-oonVibutory to any htsLrrsnce maintained by tho additional insurod. Cross Llabilily is InCludAd,
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