HomeMy Public PortalAboutChange Order No. 4 to Contract No. 95-2014 - Metro - INDOT (R35686) - Consultant - Rundell Ernstberger - Starr Gennett area redevelopmentContract No:R -35686 Change Order No.: 004
INDIANA Department of Transportation Page: 1
Construction Change Order and Time Extension Summary
Contract Information Contract No.: R -35686 Letting Date:12/10/2014
District:GREENFiELD DISTRICT AE:Anthony, Oliver R. PE/S:Newkirk, Eric Status:Approved
Change Order Information Change Order No.: 004 EWA: Y or Force Acct: N
Date Generated: 09/1W015 Date Approved: 09/15/2015
Reason Code: SCOPE CHANGES, Added Quantities/items
Description: Brick Repairs to Starr-Gennett Building
Original Contract Amount $ 2,648,720.86
Current Change Order Amount $ 3,436.89 Percent: 0.130 %
Total Previous Approved Changes $-33,350.76 Percent: -1.259 %
Total Change To -Date $-29,913.87 Percent: -1.129 %
Modified Contract Amount $ 2,618,806.99
Time Extension Information
Date Initiated 00/00/0000 Date Completed 00/0010000
Original Contract Time SS Completion Date 00/00/0000 or SS Calendar/Work Days 0
SP Date 00/00/0000 or SP Days
(SS = Standard Specification, SP = Special Provision)
Time Element Description:
Current Time Extension SS Days 0 SP Days 1 SP Days Value $ 0.00
Previous Time Approved SS Days by AE: DCE: SCE: DDCM:
SS Days SP Days Value $
Revised Contract Time SS Completion Date 00/00/0000 or SS Calendar/Work Days 0
SS Date 00100/0000 or SP Days 0
Contract No:R -35686
INDIANA Department of Transportation
Construction Change Order and Time Extension Summary
Review and Approval Information
Required Approval Authority
($ per Change Order)
(Days per Contract)
Verbal Approval Required?
Total Change To-Date>5%?
Scope/Design Recommendation
Required?
Change Order No.: 004
Page: 2
AE: DCE: SCE: * DDCM:
(-LE$250K-)(-LE$750K-)(--LE$2M--}(--GT$2M—}
( 50 SS days } ( 100 SS days ) ( 200 SS Days) ( GT 200 SS days)
Y ! N If Y, by Date Issued
Y / N If Y , Copy to Program Budget Manager
Y / N If Y, Referred to Project Manager(PM)
Date to PM Date Returned
Approval Authority Concurs with PM? Y / N If Y, Concurrence by Date
If N,Resolution: Approved Disapproved
Resolved by Date
LPA Signatures Required? Y / N If Y, Date to LPA Date Returned
FHWA Signatures Required? Y / N If Y, Date to FHWA Date Returned
Field Engineer Recommendation (Required far SCE or DDCM Approval)
Field Engineer Date
Comments:
Contract No:R -35686 INDIANA
Change Order No:004 Department of Transportation
Contract: R -36686
Project: 0810267 - State:0810267
Change Order Nbr: 004
Change Order Description: Brick Repairs to Starr-Gennett Building
Reason Code: SCOPE CHANGES, Added Quantities/Items
CLN PCN PLk Item Code knit Unit Price CO Qty Comment
0101 0810267 0101 106-06807 LS 3,436.890 1.000 C
Item Description- ADDITIOlAL
Supplemental Description I: Erick repair areas that were unsafe
Supplemental Description2:
Date:09/15/2015
Page: 3
Amount Change
Amount:$ 3,435.89
Total Value for Change Order 004 = $ 3.436.89
Milestone Time Adjustment
Milestone Nbr. 02
Milestone Description: iNTEIRMEDiATE COMPLETION DATE 2
Origtnal Completion dt: 12/18t2015 Adj cornpi dt 1212112015 Ad) No. of Days 1
Explanation: 1 day is added to the intermediate Completion Date 2
Whereas, the Standard Specifications for this contract provides for such work to be performed, the following change Is recommended,
General or Standard Change Order Explanation
This additional work was nexssarp to make the Starr-Gennett Building safe for occupants
General or Standard Change Order Explanation
INDOT Pro)act Manager has been made aware of this change order
Change Order Explanation for Specific Una Item
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It is the intent of the parties that this change order is full and complete compensation for the work describe above.
Notification and consent to tKs change order is hereby acknowledged.
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NOTE: Other required State and FHWA signatures wlil be obtained elealrorkally through the SlIeManager system.
Contract NOR -35686 INDIANA
Change Order No:004 Department of Transportation
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SUBMITTED FOR CONSIDERATION
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Date:09/15/2015
Page: 4
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APPROVED FOR INDIANA DEPARTMENT OF TRANSPORATION
Approval Level Name of Approver Date Status
Project Engineer/SuperAsor Newkirk, Eric 09/15/2015 Approved