HomeMy Public PortalAboutChange Order No. 5 to Contract No. 95-2014 - Metro - INDOT (R35686) - Consultant - Rundell Ernstberger - Starr Gennett area redevelopmentContract No:R -35686 Change Order No.: 005
INDIANA Department of Transportation Page: 1
Construction Change Order and Time Extension Summary
Contract Information Contract No.: R -35686 Letting Date: 12/1012014
District:GREENFIELD DISTRICT AE:Anthony, Oliver R. PE/S:Newkirk, Eric Status:Approved
Change Order Information
Change Order No.: 005
EWA: Y or Force Acct: N
Date Generated: 09/15/2015
Date Approved: 09/16/2015
Reason Code: SCOPE CHANGES, Material Related
Description: Reclaimed/Salvaged Aggregate Base from road removal
Original Contract Amount
$ 2,648,720.86
Current Change Order Amount
$ 5,600.00
Percent: 0,211 %
Total Previous Approved Changes
$-29,913.87
Percent: -1.129 %
Total Change To -Date
$-24,313.87
Percent: -0.918 %
Modified Contract Amount
$ 2,624,406.99
Time Extension Information
Date Initiated 00100/0000 Date Completed 00/00/0000
Original Contract Tlme 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 0 SP Days Value $ 0.00
Previous Time Approved
Revised Contract Time
SS Days by AE: DCE: SCE: DDCM:
SS Days SP Days Value $
SS Completion Date 00100/0000 or SS CalendartWork Days 0
SS Date 00/00/0000 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>50/o?
Scope/Design Recommendation
Required?
Change Order No.: 005
Page: 2
AE: DCE: SCE: * DDCM:
(-LE$250K-)(-LE$750K-)(--LE$2M—}(—GT$2M—)
( 50 SS days ) ( 100 SS days ) ( 200 SS Days) ( GT 200 SS days)
Y / N if Y, by Date Issued
Y / N if Y, Copy to Program Budget Manager
Y / N If Y, Referred to Project Manager(PM)
Date to PM Date Retumed
Approval Authority Concurs with PM? Y / N If Y, Concurrence by Date
If N, Resolution: Approved Disapproved
Resolved by Date
LPA Signatures Required? Y / N if Y, Date to LPA Date Retumed
FHWA Signatures Required? Y / N if Y, Date to FHWA Date Returned
* Field Engineer Recommendation (Required for SCE or DDCM Approval)
Field Engineer Date
Comments:
Contract No:R -35686 INDIANA
Change Order No:005 Department of Transportation
Contract: R -35686
Project. 0810267 - State:0610267
Change Order Nbr. 005
Change Order Descriptlow Reclaimed/Salvaged Aggregate Base from road removal
Reason Code: SCOPE CHANGES, Material Related
Date.09/16/2015
Page: 3
CLN PCN PLN Item Code Unit Unit Price Co Qty Comment Amount Change
0102 0010267 0102 202-02676 TON 8.750 640.000 C Amount:$ 500.00
Item Description: TRANSPORTATION OF SALVAGED MILLET) MATL
Supplemental Descriptionl: salvaged stone reused as aggregate base
Supplemental Descripiion2:
Total value for Change Order 005 = S 5,600.00
Whereas, the Standard SpoolRcations for this contract Provides for ouch work to be performed, the following change is recommended.
Genenal or Standard Change Order Explanation
The existing stone base from the road removal area was salvaged and reused in place of Item 0020 Compacted Aggregate No. ss aass The
msWW was quanhillIfted based on ftf-axle load counts which were stored on site near the poirrt of use. This change order compensates ttte
contractor for handit the material, placing it, grading it and compacting it for use under paved are.
General or Standard Change Order Explanation
INDOT Project Manager has been Informed of this change order.
Change Order Explanation for Specific Line 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 this change order is hereby acknowledged.
CatlreQor t✓ eS i ` ,, y s e signed f4lli-" e2-O7
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NOTE: Otter required State and FH WA signatures WIN be obtained electronically through the SIeManaGW system.
Contract No:R -35686 INDIANA
Change Order No:005 Department of Transportation
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APPROVED FOR LOCAL PUBLIC AGENCY
,MMIATURE) (TITLE)
SUBMITTED FOR CONSIDERATION
PE[S
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Date:09/16/2015
Page: 4
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APPROVED FOR INDIANA DEPARTMENT OF TRANSPORATION
Approval Level Name of Approver Date Status
Project Engfneer/Supervisor NevAdrk, Eric 09/1612015 Approved