HomeMy Public PortalAboutChange Order No. 15 to Contract No. 95-2014 - Metro - INDOT (R35686) - Consultant - Rundell Ernstberger - Starr Gennett area redevelopmentContract No:R -35686
Change Order No.: 015
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:Pending
Change Order Information
Change Order No.: 015 EWA: Y or Force Acct: N
Date Generated: 01/21/2016
Date Approved: 00/00/0000
Reason Code: CHANGED COND, Utility Related
Description: water service size change
Original Contract Amount
$ 2,648,720.86
Current Change Order Amount
$ -4,600.00 Percent: -0.174 %
Total Previous Approved Changes
$ 95,811.36 Percent: 3.617 %
Total Change To -Date
$ 91,211.36 Percent: 3.443 %
Modified Contract Amount
$ 2,739,932.22
Time Extension Information
Date Initiated 00/00/0000 Date Completed 00/00/0000
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 0 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 00/00/0000 or SP Days 0
- 7..e " y
r
s
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.: 016
Page: 2
AE: DCE: SCE: * DDCM:
(-LE$250K-)(-LE$750K-)(—LE$2M--)(--GT$2M—)
( 50 SS days ) (100 SS days) ( 200 SS Days) ( GT 200 SS days)
Y / N If Y, by Date Issued
Y / N If Y, Copy to Program Budget Manager
Y / N If Y, Referred to Project Manager(PM)
Date to PM Date Returned
Approval Authority Concurs with PM? Y / N If Y, Concurrence by Date
If N,Resolution: Approved Disapproved
Resolved by Date
LPA Signatures Required? Y / N If Y, Date to LPA Date Returned
FHWA Signatures Required? Y / N If Y, Date to FHWA Date Returned
* Field Engineer Recommendation (Required for SCE or DDCM Approval)
Field Engineer Date
Comments:
Contract No:R -35686 INDIANA
Change Order No:015 Department of Transportation
Date:01 /22/2016
Page: 3
Contract: R -35686
Project: 0810267 - State:0810267
Change Order Nbr: 015
Change Order Description: water service size change
Reason Code: CHANGED COND, Utility Related
CLN PCN PLN Item Code Unit Unit Price CO city, Comment
Amount Change
0103 0810267 0103 715-02574 EACH 7,400.000 -2.000 C
Amount:$-14,800.00
Item Description: WATER SERVICE CONNECTION, 21N.
Supplemental Desaiptionl:
Supplemental Description2:
0113 0810267 0113 715-11896 EACH 2,600.000 1.000 C
Amount:$ 2,600.00
Item Description: WATER SERVICE CONNECTION
Supplemental Descriptionl: revised pricing and size
Supplemental Descdpbon2:
0115 0810267 0114 715-11896 EACH 7,600.000 1.000 C
Amount:$ 7,600.00
Item Description: WATER SERVICE CONNECTION
Supplemental Descriptions: revised pricing and size
Supplemental Description2:
Total Value for Change Order 015 = S-4,600.00
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
delete 2 inch services and replace with 1 inch service for Veterans Park and 1-1/2 inch service for Starr Gannett Bldg.
Change Order Explanation for Specific Line Item
atlflf ltflf f a1f}f!H}NN}HNt}H}fMlflf#}NH1NM}tf Nf f}f itllNNif YMkff f tttlfYY}fYR}NN1MNfHHt}lfef}1f tf of 1tMf f}
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.
Contractor:- _ �) t lYt� r� r Signed By: i L A .Al r
Date:
fHaRRf}ffNN}RaffRfflHalNRf}lNYRf,N Nftta flflttffRNfiRlRRftfRf}}HftHtitNt}a}Yf}fltNN}NHf,liHftHfMivNNfMif
NOTE: Other required State and FHWA signatures will be obtained electronically through the SlteManager system.
Contract No:R -35686 INDIANA
Change Order No:015 Department of Transportation
fffffflfffHfffMfllMlHf fflfHffHfeHfHHfMfff f ffffHfMHfHfMtMHMffHHMfHfMlMMfH1HfMHfMffHfefffNfH
APPROVED FOR LOCAL PUBLIC AGENCY
(S-�' '/�'•;� (TITLE)
(TITLE)
PENS
SUBMITTED FOR CONSIDERATION
ffMMHf fNNHMHfMfffffHfMfHHRfHfHMlHfifHlHHflefifHHHfHfHfMlN1MMN{fffH�HHMM1M11iMfffHfMfff
Date:01 /22/2016
Page: 4
(DATE)
.2-
(DATE)
APPROVED FOR INDIANA DEPARTMENT OF TRANSPORATION
Approval Level Name of Approver Date Status
Project Engineer/Supervisor Newkirk, Eric 00/00/0000 Action Pending