HomeMy Public PortalAboutChange Order No. 7 to Contract No. 85-2016Contract No:R -34206 Change Order No.: 007
INDIANA Department of Transportation Page: 1
Construction Change Order and Time Extension Summary
Contract Information Contract No.: R -34206 Letting Date:09/14/2016
District:GREENFIELD DISTRICT AE:Prather, Michael PE/S:Stevens, Mark Status:Pending
Change Order Information Change Order No.: 007 EWA: Y or Force Acct. N
Date Generated: 05/03/2018 Date Approved: 00/00/0000
Reason Code: CHANGED COND, Weather Related
Description: Installed a Concrete Waterway
Original Contract Amount $ 1,095,465.00
Current Change Order Amount $ 3,968.81 Percent: 0.362 %
Total Previous Approved Changes $ 35,183.65 Percent: 3.212 %
Total Change To -Date $ 39,152.46 Percent: 3.574 %
Modified Contract Amount $ 1,134,617.46
Time Extension Information
Date Initiated 00/0o/0000
Original Contract Time
Time Element Description:
Current Time Extension
Previous Time Approved
Revised Contract Time
Date Completed 00/00/0000
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)
SS Days 0 SP Days 0 SP Days Value $ 0.00
SS Days by AE:_ DCE: SCE: DDCM:
SS Days SP Days Value $
SS Completion Date 00/00/0000 or SS Calendar/Work Days 0
SS Date 00/00/0000 or SP Days 0
Contract No:R -34206 Change Order No.: 007
INDIANA Department of Transportation Page: 2
Construction Change Qrder and Time Extension Summary
Review and Approval Information
Required Approval Authority AE: DCE: SCE: * DDCM:
($ per Change Order) (-LE$250K-){-LE$750K-)(—LE$2M--)(—GT$2M--)
(Days per Contract) ( 50 SS days ) ( 100 SS days ) ( 200 SS Days } ( GT 200 SS days)
Verbal Approval Required?
Y / N If Y. by Date Issued
Total Change To-Date>5%?
Y / N If Y, Copy to Program Budget Manager
Scope/Design Recommendation
Y / N If Y, Referred to Project Manager(PM)
Required?
Date to PM Date Returned
Approval Authority Concurs with PM?
Y / N If Y, Concurrence by Date
If N,Resolution: Approved Disapproved
Resolved by Date
LPA Signatures Required?
Y / N If Y, Date to LPA Date Returned
FHWA Signatures Required?
Y / N If Y, Date to FHWA _ Date Returned
* Field Engineer Recommendation (Required for SCE or DDCM Approval)
Field Engineer
Date
Comments:
Contract NOR -34206 INDIANA
Change Order No:007 Department, of Transportation
Contract: R -34206
Project: 1173174 - State:1173174
Change Order Nbr: 007
Change Order Description: Installed a Concrete Waterway
Reason Code: CHANGED COND. Weather Related
CLN PCN PLN Rant Code Unit Unit Price CO Oty Comment
0113 1173174 0113 109-04299 DOL 3.968.810 1.000 C
Item Description: FORCE ACCOUNT WORK
Supplemental Descriplionl :
Supplemental Oescrip0on2-
Date:05/30/2018
Page: 3
Amount Change
Arnow:$ 3,968.81
Total Value (Of Change Order 007 = S 3.968.81
whereas, the Standard SWIficationa for this contract provides for such work to be performed, lt►e folio
wing change IS recommended.
General or Standard Change Order Explanation
During the Pee -Final Inspection. it was determined by everyone in attendance (Greg Stiens-City of Richmond, Scoff Oufl-Miiesik
torte. Me
Prather-AE for INppT, H Phan -PM for tNOdT and Mark Stevens-BLN), there was an area, at approximate Station 23+00 RT where you could
tell there would be a substantial amount of erosion from water running off a nearby parking lot onto the RM for this project Everyone agreed that
a modified concrete ditch should be built from the RAN fine leading to an existing calch basin This work is to be done as a Force Account
because Substantial Completion had already been completed and the contract did not have items to cover this type of work. The Project
Manager for INGOT. H. Pham, is aware of ous change order and a draft wpy will be sent to horn. The .vor% is necessary to complete the original
COMract scope but is considered non -participating.
Change Order Explanation for Specific fine Item
II is the intent of the parties that this change order is full and Conptete compensation for the work describe above
Notification and consent to this change order is hereby acknowledged.
r ,
Contractor:.--- Mkt Contractors, LA
Uale:
NOTE: Other required State and FHWA signatures will be obtained efectronicaffy throtigh the SiteMOnager system
Contract No:R -34206 INDIANA
Change Order No:007 Date:05/30/2018
g Department of Transportation Page: 4
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APPROVED FOR INDIANA DEPARTMENT OF TRANSPORATION
Approval Level Name of Approver Date`
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Project Engineer/Supervisor Stevens, Mark
00/00/0000 Action Pending