HomeMy Public PortalAboutChage Order No. 8 to Contract No. 148-2014 - INDOT Coordination Agreement (R-37463) 1382810 - Bike Pedestrian facilities- j0q*64'000-�K -d$
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Coot -act N-o-.::R r"3746'3' IN . DIANA
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APPAOVJ=-'D FORLOGAL PUMICA6ENCY
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SUBMITTED :PbR CbN8ibtMtI0N
(DATE):
-(DATE).
APFI�OVED FOR INDIANA t)EPAR-TMeNT.OF-hRANSPORTATION.
Date:01/08!/202.0.
App
roval Level Name of Approver Date Status
CHANGE ORDER REQUEST FORM
CONTPAMNM R-37463mB
DATE OF SUB M 1�S I o' 0
eptem4erg,,4,
.2019,
PR'QJ*ECT0Ek'RfPT-I N,
. . . . . . . . . . . . . . . . . . . . . . . . . .
0lKjEiPEPE.%7rRJAN.fbtiES IN RIGHIVION . E}1- IN
FAQ
1 -MANGEP-0- E--RR-EC-tU8T:SiJMMAftY'
tE-'
G- ADDED
I DESCRIPTION
PRXVOSEDISOIWON'SW'
OL jBm.r PRidE fOR N 'ITEM
16M,Upon: re fimw-gWlh�iirizni� 6io*Ped:-Oech�b6n 617.. g
Oest r E t 2-
ONS�ET . PA . E. . Of CHA GE: eept,
qmber Z4,2010 C"ANIGE0 RDERTYPE
PROPOSED COT AND TIME ADJUSTMENT
COST .'COST INCREASE t (DECREASty. �03*4
V
Tate cost dj�strnenl: shall` Inctuae tirtnp scim arid/or°:sstiina l.totated'anit=pricsct Item costs Aifa�h
Ppar.ax-s items ee
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on,.:uni - o measurement, s.mae.:qLmp pr(pe..
.QiK-K APPROPRIAT E.S. g:'B.GX- :PE!3'APiROPRIATE'M,)S-O'FCOSTCH-ANGE.-
'0: 1-0-M Altered (Quantities! -109665(0)'Agregd .:Price n! 109M(b) Force.Account -n IG90101 Delay C44,
VIOPOSM'COST C14ANdE INCLUDES: D. Labor Cl Mat1 0 EqOPMent U. Lease A . I ....
TIMEADIUSTIVIENT
tH' EC''K A P. PA G' P-A t M Z. B dk i t s. 'P"E' Rk A 0 P* R* 6 A tA7 t E'S'A si 0 r- -T. i mf,- t 0 N*G 6
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SUPPLEMENTAL'INFORMATION-
CHA'4(k OR bER, ON't 04NDor1 tPA -Cclhtrad6i
CH k;bere tia evitor toxt
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CHANPEORDERAFFEP-5 PSEPAFMCIPARON.... Elyek, Ono. (if Vit 44m6 detmtsj
v6r. 10.11-6--la
CKAKGE ORDER REQUEST FORM
CORTRACT, KGW. R-37 (!i-.13
UPON WRITTEN REQUEST TROM T14E ENGINF-ER;:P.ROVIDE ADDITIONAL DETAIL
-DATE RECEIVED PXQUESTFOR
[Select P.4tel,
_SL1Bm11rTALD&TE 6-F
'[S.0eq.t.batel.
ADDITIONAL DEWL
At)DITIONAL.DET-AIL.
-DETAILED bt9dZIPtION / AJ�TIFICATION':
(4ndudeT1oqat!bn(sj, actions of contractorowner, and Dtherstakeholders, key events. and ralated-causg(Tl, dtscvveqes,
discussions. meetings: and effect oil the contract if ab actfoh istaken-Also fficlude rgfkrences.to key-ddcuments attached
or ovallable to.support this chetage order requestj
INDOT.REQUESTTO ADD RETRO REFLECTIVITY ITEM
PROPOSED SOLUTIPNADDITIONAL DIFIFAILS:
.(Indudeproposed.sc4peof work, #7eans &methods, materfatkl epipment, utility relopg0on reqUired, subcontracted
- sc
ope. and the effect on the copttoet.scbodufe, Alsainehide references to -attached documentsincluding, but not 11m.1ted
.to, sketches; calcuattops,.photos,;MptefiattnformaticiT,.upd su6mlttals and.meetfilg minutes.)'
WLWpr4ET,G SUBMIT -PRICE FOR NEW ITEM
SJONATURIE
; Cdhtractoft
Namg�.(prinfJ..MILE-STbNE'CONfRAcroRs,::.P..—.sco.-T.rA.-HEs'r�k�-
Date-.
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CHANGE ORDERREQUEST FORM
CONTRACT NO. i R-37463B
ATTACHMENT- UNIT PRICE ITEMS DETAIL
Attach or pe,,5ts a unit price Item detail.
RErRQ REFLECTIVIMTESTING I LS @ $3G33.47
ME
NUM LAWR-
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RATE"
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A*
•AMOUNT'
MATERIAL
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IDTAL SUPPLIES WITH MARKUP
Sig. a
TOTAL WdcNTR;6,OrmST
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-MTAL WBCCNTWT WITH MARKUP
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.AC )OMORkb6ND'4iNtUkANCE
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-mNrPlp.F0A4 -41,W347� TOTAL 53,0=.47
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$m 8965 North Gammaraiaf Parkwq t i %e Number: "� fE-BQ S
�re��eltE,, ��dian,2 �t4� Fax �tus»beC �t%-��t1'-824$
ZRANG: ORDER
Tact DBE.. State af;illdialla Eoirtt> <ad TSB€: MY of Wdiahapdiis
t4 S`u6ritKeiE:b: ;Carr�r:tuasatt
o•mail;: LamyH(Mtrsd€nnairafk(�tenv res_doin
SEE' Getf t+tuniter<. 3ETtli�ifs=>�fit}3
INDIAN:A DEP CRTMENT-OFTHAWSPORTATION
PRONE: (517) 23M5�
FAX (317) 94245561
1k-&41,1017
-Eff6-:Hb(cdfiib;% Gov'
-CON9TRUCTIONW4
Distrta Npity Conu*st'liners
Di$EaTt.chnicEd,Seryides Diter,tots-
District ATei
D!
Pistddt Tbstffig Eqg*ds
.7isttict tatdordffiato'
C�lti1: Gregory Qf.-Pau, Apting Iectox.
ft
i0h df._Co#sfrtzcfixa�:]Wmageu PPQ. W
Testing
np! intent- of tl4s - memo is, to - clarify ihe: req=" enb. D'f:seq0ons,.9U9,07 and IMA-4:.-as vdlos
e4m
14 7, i4*0the Adi . to p-5ted Po po�4 -CoMp1qdoA:Dateand-fqtro-
5 fty
allows , ecernirad. or a4to } t4�mefraina;tO.Opm-
Qncp.
=akk-iags,,*.MV,0 been pi�o& 0 ,QC_c-as'ion,,the_enJd of '3'0 days will M-after'the-
., placed. . ... a, 1" �Usbed
Conixact PPPMOnt AC
C li4pidated dwnagqs:.-s:ko&-d not �e
muDate aft. In umtE=*_ , o,
.dsgossed,iff testing , tales place after. the, Dde.biovided no a#1gr
.
wait Xmsi-established. b,y 'ntract, WO&
Moro4um 15-17, "All Co
0bra h, dd b co Jb� W tie -.d
pldtl�,,. t ate on wdolj aR.-. -pay'' items, with the exception of retro-
ciobvldd `fig ens e.. tibiittactdt- has gi*e time td'd
x6ffiec� --teg' fia- havebe=
'i-f testing, -does w'IifMda-thq14-ja'3 clay p m br"fieng ifLbdb6
fall" 'a to iffie.
- iva&�-. ih'Aacer- - ae, va �W3 ar& where the 36 day respect . ,Y. MM=utn s,,W;T.
..�h rogg of
A,djtzsted Core .,Cotdlelon-:Datm aiidt6q,.provid.provided retro��di.ty t6�tapes
AaCewithin
fLineft wq& 4a e-oharged. for thmop -final
ffia, 14 to day ame, qs�AoWdn� operation in prqwWoa for
petos
-d'
''Mana
All Op In.
portunity- Employer
The above information should be kept in mind when determining intermediate and overall completion
dates for contracts.
Proper traffic control measures must be utilized anytime retro reflectivity testing is performed.
Construction Memorandum 11-07 provides additional information on these requirements.
Questions should be directed to the Office of Construction Management.
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