HomeMy WebLinkAboutOLCO/ENG/CO2/Main Street PathContract No:R -36869
INDIANA Department of Transportation
Construction Change Order and Time Extension Summary
Contract Information
Change Order No.: 002
Page: 1
Contract No.: R -36869 Letting Date:08/06/2014
District:GREENFIELD DISTRICT AE:Nierman, Chad
Change Order Information Change Order No.: 002
Date Generated: 02/02/2015 Date Approved: 00 /00 /0000
Reason Code: CHANGED COND, Materials Related
Description: REVISED TREE SIZES
Original Contract Amount $ 821,339.94
Current Change Order Amount $ 0.00
Total Previous Approved Changes $ 0.00
Total Change To -Date $ 0.00
Modified Contract Amount $ 821,339.94
Time Extension Information
Date Initiated 00/00 /0000
Original Contract Time
Time Element Description:
Current Time Extension
Previous Time Approved
Revised Contract Time
Date Completed 00 /00 /0000
PE /S:Gregg, Michael Status:Draft
EWA: Y or Force Acct: N
Percent: 0.000 %
Percent: 0.000 %
Percent: 0.000 %
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 -36869 Change Order No.: 002
INDIANA Department of Transportation
Construction Change Order and Time Extension Summary
Page: 2
Review and Approval Information
Required Approval Authority AE: DCE: SCE: * DDCM:
($ per Change Order) (- LE $ 250K -) (- LE $ 750K -) ( -- LE $ 2 M - -) ( -- GT $ 2 M -- )
(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 No:R -36869
Change Order No:002
INDIANA.
Department of Transportation
Date :02/03/2015
Pager 3
Contract: R -36869
Project: 1383166 - State:138316600LC3
Change Order Nbr: 002
Change Order Description: REVISED TREE SIZES
Reason Code: CHANGED COND, Materials Related
CLN • PCN PLN Item Code Unit Unit Price CO Qty Comment Amount Change
0044 1383166 0044 622 -05649 EACH 307.000 - 68.000 C Amount:$ - 20,876.00
Item Description: PLANT, DECIDUOUS TREE, SINGLE STEM, 1.25 TO 2 IN
Supplemental Descriptionl:
Supplemental Description2:
0074 1383166 0073 622 -05650 EACH 614.000 34.000
Item Description: PLANT DECID TREE SINGLE STEM 2 -2.5 IN
Supplemental Descriptionl:
Supplemental Description2:
C Amount:$ 20,876.00
Total Value for Change Order 002 = $ 0.00
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
THE CONTRACT HAD ORIGINAL BID ITEM NO. 44 - PLANT, DECIDUOUS TREE, SINGLE STEM, 1.25 TO 2.0 IN., WITH A QUANTITY OF
68.0 EACH AT 307.00 DOLLARS. THE CITY OF CARMEL'S FORESTER STATED THAT THEIR STANDARD IS NORMALLY A 2. 5 IN.
CALIPER TREE. HE ALSO DID NOT SEE TOO MANY PLACES TO PLANT THE ORIGINAL PLANNED 68.0 TREES ON THE JOBSITE. AT A
REQUEST FROM THE CITY FORESTER, IT WAS DECIDED TO INCREASE THE CALIPER OF TREES AND PLANT FEWER TREES FOR
THE SAME MONEY. THIS IS A ZERO DOLLAR CHANGE, ONLY A CHANGE IN MATERIAL. ITEM NO 72 PLANT DECIDUOUS TREE,
SINGLE STEM, 2.0 TO 2.5 IN, IS BEING CREATED WITH A QUANTITY OF 32:0 EACH AT 614.00 DOLLARS TO REPLACE THE PLANNED
ITEM NO. 44. l{
Change Order Explanation for Specific Line Item
9,ie.
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.
L
Contractor.. U L_ ( f
Date: ol/ C , Jib I S
/
Signed By:
NOTE: Other required State and FHWA signatures will be obtained electronically through the SiteManager system.
Board of Public Works and Safety:
3- -`f -/5
Mayor James Brainard Date
Member OP atson
Attest:
Date
Date
3 /445-
Diana L. Cordray, Clerk Treasurer Date
Contract No:R -36869 INDIANA
Change Order No:002 Department of Transportation
(SIGNATURE)
APPROVED FOR LOCAL PUBLIC AGENCY
ec
(TITLE) (DATE)
Date:02/03/2015
Page: 4
(TITLE) (DATE)
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PE/S
Approval Level
SUBMITTED FOR CONSIDERATION
APPROVED FOR INDIANA DEPARTMENT OF TRANSPORATION
Name of Approver Date Status