HomeMy WebLinkAboutYardberry/ENG/CO 2/1376/Shared Use Path 136thTO:
CITY OF CARMEL
CONTRACT CHANGE ORDER NO.:
DATE: 6/5/15
7
PROJECT NAME: Shared Use Path 136th Street
CPCY REQ. NO.:
CITY PO NO.:
CITY PO DATE:
1. You are directed to make the following changes in this Contract:
Delete Item: Seed Mixture U
Add Item Mulched Seeding U
SCHEDULED ADJUSTMENT
ITEM AMOUNT (+) OR (-) DAYS
II. The following referenced Documents further describe the changes outlined in Paragraph I,
and are to be considered a part of this Change Order: R.F.P.: W.D.C. No.:
Other: Contractors Heine.
The changes result in the following adjustment of Contract Price and Contract Time:
Contract Price prior to this Change Order $ 690.530.50
_Contract Price will be increased/decreased by this Change Order $ 1376.00
New Contract Price including this Change Order S 69 1.912.50
Contract Time Prior to this Change Order Days 6/10/15 Completion Date
Net increased/decreased resulting from this Change Order 0 Days
Current Contract Time including this Change Order Days 6/10/15 Completion Date
This Change Order is for full and final settlement of all direct, indirect, impact costs and time
extensions incurred at any time resulting from the performance of the changed work.
The Above Changes Are
Recommended
Cia
ENGINEER
3cv 5 filE.liDi.4N
Address
City/State/Zip
By:
o 4-e ;, 7
phone: 3"7-5o3--52So
y(,zz
Date: SSA—
Phone: ./e5-
SA
The Above Changes Are
c Accepted:
Gl'r�besz'z L ivisofx
CONTRACTOR
' 940 loco
W.
Address r
tUn visa /N Ytaag
City/State/Zip
By:
Phone:`7%j 37R- D• &S
Date: ^✓a ails—
Approved:
Mary R - Member
Lori' Wa , Member
Tana Cordray,
Treasurer
Date: C// /,5
JEREMY KASHMAN
Contract No:R -36889 Change Order No.: 002
INDIANA Department of Transportation Page: 1
Construction Change Order and Time Extension Summary
Contract Information
District:GREENFIELD DISTRICT
Change Order Information
Contract No.: R -36889
AE:Nierman, Chad
Change Order No.: 002
Letting Date:08/06/2014
PE/S:Gregg, Michael Status:Pending
EWA: Y or Force Acct: N
Date Generated: 00/00/0000 Date Approved: 00/00/0000
Reason Code: ERRORS & OMISSIONS, Item Related
Description: Add Item Mulched Seeding, U; Remove Item Seed Mixture, U
Original Contract Amount
Current Change Order Amount
Total Previous Approved Changes
Total Change To -Date
Modified Contract Amount
Time Extension Information
Date Initiated 00/00/0000
Original Contract Time
Time Element Description:
Current Time Extension
Previous Time Approved
Revised Contract Time
$ 666,736.50
$ 1,376.00
$ 0.00
$ 1,376.00
$ 668,112.50
Date Completed 00/00/0000
Percent: 0.206 %
Percent: 0.000 %
Percent: 0.206 %
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 -36889 Change Order No.: 002
INDIANA Department of Transportation Page: 2
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?
Approval Authority Concurs with PM?
LPA Signatures Required?
FHWA Signatures Required?
AE: DCE: SCE: "DDCM:
(-LE$250K-)(-LE$750K-)(—LE$2M—)(--GT$2M--)
(50 SS days ) ( 100 SS days ) ( 200 SS Days ) ( GT 200 SS days)
Y / N If Y, by Date Issued
Y / N If Y , Copy to Program Budget Manager
Y / N If Y, Referred to Project Manager(PM)
Date to PM Date Returned
Y / N If Y, Concurrence by Date
If N,Resolution: Approved Disapproved
Resolved by Date
Y / N If Y, Date to LPA Date Returned
Y / N If Y, Date to FHWA Date Retumed
" Field Engineer Recommendation (Required for SCE or DDCM Approval)
Field Engineer
Comments:
Date
Contract No:R -36889 INDIANA Date:06/08/2015
Change Order No:002 Department of Transportation Page: 3
Contract: R -36889
Project: 1383165 - State:138316500LC3
Change Order Nbr: 002
Change Order Description: Add Item Mulched Seeding, U; Remove Item Seed Mixture, U
Reason Code: ERRORS & OMISSIONS, Item Related
CLN PCN PLN Item Code Unit Unit Price CO Qty Comment Amount Change
0039 1383165 0039 621-06554 LBS 15.000 -30.000 C Amount:$ -450.00
Item Description: SEED MIXTURE, U
Supplemental Descriptlont:
Supplemental Descrlptlon2:
0073 1383165 0073 621-06560 SYS
Item Description: MULCHED SEEDING U
Supplemental Descriptionl:
Supplemental Descripuon2:
2.200 830.000 C Amount:$ 1,826.00
Total Value for Change Order 002 = $ 1,376.00
Whereas, the Standard Specificationsfor thls contract provides for such work to be performed, the following change Is recommended.
General or Standard Change Order Explanation
This change order will accomodate payment for fertilizer and mulching material required under SecIfication 621 tor seeding. The contract did not
include Items for fertilizer and mulch. A new Item Mulched Seeding, U Is being added to the contract to replace Item 0041 Seed Mixture, U. The
contractor's proposed unit pricing for the new pay Item was compared against recent bid history for this work and was deemed acceptable.
Change Order Explanation for Specific Line Item
It Is the Intent of the parties that this change order Is full and complete compensation for the work describe above.
Notification and-orrsent to this change order is hereby acknowledged.
Contractor:
- Date
ttrc( r
Signed By:
NOTE: Other required State and FHWA signatures will be obtained electronically through the SiteManager system.
Contract No:R -36889
Change Order No:002
(SIGNATURE)
PENS
Approval Level
Project Engineer/Supervisor
INDIANA Date:06/08/2015
Department of Transportation Page: 4
APPROVED FOR LOCAL PUBLIC AGENCY
CZr✓/Zn16Z"%,(CdZ 7I2%I IS
ITI TLE) (DATE)
(TITLE) (DATE)
SUBMITTED FOR CONSIDERATION
APPROVED FOR INDIANA DEPARTMENT OF TRANSPORATION
Name of Approver
Gentry, Thomas
Date
00/00/0000
Status
Action Pending