HomeMy WebLinkAboutSchutt-Lookabill/CO 9/Cool Creek TrailContracfNo:B -27185 Change Order'No.: 009
INDIANA :Department.ofTransportatlon
.Construction 'Change:OrderandTime iExtension :Summary
:Contract Information Conk act No.: :B -27185 .Letting Date:05 /14/2008
'District:GREENFIELD DISTRICT AE:Goldner, -Rob
Page: -1
PE /S:Miiler, Christopher Status:Draft .
Change Order Information .Change Order'No.:.0.09 .EWA:'N.or Force Acct: 'N
Date Generated: 07/06/2012 Date Approved:•00 /00 /0000
Reason Code: CHANGED COND, .Utilities Related
.Description: Time extension 'to Intermediate Completion Date :Milestone
Original Contract Amount :$ 3,246,858 :18
Current Change Order Amount .$.0.00
Total.Previous Approved Changes $- 100;644.04
Total ChangeTo =Date :$ 100;644.04
:Modified Contract Amount 3.3;347;502.22
TimeExtension Information
:Date Initiated' 0.0/00 /0000
Original ContractTime
Time:Element :Description:
CurrentTime Extension
PreviousTime Approved
Revised Contract-Time
Percent: 0.000 %
'Percent:3.100 %
Percent:3:100 %
.Date Completed 00/00/0000
-.SS Completion Date D0 /00 /0000 .or SS Calendar/Work.Days.O
SP:Date 00 /00 /00.0D or SP:Days
(SS= 'Standard Specification, SP= .Special Provision)
SS :Days .0 :SPDays :0 'SP Days V.alue$'0.00
'SS Days .by AE: D.CE: SCE: DDCM:
SSDays •SPDays Value =$
SS CompletionDate 00 /00 /0000.or:SS Calendar/WorkD.ays.
SS *Date.00 /00 /000.0 or SP Days 0
80,0 v-
Contract.No :B -= 27185 Change Order No.: 009
INDIANA Department .�fTransportation Page:2
D.onstructlon Change .Order-and ?ime.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:
(- LEI '250K -) (- .$ 750K - -) ( -- LE.$2 M —) ( -- GT32 M— )
(50 SS days) (100 SS .days) (200 SSDays//) (.GT200 SS .days)
N If Y, by bGeldrev- Date Issued 7hil is-
Y / N If Y , Copy toProgram Budget Manager
Y /1\11f Y,Referred to Project Manager(PM)
Date to PM Date Returned
Y /'N• If Y, Concurrence by Date
If•N;Resolution: Approved .Disapproved
Resolved.by Date
N If Y, Date-to .EPA Date- Returned
Y /9If Y, Date to -FHWA :Date Returned
Field-Engineer Recommendation (Required-for SCE orDDCM Approval)
Field Engineer
Date
Comments:
Contract No :B 2718'5
Change Order No:0.09
INDIANA
. Department of.Transportation . .
Date:07/09/2012
"Page: "3
Contract:
Project:
Change OrderNbr
27185
State: 9929036
009
Change Order: Description: Time extension to intermediate Completion Date Milestone
Reason Code: CHANGED COND, Utilities Related
CLN
PON
P1 N Item Code Unify U it•Price CO .Qty Comment Amount Change
Total Value for Change Order 009 =•$ 0.00
MilestoneTime Adjustment
MileStone Nbr: 01
Milestone Description: INTERMEDIATE COMPLETION DATE
Original Completion dt: 06/12/2009 AdJ comp) dt 07/2912009 AdJ No. of Days •47
Explanation:
Whereas, the "Standard:Specifications forthls.contract:provldes for such work to .beverformedrtheiollowIng change is recommended.
General or Standard Change Order Explanation
The Contractor hes requested •a time extension of the Intermediate completion date. The dates provided by the contractoragree with project
engineers records.The delay began on. June 12.2008 and ended on July 28 2008.The delay affected all the above mentioned dates. By
•execution ofthis change order -47 additional days are granted to the intermediate comlpletion date. Overall completion date will not.be affected.
Please see attached time extension request-from contractor.
Change Order .Explanationfor.Specific.Line Item
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It lathe Intent of the parties thatthls change order Is full and complete compensatlon%rthe work describe above.
Notification and consenttoihis change order is hereby acknowledged.
too
Contractor
Date:
Jtic.y y, 201
Signed By:
NOTE: Other required State and FHWA sIgnatures will be obtained electronically through the SlteManager system.
Contract -No :B - =27185
Change Order'No:009
INDIANA
Department :of Transportation
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(SIGNATURE)
APPROVED FOR LOCAL PUBLIC AGENCY
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(TITLE)
(TITLE)
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SUBMITTED FOR CONSIDERATION
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Date:07 /09/2012
Page : -4
1td6. . ?, 2212.
(DATE)
(DATE)
APPROVED FOR INDIANA DEPARTMENT OFTRANSPORATION
Approval .Level . •
Name of Approver •
Date
Status