HomeMy WebLinkAboutIowa Department of Transportation-5/7/2012 (3)Form 830240wd
04-08
Contract
�1Iowa Department of Transportation
Change Order
s
No. 1
Non -Substantial:
Please return this copy to:
City Clerk & Finance Department
715 Mulberry Street
Waterloo, IA 50703
Non -
Part
0
Part
Substantial: 0 0
Accounting ID No.: 29528 County Black Hawk
Concurrence Date
Project No: STP -U-8155(711)-70-07
Kind of Work: PCC Paving Date Prepared: April 23, 2010
Contractor: Croell and Subsidiaries, Inc.
You are hereby authorized to make the following changes to the contract documents.
A - Description of change to be made or extra work to be done:
8001 - Removal of Field Tile - Remove field tile and recompact trench.
8002 -_8" Subdrain Plastic Pipe. 8 IN. - Place tile collection line to connect field tiles to RCP subdrain that will cross the Right of Way.
The effect on Working Days is unknown at this time and will be addressed by a future Change Order.
B — Reason for change or extra work:
8001 - Field tile lateral lines were found existing within the Right of Way. Work is to remove tile lines that were found to not have sub -standard
pipe existing under the road.
8002 - Tile collection line to be put along the Right of Way and collect all tile lines were removed within the Right of Way and carry them to a
concrete subdrain that will connect across the Right of Way.
Approved
(Continued
Approved '� `-. 5/?18-
District
1Z
District Construction Engineer Date
City of Waterloo
Fa ' Project Engineer
Receipt is acknowledged of this change or extra work and terms of settlement are hereby agreed to.
Approved contingent upon funds being available under the existing
project agreement or upon additional Federal -aid funds being
made available by a modified project agreement.
Date For the Division Administrator
Federal Highway Administration
56 td.02—
Date
Date
By
Date
Approved
Assistant Construction Engineer Date
DISTRIBUTION: Project Engineer — Forward original to District.
District — Nonsubstantial — Forward original and ane Dopy to the Office of Construction and two copies bads to the Project Engineer.
- Substantial - Forward original and two copies to the Office of Construction.
C-1 —Settlement for cost of work to be made as follows:
8001 - 2900 LF x 5.00/LF = $14,500.00
8002 - 900 LF x 16.00/LF = $14,400.00
$14,500.00 + $14,400.00 + 10% = $31,790.00
Accounting ID No. 12 19 15 12 18 I I
1 2 3 4 5 6
Change Order No. 1
C-2 — Justification for cost(s)
8001 - Individual costs have been agreed to based on certified payroll expenses, and equipment rates justifiable by Rental
Rate Blue Book values. A copy of the contractor invoice is filed with the project.
8002 & 8003 - Agreed price is comparable to other Awarded Contract Prices on DOT let projects for similar items. A copy of
the contractor invoice is filed with the project.
D - ITEMS INCLUDED IN CONTRACT
If Credit
Add "CR"
Item Number
Change
No.
Line Item Number
Unit Price
.xxx
Quantity
.xxx
Amount
.xx
7
2599-
9999009
$5.50
2900.00
7
8002
Subdrain Plastic Pipe, 8 IN.
2502-
8212108
7
900.00
$15,840.00
8
7
7
7
8
IOWA DEPARTMENT
7
8
TOTAL
- ITEMS NOT INCLUDED IN CONTRACT
If Credit,
Add "CR"
Change
No.
Item Description
Item Number
Function
Code
Unit Price
.xxx
Quantity
.xxx
Amount
.xx
8001
Remove Field Tile
2599-
9999009
$5.50
2900.00
$15,950.00
8002
Subdrain Plastic Pipe, 8 IN.
2502-
8212108
$17.60
900.00
$15,840.00
8
8
8
IOWA DEPARTMENT
8
OF TRANSPOR I A t „
DISTRICT2
8
14AY 2 5 2012
MASON CITY, IH
TOTAL $31,790.00