HomeMy WebLinkAboutIDOT-4/11/2016Form 830240wd
04-08
Iowa Department of Transportation
NNW
Change Order
No. 19
Non -
Part Part
Non -Substantial: ® ❑
Substantial: ❑ 0
Contract
Accounting ID No.: 29528 County Black Hawk
Project No: STP -U-8155(711)-70--07
Concurrence Date
Kind of Work: PCC Paving Date Prepared: November 17, 2015
Contractor: Croell & Subsidiary
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:
7003 - Increase Item 0050 for "Compaction w/ Moisture & Density Control" from 16745,00 CY to 17024.65 CY
7004 - Increase Item 0060 for "Modified Subbase" from 6772.000 CY to 6804.705 CY.
7005 - Increase Item 0080 for "Shoulder Construction, Earth" from 108.10 Sta. to 216.20 Sta.
7006 - Increase Item 0090 for "Standard or Slipform PCC Pavement, Class C Class 2 Durability, 8 In," from 33,198.000 SY to 33,445.040 SY
7007 - Increase Item 0160 for "Excavation CL 20" from 475.000 CY to 735.000 CY
7008 - Increase Item 0210 for "Aprons, Concrete, 36 IN. DIA." from 10,0 EA to 12.0 EA
7009 - Reduce Item 0310 for "Flowable Mortar" from 64.000 CY to 52.500 CY
B — Reason for change or extra work:
7003 - Item increased because the quantity was mis-calculated in the original contract.
7004 - Item Increased because the quantity was mis-calculated in the original contract.
7005 - Item Increased because the original quantity did not include both side of the road in accordance with the typical section.
7006 - Item increased because the quantity was mis-calculated in the original contract.
7007 - Item increased because the quantity was mis-calculated in the original contract.
7008 - Item increased because the quantity was mis-calculated in the original contract,
7009 - Item decreased because the quantity was mis-calculated in the original contract.
Approved
(Continued on reverse side)
Approved
District Construction Engineer Date
City of Waterloo
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
Date
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Date
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Date
Approved
Assistant Construction Engineer Date
DISTRIBUTION: Project Engineer— Forward original to District.
District—Nonsubstantiai— Forward original and one copy to the Office of Construction and two copies back 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:
7003 - 459.65 CY x $0.30 = $137.89
7004 - 32.705 CY x $31.40 = $1026.94
7005 -108.1 STA x $120.00 = $12,972.00
7006 - 247.040 SY x $25.89 = $6395.87
7007 - 260.000 CY x $5.00 = $1300.00
7008 - 2.0 EA x $665.00 = $1330.00
7009 - (11.5 CY) x $85.00 = ($977.50)
C-2 - Justification for cost(s) All Items: Contract Unit Prices
D - ITEMS INCLUDED IN CONTRACT
Accounting ID No. 1 2 1 9 1 5 1 2 8 1
1 2 3 4 5 6
Change Order No. 1
If Credit
Change
No.
Line Item Number
• Una Price
.xxx
Quantity
.xxx
Amount
.xx
7 003
0050 - Compaction w/ Moisture & Density Control
$0.30
459.65
$137.89
7 004
0060 - Modified Subbase
$31.40
32.705
$1026.94
7 005
0080 - Shoulder Construction, Earth
$120.00
108.1
$12,972.00
7 006
0090 - Standard or Slip Form PCC Pavement, Class C,
Class 2 Durability, 8 In.
$25.89
247.040
$6395.87
7 007
0160 - Excavation, CL 20
$5.00
260,000
$1300.00
7 008
0210 - Aprons, Concrete, 36 IN. DIA.
$665.00
2.0
$1330.00
7 009
0310 - Flowable Mortar
$85.00
-11,500
-3977.50
E - ITEMS NOT INCLUDED IN CONTRAC
TOTAL
$22,185.20
If Credit,
Add "CR"
Change
No.
Item Description
Item Number
Function
Code
Unit Price
.xxx
Quantity
.xxx
Amount
.xx
8
8
8
8
8
8
8
TOTAL