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Rev. July 2020 <br />CHANGE ORDER Page 1 of 1 <br />WSB Project No. 021412-000 Owner Project No. Change Order No. 2 <br />Project Title/Description: Pheasant Run Reconstruction Project <br />Owner: City of Lino Lakes <br />Owner Address: 600 Town Center Parkway Lino Lakes, MN 55014-1182 <br />Contractor: A-1 Excavating, Inc. <br />Contractor Address: PO Box 90 Bloomer, WI 54724 <br />Total Change Order Amount: $58,440.00 <br />Description: <br />Emergency gate valve replacements for Captain’s Place/Black Duck (Site 1), Pheasant Run North (Site 2) and Pheasant Run <br />South (Site 3). <br />Sanitary Lining #6001 and #6002 Flex Seal. <br />Estimate Of Cost: (Include any increases or decreases in contract items, any negotiated or force account items.) <br />Group/Funding <br />Category Item No. Description Unit Unit Price + or – <br />Quantity <br />+ or – <br />Amount $ <br />Local CO2-1 Captains Place / Black Duck (Site 1) LS $34,768.00 1 $34,768.00 <br />Local CO2-2 Pheasant Run North (Site 2) LS $6,136.00 1 $6,136.00 <br />Local CO2-3 Pheasant Run South (Site 3) LS $13,246.00 1 $13,246.00 <br />Local CO2-4 FLEX SEAL LS $4,290.00 1 $4,290.00 <br />Net Change This Change Order $58,440.00 <br />Due to this change, the contract time: (check one) <br />( ) Is NOT changed ( ) May be revised as provided in MnDOT Specification 1806 <br />Number of Working Days Affected by this Contract Change: Number of Calendar Days Affected by this Contract Change: <br />Approved By Project Engineer: Date: <br />Approved By Contractor: Date: <br />Approved By Owner: Date: