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J <br />• SEH CHANGE ORDER <br />City of Lino Lakes, Minnesota December 15, 2008 <br />• <br />OWNER DATE <br />OWNER'S PROJECT NO <br />Legacy at Woods Edge - Phase 2 <br />PROJECT DESCRIPTION <br />5 <br />CHANGE ORDER NO. <br />A- LINOL0305.03 <br />SEH FILE NO. <br />The following changes shall be made to the contract documents: <br />Description: <br />Additional Charges to Complete Lake Drive Lighting <br />• Additional mobilization $725.00 <br />• Traffic control on 35W $822.00 <br />• Traffic control on Lake Drive $517.86 <br />• Modify bridge pole adapter plates $560.45 <br />• Total for this work $2,625.31 <br />Total Cost: $2,625.31 <br />Purpose of Change Order: <br />Additional work required to mobilize and install light poles on the Lake Drive bridge over 35W due to <br />anchor bolt pattern changes installed under Lake Drive contract. <br />Basis of Cost: ® Actual ❑ Estimated <br />Attachments (list supporting documents) <br />Details of work completed for Change Order #4 <br />Contract Status <br />Original Contract <br />Net Change Prior C. O. 's 1 to 4 <br />Change this C.O. <br />Revised Contract <br />Time <br />N/A <br />Recommended for Approval: Short Elliott Hendrickson Inc. by <br />Agreed to by Contractor: <br />Cost <br />$483,135.84 <br />$153,504.41 <br />$2,625.31 <br />$639,265.56 <br />Susan Mason /Project Manager <br />Approved for Owner: <br />BY Signature Lighting Inc. BY City of Lino Lakes, Minnesota <br />TITLE TITLE <br />Distribution Contractor 2 Owner 1 Project Representative 1 SEH Office 1 <br />s:\ko \I \linol\ 030503 \legacyph2 \constphase \co #5.doc 1/04 <br />Short Elliott Hendrickson Inc., 3535 Vadnais Center Drive, St. Paul, MN 55110 -5196 <br />SEH is an equal opportunity employer 1 www.sehinc.com 1 651.490.2000 1 800.325.2055 1 651.490.2150 fax <br />