HomeMy WebLinkAboutItem 7 - Change Order No 4 CONTRACT CHANGE ORDER FORM
CITY OF LAKE ELMO, MINNESOTA FOCUS ENGINEERING, inc.
KEATS MSA STREET AND TRUNK WATERMAIN IMP
PROJECT NO.2012.129
CHANGE ORDER NO. 4 DATE: September 24, 2013
TO: T.A.SCHIFSKY&SONS, INC.,2370 E HIGHWAY 36,NORTH ST. PAUL, MN 55109
This Document will become a supplement to the Contract and all provisions will apply hereto.The Contract Documents are
modified as follows upon execution of this Change Order.
CHANGE ORDER DESCRIPTION/JUSTIFICATION:
This change order provides compensation to the contractor to remove and replace an existing 12"flared end section and to
perform ditch grading in multiple locations that were beyond the limits of the original project scope.The original contract
required this flared end section to be salvaged and replaced.However,the flared end section was found in the field to be
damaged. The additional ditch grading work was requested by the City in various locations to provide a better final grade and
drainage system.Time associated with the additional grading was tracked in the field and is reflected in the itemization below.
Attachments (list documents supporting change): N/A
ITEM DESCRIPTION OF PAY ITEM UNIT QTY UNITE PRICE INCREASE/(DECREASE)
C04-1 Install 12"RCP Apron w/Trash Guard EA 1 $1,155.00
$1,155.00
C04 2 Time and Material-Backhoe HR 10 $60.00
_$600.00_
C04-3 Time and Material-Laborer HR 10 $68.00
$680.00
C04-4 Time and Material-Operator HR 10 $72.00
$720.00
C04-5 Time and Material-Truck/Driver HR 10 $95.00
— $950.00
NET CONTRACT CHANGE $4,105.00
Amount of Original Contract $ 1,606,833.47
Sum of Additions/Deductions approved to date(CO Nos. 1,2,and 3) $ 7,260.00
Contract Amount to date $ 1,614,093.47
Amount of this Change Order (ADD) (s€Bl'C-- ) (Nc)GHAp,C ) $ 4,105.00
Revised Contract Amount $ 1,618,198.47
The Contract Periods for Completion will be (UNCHANGED) (INGo P) (DK gip) 0 days
Y
APPROVED BY ENGINEER: FOCUS Engineering, inc. APPROVED BY CONTRACT R
CUa
ENGINEER
9/24/2013
DATE DATE
APPROVED BY OWNER: CITY OF LAKE ELMO, MINNESOTA
BY
BY
DATE
DATE
FOCUS Engineering,inc.
CHANGE ORDER FORM