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Change Order No. 3 - Olive Street and Sample Street Reconstruction Proj No 113-002 - INDOT
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Change Order No. 3 - Olive Street and Sample Street Reconstruction Proj No 113-002 - INDOT
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3/28/2025 1:51:46 PM
Creation date
8/11/2016 1:42:20 PM
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Board of Public Works
Document Type
Projects
Document Date
8/9/2016
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Contract No:R -35727 <br />Change Order No.: 003 <br />INDIANA Department of Transportation Page: 2 <br />Construction Change Order and Time Extension Summary <br />Review and Approval Information <br />Required Approval Authority AE: DCE: SCE:_* DDCM: <br />($ per Change Order) (-LE$250K-)(-LE$750K-)(--LE$2M--)(--GT$2M--) <br />(Days per Contract) ( 50 SS days) (100 SS days ) (200 SS Days) (GT 200 SS days) <br />Verbal Approval Required? <br />Total Change To-Date>5%? <br />Scope/Design Recommendation <br />Required? <br />Y / N If Y, by Date Issued <br />Y / N If Y, Copy to Program Budget Manager <br />Y / N If Y, Referred to Project Manager(PM) <br />Date to PM <br />Approval Authority Concurs with PM? Y / N If Y, Concurrence <br />LPA Signatures Required? <br />FHWA Signatures Required? <br />If N,Resolution: Approved <br />Resolved <br />Y / N If Y, Date to LPA <br />Date Returned <br />Date <br />Disapproved <br />Date <br />Date Returned <br />Y / N If Y, Date to FHWA Date Returned <br />" Field Engineer Recommendation (Required for SCE or DDCM Approval) <br />Field Engineer <br />Comments: <br />Date <br />
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