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Change Order Nos. 1,2,4,5,6 - INDOT - Boland Trail Project No 113-047
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Change Order Nos. 1,2,4,5,6 - INDOT - Boland Trail Project No 113-047
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4/3/2025 10:22:10 AM
Creation date
7/11/2018 11:05:01 AM
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Board of Public Works
Document Type
Projects
Document Date
7/10/2018
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CHANGE ORDER REQUEST FORM <br />CONTRACT NO. R �6881 <br />UPON WRITTEN TE REQUEST FROG#! THE ENGINEER, PROVIDE ADDITIONAL DETAIL <br />BATE RECEIVED RERU1 ST FOR <br />I�ly �.8 <br />2, �a <br />SUBMITTAL DATE OF <br />July <br />ADDITIONAL DETAIL <br />ADDITIONAL DETAIL <br />DETAILED DESCRIPTION / JUSTIFICATION: <br />(include location(s), actions of contractor, owner, and other stakeholders, key events and related couse(s), discoveries, <br />discussions, meetings, and effect on the contract if no action is taken. Also include references to key documents attached <br />or available to support this change order request.) <br />PROPOSED SOLUTION --ADDITIONAL DETAILS: <br />(include proposed scope of work, means & methods, materials, equipment, utility relocation required, subcontracted <br />scope and the effect on the contract schedule. Also include references to attached documents including, but not limited <br />to, sketches, calculations, photos, material information, and submittals and meeting minutes.) <br />Hawk Erterpris,es is tlodrsolebBt source,n this protect This change will;sl�ghti.y raise"our.©BE <br />percentage on'he protect <br />Submittals for the sonar flasher system and Telco cabinet have been provided ,to the,E.n;ineer <br />SIGNATURES <br />Contractor: �-�-- <br />Name: (print) J be sA C.S <br />ji <br />(signature) 9!!� � Date <br />7-9- ce <br />"o 2 <br />
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