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Contract No:R置39540 <br />1ND霊ANÅ Del阿れme巾of T略nSPO巾贈on <br />Cons同く期on Change O巾e富and TIme E加o「lslon §umm貧ry <br />Change Order No∴ 004 <br />Page: 1 <br />Co調鴫ct lnlom寄書ion Contract No.: R -39540　　しe帖喝D重fo:03畑上陸2020 <br />D istrict:LAPORTE D ISTR!CT AE:Pa鵬rson ’Patrick PE/S:胴Is, DaIe Status‥Pending <br />Change Order lnformation Change Order No.: 004　　EWA: Y or Foroe Ac劇: N <br />Date Generatedこ09/29佗020　　　　Date Approved: 00/00/0000 <br />円ea§On Code: ERRORS & OMISSIONS, Spec Rel如ed <br />Desc吋tion: Added T「a糊c Signa冊ead & Light Pole Wo「k <br />Originai Cont「act Amount <br />Cu巾en書Change Order Amount <br />TotaI Previous Approved Changes <br />Tc固Change To-Date <br />Mod胴ed Con廿act Amount <br />Time E照ension Info「ma重!on <br />Date lnitiated OOIOO10000 <br />OriginaI Oont旧劇Time <br />Time Element Desc巾調On: <br />Current Time ExIension <br />Previous Time Approved <br />鼠evised Contract Time <br />$ 3,1雷5,了29.00 <br />$ 1 ,592.85　　　　　Percent: O.051 % <br />$ 0.OO Percent: 0。00O % <br />$ 1 ,592.85　　　　　Percen置: 0.051 % <br />$ 3,137,321 。85 <br />Date Com pleted OO/00/0000 <br />SS Completion Date OO/00/00OO or SS Calenda面付o血Days O <br />SP Date OO/00/0000　　　or SP Days <br />(SS = S帥dard Spec鵬劃ion, SP = SpeciaI Provision〉 <br />SS Days O SP Days O SP Days Value $ 0.00 <br />SS Days by AE:　　DCE:　　SCE:　　DDCM　」 <br />SS SP Days VaIue $ <br />SS CompIetion Date OO/00伯OOO or SS CalendamNork Days O <br />SS Date OO畑O伯OOO or SP Days O