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Cont略ct No :R -39540　　　　　　　　　I N DIANA Date:脚佗9/2020 <br />Change O巾er No‥004　　　　Dep軸men喜of Transpo鷹ation page: 3 <br />Contract:　　　　　　　　　R書39540 <br />Pやject:　　　　　　‘ 1 60OO74 - St繍晦:1 60007400LC4 <br />Change Orde「 Nbr:　　　004 <br />Change Order Descriptlon: Added Tr鮒lc S屯nal Head & 」ight Pole Work <br />Reason Cod匂:　　　　　巨RFiORS & OMISSIONS, §pec Related <br />占調音‥∴音音音曲∴∴∴討議二五品￣山高￣￣￣⊥高p巾　00印　加軸　　　▲血証跡調印　￣ ￣￣￣￣￣￣ <br />0150 160脚74　　0150 10帥範07　」S l,50芝.鎚町　　　1.000　　　　　c A請ou聴$　　　1,592勝 <br />Itom Dl掲crIptIon: ADDITIONA」 <br />Supple巾ental Desc巾tIonう: T融flc S鴫画l Hea寄VIcor and uきht Pole Bannor A剛Wb血 <br />Supplem ental Desol呼Ionと: <br />To曲Value for Change Orde「 OO4 = $ 1.5g2.85 <br />W鵬能町同e St轟nd種巾SpcelIlc種曲れ3 for洲3 ∞nmct Pro伽e$ to'関ch w馴庇to be p強心営medl請e foIIo軸的ch創nさeぬl.e∞mmendeさ. <br />Gene軸or §I劃dard Change Old合r ExplanatloII <br />The Cfty o鴫ou請Bend r叩鳩sted iha=he t脇間軸na用e蘭visors be o旭nge[=or伽e Rock鵬DI・ ea拙ound sゆa底. New v迫r8 We「e Prov絢ed <br />by the Cfty. The co$t to do個8 WOrk was $5G5.19・珊e Cfty of South Bond also request‘如[ha=he i)gm poleぬnner moun伽g bracke屯be <br />鳩mo唯d from the他ht poIes・ The cost to do胴s work was $l ,027.66. <br />change O同部Explan競Ion foI' SpcelfloしIne同m <br />教書〇番●裏書◆●青書●青書書書事後〇番裏書青書●青書●●青書裏書置後書き●青書書裏書裏書書後置書富農青書書筆書書●書青書着後書曾青書●筆書青書書青書よこ古さ●青書賀青書"置場青書青書青か青書●裏書書書青書青●書曾筆書●●●曾筆書●青書筆書青書筆書 <br />It速肌β lntem of請e pa鵬s that部§くれange ordor l§ full aJld ∞叩f廟9 CO叩鵜鴫劇fb両or請e wo水descrlbe abov○○ <br />No競同c鮎on and consem Io lhls cha叩e Order ls n訓ol坤acknow鳳的鎖]. <br />○○n同職or : <br />ロ相　手青少年♂ <br />●青書“物置剛州叩き●剛書冊酬動議青書偉観裏書裏書納ま <br />NOTE: O請e「 r印uire鴫State and FHWA slgn軸u「es聞l be o膜alned軸伽o面ca叩y請roug掴he Slt的動的o鴫ystem.