Laserfiche WebLink
Contract No:R -37497 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? Y / N If Y, <br />Total Change To-Date>5%? <br />Scope/Design Recommendation <br />Required? <br />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 <br />Date Returned <br />Approval Authority Concurs with PM? Y / N If Y, Concurrence by Date <br />If N,Resolution: Approved Disapproved <br />Resolved by Date <br />LPA Signatures Required? Y / N If Y, Date to LPA <br />Date Returned <br />FHWA Signatures Required? 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 />