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Contract No:R -37497 Change Order No.: 012 <br />INDIANA Department of Transportation Page: 1 <br />Construction Change Order and Time Extension Summary <br />Contract Information Contract No.: R -37497 Letting Date:09/11/2019 <br />District:LAPORTE DISTRICT AE:Hauersperger, Steven PE/S:Dietz, Don Status:Pending <br />Change Order Information Change Order No.: 012 EWA: Y or Force Acct: N <br />Date Generated: 00/00/0000 Date Approved: 00/00/0000 <br />Reason Code: SCOPE CHANGES, Project Upgrades <br />Description: Permanent Pavement Markings Change <br />Original Contract Amount $ 4,089,000.00 <br />Current Change Order Amount $ 9,604.74 Percent: 0.235 % <br />Total Previous Approved Changes $ 130,406.70 Percent: 3.189 % <br />Total Change To-Date $ 140,011.44 Percent: 3.424 % <br />Modified Contract Amount $ 4,229,011.44 <br />Time Extension Information <br />Date Initiated 00/00/0000 Date Completed 00/00/0000 <br />Original Contract Time SS Completion Date 00/00/0000 or SS Calendar/Work Days 0 <br />SP Date 00/00/0000 or SP Days <br />(SS = Standard Specification, SP = Special Provision) <br />Time Element Description: <br />Current Time Extension SS Days 0 SP Days 0 SP Days Value $ 0.00 <br />Previous Time Approved SS Days by AE:______ DCE:______ SCE:______ DDCM:______ <br />SS Days____________ SP Days Value $ _______________ <br />Revised Contract Time SS Completion Date 00/00/0000 or SS Calendar/Work Days 0 <br />SS Date 00/00/0000 or SP Days 0