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Contract No:R -38064 INDIANA Date:06/27/2022 <br />Change Order No:014 Department of Transportation Page: 3 <br />Contract:R -38064 <br />Project:1401810 - State:140181000LC4 <br />Change Order Nbr: 014 <br />Change Order Description: HNA Patching <br />Reason Code:ERRORS & OMISSIONS, Design/Plan Related <br />CLN PCN PLN Item Code Unit Unit Price CO Qty Comment Amount Change <br />0142 1401810 0141 304-07490 TON 401.250 56.000 C Amount:$ 22,470.00 <br />Item Description:HMA PATCHING TYPE B <br />Supplemental Description1: <br />Supplemental Description2: <br />Total Value for Change Order 014 = $ 22,470.00 <br />Whereas, the Standard Specifications for this contract provides for such work to be performed, the following change is recommended. <br />General or Standard Change Order Explanation <br />There was no pay item for HMA patching in the contract. HMA patching was necessary along the edge of the Portage Plaza parking lot after <br />constructing the trail and on Woodward Avenue after construction of the pedestrian crossing and install storm sewer across Woodward Avenue. <br />The contractors change order request form is attached to this change order. A cost analysis was performed, and the cost was found to be within <br />the average unit price for this item and deemed acceptable. The work is necessary to complete the original scope of the contract and therefore <br />deemed participating. The AE and PM have been notified and their notification, concurrence emails are attached. <br />Change Order Explanation for Specific Line Item <br />**************************************************************************************************************************** <br />It is the intent of the parties that this change order is full and complete compensation for the work describe above. <br />Notification and consent to this change order is hereby acknowledged. <br />Contractor:____________________________________________Signed By:_____________________________________________ <br />Date:__________________________________________________ <br />*************************************************************************************************************************** <br />NOTE: Other required State and FHWA signatures will be obtained electronically through the SiteManager system. <br />Robert P. Kuhns, P.E. <br />Selge Construction Co., Inc. <br />6/28/22