Change Order No 27 - Michigan Street Repaving Proj No. 123-066 - INDOT

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Contract No:B -40600 INDIANA Date:01/09/2024 Change Order No:027 Department of Transportation Page: 3 Contract: B -40600 Project: 1701538 - State:170153800ST4 Change Order Nbr: 027 Change Order Description: Over/Under CO for the City of South Bend Reason Code: FINAL QUANTITY ADJUSTMENT CLN PCN PLN Item Code Unit Unit Price CO Qty Comment Amount Change 0209 1701538 0147 306-08038 SYS 8.300 -2576.000 C Amount:$ -21,380.80 Item Description:MILLING ASPHALT 4 IN Supplemental Description1: City of South Bend Supplemental Description2: 0210 1701538 0148 109-08440 DOL 1.000 25595.000 C Amount:$ 25,595.00 Item Description:QUALITY ADJUSTMENTS HMA Supplemental Description1: City of South Bend Supplemental Description2: 0212 1701538 0150 401-07404 TON 98.000 -265.000 C Amount:$ -25,970.00 Item Description:QC/QA-HMA 4 76 INTERMEDIATE 19.0 mm Supplemental Description1: City of South Bend Supplemental Description2: Total Value for Change Order 027 = $ -21,755.80 Whereas, the Standard Specifications for this contract provides for such work to be performed, the following change is recommended. General or Standard Change Order Explanation The original calculations for the asphalt milling were rough calculations. When the milling was field measured it amounted to 2576 Syds less than anticipated. Asphalt quantities were based on rough calculations and the amount of Intermediate was 265 Tons under the anticipated amount. The original amount of Quality Adjustment was placed at $1.00 to have the item available without creating a new change order once all of the testing was completed. After the testing was complete an additional $25,595.22 was due to the contractor based on results from INDOT Testing. General or Standard Change Order Explanation A contract time adjustment is not required for this change. Change Order Explanation for Specific Line Item **************************************************************************************************************************** It is the intent of the parties that this change order is full and complete compensation for the work describe above. Notification and consent to this change order is hereby acknowledged. Contractor:____________________________________________ Signed By:_____________________________________________ Date:__________________________________________________ *************************************************************************************************************************** NOTE: Other required State and FHWA signatures will be obtained electronically through the SiteManager system.