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Contract No:R -38065 Change Order No.: 004 <br />INDIANA Department of Transportation Page: 1 <br />Construction Change Order and Time Extension Summary <br />Contract Information Contract No.: R -38065 Letting Date:09/14/2022 <br />District:LAPORTE DISTRICT AE:Hauersperger, Steven PE/S:Dietz, Don Status:Draft <br />Change Order Information Change Order No.: 004 EWA: N or Force Acct: N <br />Date Generated: 00/00/0000 Date Approved: 00/00/0000 <br />Reason Code: FINAL QUANTITY ADJUSTMENT <br />Description: Final Quantity Balancing Change Order <br />Original Contract Amount $ 1,696,460.65 <br />Current Change Order Amount $ 82,640.84 Percent: 4.871 % <br />Total Previous Approved Changes $ 124,414.12 Percent: 7.334 % <br />Total Change To-Date $ 207,054.96 Percent: 12.205 % <br />Modified Contract Amount $ 1,903,515.61 <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