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Contract No:R -38065 INDIANA Date:04/24/2024 <br />Change Order No:004 Department of Transportation Page: 3 <br />Contract:R -38065 <br />Project:1401811 - State:140181100LC4 <br />Change Order Nbr: 004 <br />Change Order Description: Final Quantity Balancing Change Order <br />Reason Code:FINAL QUANTITY ADJUSTMENT <br />CLN PCN PLN Item Code Unit Unit Price CO Qty Comment Amount Change <br />0021 1401811 0021 301-12234 CYS 139.000 255.840 C Amount:$ 35,561.76 <br />Item Description:COMPACTED AGGREGATE NO. 53 <br />Supplemental Description1: <br />Supplemental Description2: <br />0026 1401811 0026 601-03667 LFT 205.000 240.500 C Amount:$ 49,302.50 <br />Item Description:RAILING ORNAMENTAL <br />Supplemental Description1: , FOR TRAIL <br />Supplemental Description2: <br />0044 1401811 0044 621-06575 SYS 13.700 1501.940 C Amount:$ 20,576.57 <br />Item Description:SODDING, NURSERY <br />Supplemental Description1: <br />Supplemental Description2: <br />0052 1401811 0052 731-93947 LFT 100.000 -228.000 C Amount:$ -22,800.00 <br />Item Description:LEVELING PAD, CONCRETE <br />Supplemental Description1: <br />Supplemental Description2: <br />Total Value for Change Order 004 = $ 82,640.83 <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 />This is a balancing change order for the final contract quantities for the over/under runs. <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.