Laserfiche WebLink
Contract No:R -37497 Change Order No.: 004 <br />INDIANA Department of Transportation Page: 2 <br />Construction Change Order and Time Extension Summary <br />Review and Approval Information <br />Required Approval Authority AE: DCE: SCE: * DDCM: <br />($ per Change Order) (- LE $ 250K-) (- LE $ 750K -) ( -- LE $ 2 M --) (-- GT $ 2 M -- ) <br />(Days per Contract) ( 50 SS days ) ( 100 SS days) ( 200 SS Days) ( GT 200 SS days) <br />Verbal Approval Required? <br />Total Change To-Date>5%I <br />Scope/Design Recommendation <br />Required? <br />Y / N If Y, by Date Issued <br />Y / N If Y, Copy to Program Budget Manager <br />Y / N If Y, Referred to Project Manager(PM) <br />Date to PM <br />Approval Authority Concurs with PM? Y / N If Y, Concurrence <br />LPA Signatures Required? <br />FHWA Signatures Required? <br />If N,Resolution: Approved <br />Resolved by. <br />Y / N If Y. Date to LPA <br />Date Returned <br />Date <br />Disapproved <br />Date <br />Date Returned <br />Y / N If Y, Date to FHWA Date Returned <br />* Field Engineer Recommendation (Required for SCE or DDCM Approval) <br />Field Engineer <br />Comments: <br />Date <br />