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Contract No:B -44292 <br />INDIANA Department of Transportation <br />Construction Change Order and Time Extension Summary <br />Review and Approval Information <br />Required Approval Authority <br />($ per Change Order) <br />(Days per Contract) <br />Verbal Approval Required? <br />Total Change To-Date>5%? <br />Scope/Design Recommendation <br />Required? <br />Change Order No.: 006 <br />Page: 2 <br />AE: V DCE: SCE: * DDCM: <br />(-LE$250K-)(-LE$750K-)(--LE$2M--)(--GT$2M--) <br />( 50 SS days ) ( 100 SS days) ( 200 SS Days ) ( GT 200 SS days) <br />®/ N If Y, by S.Hauersperger Date Issued 5/20/24 <br />Y /(E)If Y, Copy to Program Budget Manager. <br />Y AMIf Y, Referred to Project Manager(PM) <br />Date to PM Date Returned <br />Approval Authority Concurs with PM? Q/ N If Y, Concurrence by J.Krueckeberg <br />LPA Signatures Required? <br />FHWA Signatures Required? <br />Date 5/20/24 <br />If N,Resolution: Approved Disapproved <br />Resolved by <br />0/ N If Y, Date to LPA 5/22/24 <br />Date <br />Date Returned <br />Y /lalf Y, Date to FHWA Date Returned <br />* Field Engineer Recommendation (Required for SCE or DDCM Approval) <br />Field Engineer <br />Comments: <br />Date <br />