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Contract No:R -35727 INDIANA Date:05/0312016 <br />Change Order No:001 Department of Transportation Page: 3 <br />_. <br />Contract: R -35727 ` <br />Project: 1298579 - $late:12985790OLC <br />Change Order Nbr: 001 <br />Change Order Description: Lower Existing Metronet Conduit & Fiber on Sample St <br />Reason Code: CHANGED COND, Utility Related <br />CLN ' N "PLN Item Code Unit Unit Price ....,....d '6tyty, , ..,, <br />4 Comment Amouunn t Change <br />0247 1298579 0226 202-06542 EACH 10,400.000 1.000 C Amount$ 10,400.00 <br />Item Description: RELOCATE <br />Supplemental Oescriptiont: Lower existing Metronet fiber and conduit for MOT 1A. <br />Supplemented Description27 <br />Total Value for Change Order 001= S 10,400.00 <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 />Existing Metronet line on Sample east of Olive did not have enough cover to facilitate the temporary widening of Sample for MOT 1A. Price is for <br />lowering to a suitable depth for placement of temp HMA. Work took 2 days to complete. <br />Change Order Explanation for Specific Line Item <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 <br />to this �change order is hereby acknowledged. <br />- j?Kr�-t <br />Contractor; �-< /" / V �._._C.L ROk5eg-N�jC}Gq�S- aA <br />Signed 6y: rM6R, <br />Date: <br />wxtM„w xyxxxrxx»K1xr,lrxxxxxrrrx+yµ»xrx,HxYwxxexfxx.xix/:M.ehxrxxwGsrxxxxMxxxw.x»rxxrrxrxxwexrv�xxxr»xxxxxrx'x axxxurbrxre <br />NOTE: Other required State and FHWA signatures will. be obtained electronically through the SiteManager system. <br />