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10-21-19-WS
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10-21-19-WS
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mvl STATE AID FOR LOCAL TRANSPORTATION <br />CHANGE ORDER <br />1RA"StOTA(IOH <br />Rev. February 2018 <br />Sp/SAP(s) x187-020-021 MN Project No.: Change Order, No. 4 <br />Of Cost: <br />(Include any increases or decreases in contract iten7s, <br />Di dription <br />any <br />Unit <br />negotiatedEstimate <br />Unit Price <br />Quantity <br />Amount $ , <br />Group/ <br />funding <br />Category <br />Item No. <br />4Adjustments <br />Pedestrian Flasher System <br />EACH <br />$ 1,540.00 <br />2 <br />$ 3,080.00 <br />Prime Contractor Markup <br />10% <br />$ 308.00 <br />4 <br />Extra Drain Tile Work <br />LS <br />$ 2,516.56 <br />1 <br />$ 2,516.56 <br />Net Change this Change Order <br />$ 5,904.56 <br />*Estimated amount, final quantities have not been completed <br />**Group/funding category is required for federal aid projects <br />Due to this change, the contract time: (check one) <br />(X) Is NOT changed I () May be revised as provided in MnDOT Specification 1806 <br />( ) Is Increased by Working Days (X) Is Increased by _12 Calendar Days <br />( ) Is Decreased by Working Days ( ) Is Decreased by Calendar Days <br />Approved by P, r: <br />Date: IZ IJ <br />Print Name: <br />Approved by Contractor: Date: jVIA// <br />Print Name: M SN-�-+ • <br />Approved by Ramsey County: <br />Date: <br />Print Name: <br />Consultant Engineer:� Date: 12AI--- I.9 <br />Print Name: (Ira` C_ 1� � <br />DSAE Portion: The State of Minnesota is not a participant in this contract. Signature by the <br />District State Aid Engineer is for FUNDING PURPOSES ONLY and for compliance with State <br />and Federal Aid Rules/Policy. Eligibility does not guarantee funds will be available. <br />This work is eligible for: — Federal Funding _ State Aid Funding _ Local funds <br />District State Aid Engineer: <br />Page 2 of 2 <br />Date: <br />
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