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10-21-19-WS
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10-21-19-WS
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MI STATE AID FOR LOCAL TRANSPORTATION Rev. February 2018 <br />PARTM. <br />RECHANGE ORDER <br />T 10 <br />TRANSPORTATION1 <br />I-TM <br />SP/SAP(s) 187-020-021 MN Project No.: Change Order No. 6 <br />Estimate Of Cost: <br />(Include any increases or decreases in contract items, <br />any negotiated or force <br />account items.) <br />**Group/ <br />funding Item No. <br />Description <br />Unit Unit Price <br />+ or— <br />+ or — <br />Category <br />Quantity <br />Amount $ <br />3 <br />Additional Traffic Control <br />LS <br />$ 1,540.00 <br />2 <br />$ 19,061.35 <br />Extra Concrete work for added Catch <br />5 <br />Basins <br />LS <br />1 <br />$ 9,352.80 <br />Prime Contractor Markup <br />10% <br />$ 2,841.42 <br />Net Change this Change Order $ 31,255.57 <br />*Estimated amount, final quantities have not been completed <br />"Group/funding category is required for federal aid projects <br />Approved by City Engineer: <br />Print Name: <br />Approved by Contractor: <br />Print Name: <br />Approved by Ramsey County: <br />Print Name: <br />Consultant Engineer: <br />Print Name: <br />Date: <br />Date: <br />Date: <br />Date: <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 2of2 <br />Date: <br />
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