HomeMy WebLinkAboutChange Order 1
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CHANGE ORDER - EXTRA WORK AGREEMENT NO.
1
JOB NO. 0965
Project Name: Spring Street P.S. Interceptor Rehabilitation
Jeffersonville Sewer Board
Owner:
Contractor:
Insituform Technologies USA, Inc.
1. Siphon Vault Rehab, Manhole Bench Installation, Quantity Adjustments (See Attached)
$ 11,721.40
The Method of payment for this Change Order shall be an increase in the amonnt of:
One Dollars and Fort Cents
$ 11,721.40
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Owner's Approval: Jeffersonville Sewer Board
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Signature ofOwner(s)
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, Date J
Contractor's Approval: Insituform Technologies USA, Inc.
Title
Date
Authorized Representative
S\EP2002\PROJECTS\0965\0965-co1
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Attn:
Attn:
~ Insituform<
2130 Stout Field West Drive
Indianapolis, Indiana 46241
Phone (800) 633-6333 Fax (317)843-0076
Request for Change Order
November 25,2009
One
Len Ashack
Josh Hillman
City of Jeffersonville, Indiana
Jeffersonville City Hall
500 Quartermaster Court
Jeffersonville, Indiana 47130
Jacobi, Toombs and Lanz,lnc.
120 Bell Avenue
Clarksville, IN. 47129
Ii
I Description
Spring Street Pump Station Sewer Rehabilitation
Jeffersonville, Indiana
ManholeNault Lining and Sluice Gate Removal
Descriotion Unit Qty Unit Price Total
Manhole Lining EA -3 $ 2,882.60 $ (8,647.80)
Rehabilitate Siphon Vaults LS 2 $ 6,500.00 $ 13,000.00
Install Bench walls in Manholes EA 11 $ 400.00 $ 4,400.00
Remove Sluice Gates' LS 1 $ 3,750.00 $ 3,750.00
'(See attached Culy Documents)
24" Insituform@ CIPP LF -79 $ 82.60 $ (6,525.40)
21" Insituform@ CIPP LF 57 $ 74.30 $ 4,235.10
18" Insituform@ CIPP LF 8 $ 56.50 $ 452.00
Sub Total $ 10,663.90
5% OH and Profit $ 1,057.50
.,
Total
1$
11,721.40
Date:
Approved By:
Date:
Approved By: