HomeMy WebLinkAboutConstruction Contract Change Order (4)
Augusta Richmond GA
DOCUMENT NAME: ton'5-tyudion c.On\-rOL-\- CY'O.n:jC: Dreier
DOCUMENTTYPE: ~ro.r:f OVOkY
YEAR: 1-DD4
BOX NUMBER: 2--0
FILE NUMBER: \ 'l \ \ 5
NUMBER OF PAGES: 2-
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CONSTRUCTION CONTRACT CHANGE ORDER
co NUi\mER 1
BID ITEM 02-176
DATE Jan 21,2004
PROJECT TITLE
ORIGINAL CONTRACT DATE
. OWNER AUGUSTA, GEORGIA
International Boulevard Sanitary Sewer Improvements
PROJECT NUMBER
PO NUMBER
October 15. 2002
50240
P 64747
The following change is hereby made to the contract for the above project:
Description of Change (for a more detailed description see attached proposal):
The Augusta Commission approved the award of a contract to Blair Constmction for the construction of the
International Boulevard Sanitary Sewer Project at their October 15, 2002 meeting. Constmction of the project
is complete. The cost of construction was less the the original contract therefore the contract amount was
revised.
PAYEE
TOTAL AMOUNT OF THIS CHANGE ORDER
Blair Constmction, Inc.
$
14,918.07
The contract time will be INCREASED by Q calendar days as a result of this change.
OlUGIN1\L CONTR1\CT AMOUNT $
PREVIOUS CHANGE ORDER (INCREASE) $
THIS CHANGE ORDER (DECREASE) $
TOTAL REVISED CONTRACT AMOUNT \VITI-I CHANGE ORDER $
217 ,786.13
0.00
-14,918.07
202,868.06
5425210
FUNDING NUi\mERjACCOUNT NUi\mE
509043420
80150240
5425210
PROPOSED BY:
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CONTI0\CTOR
DATE:
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REQUESTED BY:
DATE:
DATE:
SUBMITTED BY:
DATE:
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DATE:
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FINANCE ENDORSEMENT:
RECOMMENDED BY:
DATE:
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APPROVED BY:
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AUGUSTA UTILITIES DEPARTMENT
CAPITAL IMPROVEMENTS PROGRAM
Payment Application and Certificate
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ID/Z/o 3
DATE:
I ,
SHEET OF 4-
-
CERTIFICATE NO.:
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TO
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YR: Zoo '::l
PERIOD: FROM
PROJECT:
PROJECT NO:
S'"D2- 4-0
CONTRACTOR:
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1. Original Contract Sum
$
3/), ?Bb 13
,
2. Contract Modifications Approved in Previous Applications:
Additions $
00
0-.
Deductions $
a
00
-
3. Contract Nlodificalions Approved this Period (List Contract Modifications Nos.
o~
. Additions $
co
?J-
Deductions $
&"p
0-
4. Net Change by Contract Modifications (sum of Lines 2 and 3)
$
o~
5. Revised Contract Amount (Sum of Lines 1 and 4)
$
13
2/ /, 7Bh
f
6. Total Value of Work to Date (Estimate attached)
$
pI::>
202.. I &~ B -
/
7. Percent Project Complete (Line 6/ Line 5) x 100=
c;'~
%
8. Total Materlais on Hand (Listing attached)
$
00
0-
10. Total Retainage (
o
% x Line 9)
202.-/ gtp8 ob
$ ,-'
,
00
$ 0 -
$ 20?-/ BIb15 b~
,
$ 2bO~ 5"B~ ofeJ
,
$ 2/285 ~
,
9. Subtotal - Work Completed and Stored (Sum of Lines 6 and 8)
11. Total Earned to Date, Less Retalnage (Line 9 less Line 10)
12. Less Previous Certificates for Payment (Item 11 from Previous Application)
13. Current Payment Due (Line 111e99 LIne 12)
The undersigned Contractor certifies that the Work covered by this Application for Payment has been completed In accordance with the
Contract Documents, that the current payment shown herein Is now due, and that title for all Work, materials, and equipment covered in
this Application will pass to the Owner free and clear of all liens at the time of payme~t.
D/c-;"", ~'15..l-r"'c--/;"D.~, :::Z:;:ic.,
CONTRACTOR '
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Dale '
By
I hereby acknowledge that the material and labor involved on the above estimate Is correct to the best of my knowledge,
information and belief, and payment on same Is due Contractor.
DESIGN ENGINEER. PROGRAM MANAGER or AUGUSTA
By
Oete