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i <br /> � r <br /> CATCH BASINS TO BE ADJUSTED(SPECIAL) 13 3/4 INCH X 30 Q.Q 275.00 0.00 0.00 <br /> IN H <br /> MANHOLES TO BE ADJUSTED 14.0 137.50 1925.00 <br /> MANHOLES TO BE ADJUSTED WITH NEW TYPE 1 FRAME, 43.0 764.50 32873.50 <br /> CLOSED LID <br /> VALVE BOXES TO BE ADJUSTED 10.0 32.50 325.00 <br /> VALVE BOX FRAMES TO BE ADJUSTED WITH NEW FRAMES 9•O 363.00 3267.00 <br /> SHORT-TERM PAVEMENT MARKING 500.0 0.60 300.00 <br /> DETECTOR LOOP,TYPE I 477.0 10.75 5127.75 <br /> DOWEL BARS 313.0 14.30 4475.90 <br /> TIE BARS 339.0 13.20 4474.80 <br /> 47,522.94 265,834.48 <br /> • Net Chan e 218,311.54 <br /> Amount of original contract $ 2,175,390.40 <br /> Amount of previously adjusted contract $ 2,179,899.12 <br /> Amount of adjusted/final contract $ 1,961,587.58 <br /> ❑ addition <br /> Totai net � deduction to date $ 218,311.54 which is 10.01 % of Contract Price <br /> State fully the nature and reason for the change Field AJustment as needed to complete the project <br /> When the net increase or decrease in the cost of the contract is $10,000 or more or the time of completion is increased or <br /> decreased by 30 days or more, one of the foltowing statements shall be checked. <br /> ❑ The undersigned has determined that the circumstances which necessitate this change were not reasonably <br /> foreseeable at the time the contract was signed. <br /> ❑ The undersigned has determined that the change is germane to the original contract as signed. <br /> � The undersigned has determined that this change is in the best interest of the local agency and is authorized by law. <br /> Signed Signed iy�� y'..���✓'� <br /> Highway Commissioner Municipal Officer <br /> City Engineer <br /> Title of Municipal Officer <br /> (2-�2—v� <br /> Date Date <br /> Approved Recommended Approved � I/u �=�C�.,� <br /> County Engineer ���al Engineer <br /> l�-/�-1 l D� <br /> Date Date <br /> Note Make out separate form for change in length quantities. <br /> Give net quantities only. <br /> Submit 3 copies of this form to Regional Engineer(4 copies for road district). <br /> If plans are required attach 3 sets. <br /> Page of 2 BLR 13210(Rev.7/0� <br /> Printed 11/5/2007 11:37:22 AM <br />