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t . � , . <br /> • State fully the nature and reason for the change Relocating inlets out of driving surfacing and failing inlet <br /> structures <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 following 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 <br /> law. <br /> Signed Signed ��� <br /> Highway Commissioner Municipal Officer <br /> ��jb'�� <br /> Title'of Municipal Officer <br /> G 22—�5 <br /> Date Date <br /> Approved Recommended Approved <br /> County Engineer District Engineer <br /> �t lv�l�' - <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 fortn to District Engineer(4 copies for road district). <br /> If plans are required attach 3 sets. <br /> BLR 6301 (Rev.2/01) <br /> Page 2 of 2 <br />