SR 522 Snohomish River Bridge to US 2 Vic - 8128 CO 188€¦ · Title: SR 522 Snohomish River...
Transcript of SR 522 Snohomish River Bridge to US 2 Vic - 8128 CO 188€¦ · Title: SR 522 Snohomish River...
l WASHINGTON STATE
DEPARTMENT OF TRANSPORTATION
CHANGE ORDER DATE: 01/17 /17 Page 1 of .3
CONTRACT NO: 008128 FEDERAL AID NO: CONTRACT TITLE: SR 522, SN'JliCMISH RIVER BRIOOE 'IO US 2 VIC � CHANGE ORDER NO: 188 RESOLVE ALL ISSUES
f'1 CC PRIME CONTRACTOR: sCARSELIA BROS., me. f= / V CD
P o oox 68697 JAN 2 0 2017 WA sex;�-0697
SELLA BRos, /Ne. SE'ATI'LE
(X) Ordered by Engineer under the terms of Section 1-04.4 of the Standard Specifications
SURETY CONSENT:
I ATTORNEY IN FACT
DATE
ORIGINAL CONTRACT AMOUNT: CURRENT CONTRACT AMOUNT: ESTIMATED NET CHANGE THIS ORDER: ESTIMATED CONTRACT TOTAL AFTER CHANGE: Approval Required: ( ) Region
DATE
73,138,890.32 75,334,803.81
2,042,000.00 77,376,803.81
( ) Olympia Service Center
�) APPROVAL RECOMMENDED ( ) EXECUTED EXECUTED:
� 77 � Tim Nau,Asst. PE
PROJECT ENGINEER
( ) Local Agency
j.A"APPROVAL RECOMMENDED ( ) EXECUTED OTHER APPROVAL WHEN REQUIRED
RmmN�AD�rk6 tLIL
DATE
CG02v04 lrevlsed Feb 2005) rb, nG. ,� "7Jq
SIGNATURE
REPRESENTING
DATE