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WA9701-CN060109 CITY OF COPPELL CHANGE OR EXTRA WORK ORDER PROJECT: CONTRACTOR: OWNER: City of Coppell CHANGE ORDER NO.: One (1) Belt Line / Denton Tap 16-Inch Water Line Project #WA 97-01 J.T. Dersner, Inc. DATE: January 4, 2006 Item # Description Quantity Unit Unit Price New 12' PVC Water 100 LF 45.65 New 12' Gate Valve 2 EA 1,450.00 12 6" Gate Valve 1 EA 800.00 13 Std Fire Hydrant 1 EA 1,675.00 New Fire Hydrant Ext. 4 VF 600.00 New 16" x 12" Tee I EA 450.00 New 12" x 6" Tee i EA 295.00 New 12' Solid Sleeve 1 EA 250.00 Total Revision to Contraet Amount Previous contract amount Net increase in contract mount Change Ord. #1 Revised contract amount Net increase in contract time of completion Revised Contract time of completion Total 4,565.00 2,900.00 800.00 1,675.00 2,400.00 450.00 295.00 250.00 $13,335.00 $791,659.50 $13,335.00 $804,994.50 N/A N/A The contractor hereby accepts this Contract adjustment as a final and complete adjustment in full accord and satisfaction of all past and future liability originating under any clause in the Contract by reason of this revision to the Contract. Re~ommend~_~ by City Engineer Accepted by City 1.5. b Date Date Agreed to by Contractor I~ate / - J. T. Dersner, Inc. 2101E. Shady Grove Irving, Texas 75060 Phone:(972)421-0930 Fax:(972)421-0934 Mr. Rick O'Dell City of Coppell ~n~ineel~ ~ 255 Pexkway Boulevard Coppell, Texas 75019 Phone: 972-304-7090 Ref: Denton Tap 16" Water Line Sub; Change Order Request ,1~ December 27, 2005 Extra Work at Tine In South of Airline DESCRIPTION QI~ITITY MIS UNIT TOTAL TOTAL 12'' PVC Water /~ 100 / If $ 45.65 $ 4,565.00 12'' Gate Valve ~" Gate Valve ( ~1~ 7'- ea $ 1,450.00 ,~ I ~/ ea $ 750.00 $ ' 736.06 Std Fire Hydrant -4-'/ ea $ 1,500.00 $ Fire H~/dt Extension 4 vf $ 600.00 $ ', 2,400.00 16'~(12'' Tee I ea $ 450.00 $ . 450.00 12'~(6" Tee I ea $ 295.00 $ '"2~5.00 12.' Solid Sleeve 1 ea $ 250.00 $ 250:00 $ TOTAL DESCRIPTION 12" Gate Valve Replace Defective 12" Gate valve (It' required) QUANTITY MIS UNIT TOTAL TOTAL I ea $ $ TOTAL 77-3 12../29/2005 1