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ST9905-CN070921 CITY OF COPPELL CHANGE OR EXTRA WORK ORDER PROJECT: Bethel Road I Project # ST 99-05 CONTRACTOR: Tiseo Paving Company OWNER: City of Coppell CHANGE ORDER NO.: Four (4) DATE: September 21, 2007 Item Description Quantity Unit Unit Price Total ADD: 1. 2. 3. 4. Changes to Storm Drain Line D: Additional Staking Connect RCP to Box Culvert Restocking Fee for unused RCP Remove Existing 16" Valve Total Revision to Contract Amount 4 EA 250.00 $1,000.00 4 EA 800.00 $3,200.00 1 LS 6,072.00 $6,072.00 1 LS 3,975.00 $3,975.00 $14,247.00 $7,293,659.00 0 $8,000.00 $8,580.00 $14,247.00 $7,324,486.00 0 573 Calendar Days Previous contract amount Net increase in contract amount Change Order #1 Net increase in contract amount Change Order #2 Net increase in contract amount Change Order #3 Net increase in contract amount Change Order #4 Revised contract amount Net increase in contract time of completion Revised Contract time of completion 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. 1lI~ KjJ_ q. 21.7 ~ende~ b~ Engineer Date i~~~ Agreed to by . ntractor 9-;2.,7-07 . Date ~d/- Date ~I, ~ 5 /v/f7/#1