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2008-24CI IANGE ORDER NO. 1 Project No. 04236000 Date October 1, 2007 Owner Cit ~ of Clermont Project Address Rloxam Avenue Contractor Rainev Construction Co. Change Ordered: Pipe sizes. and alignment of new drainage pipe. Reason for Change Order: Rc-alignment of proposed storm drainage system. CONTRACT A1~TOUN'C Original Contract Amount Previous Change Orders Change Order Addition Change order Deduction Revised Contract Amount $1,038,338.60 $0.00 $23,025.50 $1,061,364.10 This document shall become an amendment to the Contract and all stipulations and covenants of the Contract shall apply hereto. .,~' << ontract r~ Owner (City/Co ty) Y71 A y u f r K --~ Engineer Grant Administrator y2s-o ~1 Date !9 - ~~ Date 7~j~~C~ Uate Date 36 August 13, 2007 Rainey Canstruc~ion Company 4477 East CR-462 Bloxam Ave Improvements Wildwood, FE 34785 352-74$-0955 Fax 352-748-4372 Description Quantity UM Item Unft Item Total PITT S7 5TORM CHANGE 1 Delete 36" RCP -266 LF 65.00 (24,310.00} Z Delete 54" RCP -66 LF 147.00 (9,702.00) 3 Delete 5a" MES w/ Dissipator -1 EA 4,SOO.Op (4,SOO.OD} 4 42" RCP 259 LF 95.00 24,6D5.00 5 4B" RCP 84 LF 115.00 9,660.D0 6 46" MES wl Dissipator 1 EA 3,500.00 3,5D0.00 7 2" Type S-III Asphalt 650 SY 9.45 6,142.50 8 8" Limarock wl Prtme 650 SY 14.85 9,652.5D 9 12" Stabilized Subgrade 3D0 SY 3.60 1,08D.OD 10 Type FCurb -South Side Only 295 LF 10.00 2,950.OD TOTAL 19,078.00 PITT~ST QVERLAY 14+0 T(~ 1,x+75 1 1" Overlay S-III Asphalt w1 Tack 355 SY 4.50 1,597.50 2 18" RCP 40 LF 40.D0 1,600.00 3 18" MES 1 EA 750.00 750.00 TOTAL 3,947.50 GEtANO TOTAL 23,025.50 Page 1 Contractor Rainey Construction Ca. Project Name: City of Clermont - 4477 East CR 462 Bloxam Ave Improvements Wildwood, FI. 34785 contact: Mathew Bass contract#: Engineer: Kjmley-Horn Phone. (352} 748-0955 Invoice Date: 4/29!2008 Fax: (352) 748-4372 Invoice #' 4--2814 Original Contract Sum $ 1,038,338.60 Net Change by Change Order $ 23,025.50 Contract Sum to Date $ 1,061,364.10 Total Completed to Date $ 1,061,364.10 Retainage (10°~ of Completed Work) $ 106,136.41 Totat Earned Less Retainage $ 955,227.69 Less Previous Payments & Requests $ 882,827.19 Total Completed This Period $ 80,445.00 Less: Retainage This Period $ 8,044.50 TOTAL DUE THtS t?ER4OD $ 72,400.50 The Undersigned Contractor certifies that (1}all previous Progress Payments received from Owner on account of Work done under the Contract referred to above have been applied on account to discharge Contractor's legitimate obligations incurred in connection with Work covered by prior Requests for Partial Payment; (2} title of a{l Work, Materials and Equipment incorporated in said Work or otherwise listed in or covered by this Request for Partial Payment. will pass to Owner at time of Payment free and dear of at! Liens, Security interests and encumbrances; (3} all Work covered by this Request far Partial Payment is in accordance with the Contract Documents and not defective; and (4} the current Payment requested hereon is correct. RAINEY CO TRUCTION COMPANY BY~ ~.__._._ James. a Rainey Title: Presiders Date: y Z 9- f1 ~ In accordance with the provisions of the Contract and this Request for Partial Payment, the undersigned certifies that the information shown hereon has been verified and that the Contractor is entitled to payment as shown subject to the terms of the Contract. KIMLE~~ 6Ct~c~. r ~,,,.-~~.---z.-- Christop er ermana, P.E. Rate: ~~ ~~I~ ~ !n accordance with the provisions of the Contract and this Request for Portia{ Payment, the undersigned certifies that the information shown hereon has been verified and that the Contractor is entitled to payment as shown subject to the terms of the Contract. ~ ~F J~f ~ /' ., t'~~r/ y -CC~. 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