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DocuSign Envelope ID:A6E80449-4F51-48F6-85DB-7136A80CD513 <br /> CHANGE PROPOSAL FORM <br /> P,oj cct: Ef*nd SS to Mebane to Mebane Phase 2 <br /> Contract: 16.01904 <br /> Contractor: JF Wilkerson Contracting Inc. <br /> Utility <br /> Construction Proposal# FaN. <br /> '. d' <br /> Project# CIP300" <br /> Contractor# cm <br /> Description of Chang*: <br /> Edens! Alternate 2 per Line C Extension Plan and Profile Sheet C-2 as prepared by McGill Associates <br /> Items will be paid by unit pricing in the contract. <br /> Mobilization 1 I.S. $ 390.00 $ 390.00 <br /> a• DIPGS6-8 107 I.F. $ 59.00 S 6,313.00 <br /> Asphalt Road Cut 30 LF. $ 110.00 $ 3,300.00 <br /> Additional Traffic Control IE.A. $ 1.000.00 $ 1,000.00 <br /> 4•Sewer Service IE.A. S 3,500.00 3,500.00 <br /> Total Line C Extension $ 14.503.00 <br /> Time Extension Request 15 days <br /> The Contractor agrees 1)perlonn the vn1<ouU,ned n Ih,s change proposal far 11e ah04I specified above and In accordance Wh 11e <br /> Conlracl documents *the vo1<is aulhoal2ed by Iht-ONner <br /> Contractor's Signature:.___ - __ _ _________ _ Date: <br /> Approval Reavrnmended by Design Consu f ' Date: <br /> Qwrrer's Representative Approval: Date:r1la <br /> 715) <br /> rn1 <br /> CPR 002 (superseded, See CPR 002 Revised) <br />