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DocuSign Envelope ID: D776FCD3-A986-470D-9E2B-8853B19D52DF <br /> CHANGE PROPOSAL FORM <br /> Project: Efland SS to Mebane to Mebane Phase 2 <br /> Contract: 16.01904 <br /> Contractor: JF Wilkerson Contracting Inc. <br /> Utility <br /> Construction Proposal# 19 <br /> Project# CIP 30044 <br /> Contractor# C077 <br /> Description of Change: <br /> Add cattle gate adjacent to MH 27 <br /> Truck for pick up and delivery 1 L.S. $ 172.50 $ 172.50 <br /> Material 1 L.S. $ 186.25 $ 186.25 <br /> Labor 1 L.S. $ 250.00 $ 250.00 <br /> Total $ 608.75 <br /> Time Extension Request 2 days <br /> The Contractor agrees to perform the work outlined in this change proposal for the amount specified above and in accordance with the <br /> Contract documents if the work i--,-1D�g�cuSigne1d`'by: <br /> �� <br /> Contractor's Signature:f—f1313A899D'384C2 <br /> JV t Aykrsb�" Date: 4/15/2019 <br /> g DgcuSigned by: <br /> . 16CABB174ESDO4 <br /> ,;r� �9■_1.l 4/15/2019 <br /> Approval Recommended by Design Consultant: JLU f�UpV}[ti we Sig— by Date: <br /> DC rr kd 4/16/2019 <br /> Owner's Representative Approval: � � Ll Date: <br /> a1nn•nr.A2r.=n-c2 <br />