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V <br />APPLICATION FOR Extra Work Order No. <br />EXTRA WORFC EW(RV) - 02 <br />(Reasonable Value) Date: 13-Aug-o4 <br />Sheet No.: 2 of 3 <br />Village of Mayfield, Cuyahoga County <br />S.O.M. Center Road Project / CUY - 91 -13.29 <br />ODOT PID N0.20334 <br />FEDERAL PROJECT NO. TE21-G020(167) <br />The Great Lakes Construction Company <br />Contractor <br />(Each Extra Work Order (Reasonable Value) shall pertain to only one Contract and shall be numbered consecutively for each contract). <br />Formal authorization is hereby requested for the Performance of Extra Work (Reasonable Value) under the contract, described as follows: (Attach <br />drawings or sketches where applicable.) <br />1 2 3 4 <br />Description of Item Estimated Total <br />Quantity Unit Price Estimated Total Addition <br />(Detail Attached) <br /> <br />Additional costs for Item 625 -Conduit, Misc.: Conduit, 4"with 4 cell <br />Innerduct, Type 713.07 300 LF $3.09 $927.00 <br /> <br /> <br /> <br /> <br />Conduit Jacked or Drilled Under Pavement, 4" with 3-cell Innerduct <br />713.04 or 713.07, Schedule 80 75 LF $30.45 $2,283.75 <br /> <br /> <br /> <br />Explanation of necessity for above items: <br />SHEET TOTAL $3,210.75 <br />Mayfield Village requested modifications to the proposed multi-cell Innerduct system to improve accesibility and maintenance. The above quantities <br />reflect additional costs and material necessary to perform this work. The associated quantities which are extentions of existing contract items <br />appear on associated CO #02. <br />I (we) hereby agree that the work listed in the foregoing application is "extra work' as the same i <br />Requested: defined in Section 100 of the 1997 CMS Provisi sand that I (we) will perform the said work in <br />consideration for ment and co ensation as r ed in the Contract Documents. <br />URS or ora ' G La truction Company <br />uction Man ger actor L~ <br />By: ~ ~~16/Dy By: b/ <br />Dougl . Dil .E.,P.S ana er of Construction (Date) seph .Allen Senior Vice President, Gre (Da ) <br />Services Lakes Construction <br />Village of Mayfield <br />BY~ <br />fillip M. Brett Director of Finance and (Date) <br />Economic Development <br />