Change Order Form
Change Order #002 - 5/24/2017
Project: Upgrade of Sewer System Access Covers
Location: Nashua, NH
Description: Replace existing vortex structure top slab with new center access top slab with hatch.
Saw cut and remove pavement (18’x18’) on and around existing structure. Excavate to expose entire top slab section.
Drill & install lifting points. Crane onsite to remove existing top slab and set new top slab in place. Existing top slab
will be demolished onsite and concrete ruble to be disposed of. Form and caste in place new H20 rated aluminum
access hatch w/ safety grate to finish grade. Backfill, compact, and fine grade. Place 4” asphalt patch to match
existing grades.
> Total Summary:
Materials: $5,090.00
Rental / Subcontractor: $4,400.00
Labor: $4,960.00
Overhead / Profit 15% = $2,167.50 $2,167.50
Total: $16,617.50
Contract Time Extension: TBD
> Material:
Precast Top Slab 1 EA @ $1,150.00 $1,150.00
Concrete / Rebar / Form 1 EA @ $725.00 $725.00
Lifting Anchors 1 EA @ $290.00 $290.00
H20 42”X42” Hatch 1 EA @ $2,925.00 $2,925.00
Sub Total $5,090.00
> Rental / Subcontractor:
2500LB Hammer W/ Machine 1 Day @ $975.00 $975.00
Vio 45 Ex 3 Day @ $275.00 $825.00
C6500 Dump Truck 12 HR @ $75.00 $900.00
Service Truck W/ Tools 4 Day @ $175.00 $700.00
Crane 1 EA @ $1,000.00 $1,000.00
Sub Total $4,400.00
> Labor:
Supervisor 32 Hours @ $65.00 Per $2,080.00
Labor 32 Hours @ $45.00 Per $1,440.00
Labor 32 Hours @ $45.00 Per $1,440.00
Sub Total $4,960.00
nn a 1 TAA MSA EZ,
Authorized Signature:
WILLIAM P DAVIS EXCAVATION LLC
PO BOX 758 - HAMPTON, NH 03843
