Finance Committee

CLAIM TRACKING FORM

Date:

Claim Tracking Number:

Project: 2021 Paving Program - Arterial and Collector Roadways
Owner’s Contract Number: IFB0660-012821

All claims received by the City or the Contractor from the public in regards to the above
referenced project shall be documented using this form. The Contractor or their Authorized
Representative shall respond to the claimant within 7 calendar days of receipt of the claim and
within 7 calendar days after each follow up correspondence.

CHANGE ORDER
SUMMARY

CHANGE IN CONTRACT PRICE

Original Contract Price:

CHANGE IN CONTRACT TIMES

Original Contract Times:

Substantial Completion:

Ready for Final Payment:

Net Changes from previously approved Change Orders

Net Changes from previously approved Change Orders

Substantial Completion:

Ready for Final Payment:

Contract Price prior to this Change Order:

Contract Times prior to this Change Order:

Substantial Completion:

Ready for Final Payment:

CHANGE ORDER

No.
PROJECT: 2021 Paving Program - Arterial and Collector Roadways
OWNER'S CONTRACT NO.: __ 1FBQ0660-012821
EXECUTED CONTRACT DATE:
DATE OF ISSUANCE: EFFECTIVE DATE: Upon City Approval
OWNER: City of Nashua, NH

OWNER’s Purchase Order NO.::

CONTRACTOR: Sunshine Paving Corporation

ENGINEER: DPW Engineering

The Contract is modified as follows upon execution of this Change Order:

Description:

Justification:

Attachments:

ACKNOWLEDGEMENT OF NOTICE

Receipt of the above NOTICE TO PROCEED is hereby acknowledged

By

The day of , 20

By

Title

IFBO660-012821
2021 Paving Program NOTICE TO PROCEED

Arterial and Collector Roadways Page 2 of 2

NOTICE TO PROCEED

DATED:
. . . ADDRESS: 29 Continental Drive

CONTRACTOR: Sunshine Paving Corporation Hudson, NH 03051
OWNER: City of Nashua, ADDRESS: 229 Main Street

New Hampshire Nashua, NH 03060
PROJECT: 2021 Paving Program OWNER’S CONTRACT NO. IFBO660-012821

Arterial and Collector Roadways

TO CONTRACTOR:

Failure to comply with these conditions within the time specified will entitle OWNER to consider your
bid in default, to annul this Notice of Award and to declare your Bid Security forfeited.

By

(FOR THE CITY OF NASHUA)

(TITLE)

ACKNOWLEDGEMENT OF NOTICE

Receipt of the above NOTICE OF AWARD is hereby acknowledged

By

The day of , 20

By

Title

IFBO660-012821
2021 Paving Program NOTICE OF AWARD

Arterial and Collector Roadways Page 2 of 2

NOTICE OF AWARD

DATED:

CONTRACTOR: Sunshine Paving Corporation ADDRESS: 29 Constitution Drive
Hudson, NH 03051

OWNER: City of Nashua, New Hampshire ADDRESS: 229 Main Street
Nashua, NH 03060

PROJECT: 2021 Paving Program OWNER’S IFBO660-012821
Arterial and Collector Roadways CONTRACT NO.

TO CONTRACTOR:

You are notified that your Bid dated for the above Contract has been considered. You
are the apparent Successful Bidder and have been awarded a contract for

LIST OF EXHIBITS

NOTICE OF AWARD

NOTICE TO PROCEED

CHANGE ORDER

CLAIM TRACKING FORM

CERTIFICATE OF SUBSTANTIAL COMPLETION
CERTIFICATE OF FINAL COMPLETION

CONTRACTOR'S FINAL RELEASE AND WAIVER OF LIEN

QB OnS

DIVISION 8

EXHIBITS

December 23, 2020

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City of Nashua, New Hampshire
Division of Public Works
IFBO660-012821
2021 Paving Program - Arterial and Collector Roadways