~ ..~ ' . °"4EGOiv' STATE HIGHWAY DEPARTi~E1~'~, <br />, .~ - <br />.G7 ~~iCG ~~~~C~~?E.-'~~` <br />APPLYING TO EXTRA WORri AIvD E:YTRA MATERSAL <br />• ~ ~h Av~ _ ~,j~l~ a^~,ette ~~v~r (Eug~e~_.Section ~1a . 1 . <br />P:OJC'CL I~aIT1C ...~.5:~:.........r.R ........:........4...:..................r............ .... ..................«... Date .....__..........Y.....~..........._...._....., is..7. .. <br />Hi~~way ...........~.uC:° ~e...-...S}~.r~.:~~,~~5~....._...-_ ..............__ . ..._......._.._.»........................ Contract No. ...753.~..........._............................. <br />s~ <br />~ ?~?.ne ...................................:.._....... Preiix 620-1C~.'6.--........------.................._..... <br />Court ... ..~ ...:.................................. ..... ... - <br />y ........»..... .................._.......... <br />~ ~ ~~n^ld ~;1 ~rake Co.,. ........................................................................ F. A. pro~ect ho. ..'-..-105.-l:..~.1~;5~iS~....... <br />Con~rac.or ......... .-........ ~...... ... . ......... ~ <br />Address ..... .... ............ Price A rcement I~o . ........... ............ <br />?? ~0 \.~'T,...~'lancers S.~.,..,~.-°..or.~land,--Ore~on...9..7.209, ~ g ~ 2~. ............... <br />.................... ......... <br />For the belo~v desc:ibed ext:a ~vork or extra material 2o be performed or furnished unde: the contract above referred :o, !^c <br />cor.:ractor ahrees to accepi payr:zent a: tne o:ices eiven herein, understanding Yhat, ereept as 'r.e*e:n otnenvise provid^d, the ~vo:k :~ <br />':o be per:o:::~ed and ihe ::;ate:ial is to be fu:nisned in accordance ~vi;,h the specificaaons which form a part of the cor.tract and ir. <br />acco:car.ce ~~:itz tne instr;:ciio.^.s of the eaeiaee:_ <br />~vo:k to be dor.e: ~~ ~a~r, resur=~ce and upo ade streets and related facilities ad jacent to <br />na,rk area e::closed by ,•lasnin~on and Jefferson St's and lst and 6th Av~ues. <br />Locations by station numbers: j, 66+00 to L$6+00 <br />~ lmes oi pay items, estimated quantit;es and agreed prices: • <br />i ~'~ ~ ~ <br />`~ <br />See c~tt2C :2d 5::8@~ f0''_' detail Oi 1ii.2.T.S, To~al Cost~ ........ S 53,li85.31 <br />Less Flagging Costs . . . . -2~~~~~ ~ <br />~ Tot~l . e . . . . . . . . e 5~~977.cfl <br />Speci!ications, basis of ineasuzenient aiid otiicr provisions: See attached sheets. <br />'•10~iC i?:5° i~OT ~%~v:: ~0~~'E <br />•.1ST :L'C.=:i:CS <br />A:tcr thc si~r.a:u:c o: tnc cont:ac.or has. <br />bccn obt:.:ned. ~Lba11t s!x co^.:es (lnciudin~ <br />or:; Saai coPy) to :'r.~: ~::^:n Ot:icc. A:ter ap- <br />p:ov~l by thc A::s:r.:~r.t Stn:c iil;:iw:y En^!- <br />nccr. :~;,;;rovcd co,-:Sc•s vriil bc scnt to thc Con- <br />.:.:ctor. ::oc Div:s:oa ~:i, in~c:. a:d Yr.c itc~:- <br />~cat i:r.;,%r.ccr. <br />':h:: o:cc: ~o~s ro: cor,s;::L:c authoz:ty for <br />es?cac'.:tu:c t-.i1 c~~roved b, .k:c Assis:ant <br />S:.;tc Y.`~'i: vay Ea:,:i :c~r or Sta:c Highway <br />Er.r`r.ccr. ~ <br />Project authoriiation . . . . . . . <br />Present estimate of project cost,~includino <br />g.~,0~;~77,*00.,, for ~vor;c under this o:der <br />Expected. snder-run ~amount) . . . . . <br />"a~.._.=..:c: <br />~ ur.~er-run <br />~ Expected.,~~.~~ (Per cent) . . . . . <br />do <br />~~ <br />~~.706.~..41.9..~9~. =~ .. ...................._...._...... ... <br />~- <br />V <br />6~76 .775..5Q. ~ ~s .................... <br />~~....1.. ... .................. <br />, r... <br />~~ o <br />~ <br />s......29,bC~.1+..k9.~ ~ ~ ...................................... <br />. (~ L <br />u o <br />r. ~- <br />L <br />-'--..........0.~~...!.°... y~ ....................-•'......._...._ <br />~ ' ~~ J l <br />~ ~ 1~~~~ / ~~`~~~~i gned .........DQxla.~~...:1'~..T' ''•{9 O, .... . <br />..... ................ Si <br />mi:tcd by: ... Li ..~.._ .. ... ..... ~..f.......,......... ~.~.s . . . ........... .........con::;c:o= . <br />, Acs:dent Ensl~ccr ~ <br />`... ; ' ~~ <br />~ .... ~(.~,.~ G.".~-%.~ ../.~~~.s~~ ~............~..~ ................. <br />.... ... ........................ ........................... <br />A;~p:oval Rccom:r.cadcfl: '>. L' '~ <br />~Dlvislon En~lnccr <br />. .... Approved : ............................................................................................... <br />A~Prova: i~CCG.'t1:TC ::iccl . .......................... . . . .................. . <br />ConsWCt:on Enr.leccr or Dcputy S:ncc }t!:.`.••vny F^c!ncer, <br />IIrld~e Enilnecr . AaeS+tant S:nte H:C`~~~.a~. Pr.c~n:cr o: <br />.. ~ ~ ~ ' O!ftce £ns!neer. <br />S'u.t~ Pr:ntfn~ <br />Se~ ~or.::ld ,•:. ~ruke Co.;.~r::^y letter dated 17 ::ay 7,973 <br />