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way atr ��, <br />Y DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />115-017A Century B Center Convention Hall A - New Entry <br />Project Number: Project Name: _Change Order #: 2 <br />ww wwwwwwww ��mmmmmmmmmmm <br />DATE INITIATED; 5/6/2019 BPW DATE: <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Construction Change: Per order and instruction of SBFD Fire Marshal. <br />Attachments: (List documents support change — required) <br />1. Cost from Contractor. <br />.......� <br />Amount of ® Increase / ❑ Decrease.. $ 7, 911.00 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 12, 862.00 ® Scope of Work <br />....................�� El Differing Site Conditions, Changed Conditions <br />Current Perc11 ent of Change: 8- g5......_..— % ❑ Conflicted Specifications and Drawings <br />w� ........... <br />❑ Failed Materials <br />New Total Amount: $ 96, 325.00 <br />❑ Error <br />27.49 El Omission <br />Total Percent of Change: mm . -- % ❑ Final Quantity Adjustment <br />Funding Secured From: <br />(filled out by PM) <br />RECOMMENDED BY: <br />Project Inspector (Print Name)(Date) <br />REVIEWED BY: c <br />Construction ana ier (Print Name) (Signature) (Date) <br />APPR BY: <br />�I f"� <br />En in Project Manager Print Name (Signature) g 9 1 9( ) ( 9 ) (Date) <br />) <br />APPROVED BY <br />City Eng Ineer (Print N me) (Srgrfrt),` �(Daie) <br />,„ <br />