Laserfiche WebLink
ON'' 16 <br />Y, DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />118-080B ��e�at„a�r�un�� ��,,..aaa���„.�,, 1 <br />Project Number: Project Name: Change Order #: <br />DATE INITIATED:5-14-19 BPW DATE:5-28-19 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Includes masonry repairs that were unforeseen. These locations were behind the existing <br />stairwells and the extent of the repairs was unknown until the old stairs were removed. Repairs are <br />needed prior to installing the new stairs. <br />Attachments: (List documents support change — required) <br />Quote from contractor <br />......_. ........ <br />Amount ofBIncrease /❑Decrease: $47,542.00 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0.00❑ Scope of Work <br />— _...... ... 8 Differing Site Conditions, Changed Conditions <br />Current Percent of Change: 25.00 <br />❑ Conflicted Specifications and Drawings <br />❑ Failed Materials <br />New Total Amount: $, 237,713.00 <br />❑ Error <br />IT ❑Omission <br />Total Percent of Change: 25.00 <br />❑ Final Quantity Adjustment <br />Funding Secured From: ... <br />(filled out by PM) <br />RECOMMENDED BY: <br />Dan Jones <br />Project Inspector (Print Name) (Signature) (Date) <br />REVIEWED BY: <br />Toy Villa <br />. . . . . . ...... . . ................................ . . . . . . .......... . - <br />_._. <br />Construction Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Kyle Silveus <br />Engineering Project Manager (Print Name) (Sign at ) (Date) <br />APPROVED BY: <br />Kara Boyles <br />City Engineer (Print Name) (Smgn to e) (Date) <br />