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ygar �ma nr,�y <br />SOUTH BEND PARKS PROGRAM <br />CHANGE ORDER <br />NO. Z COVER SHEET <br />E INITIATED: 30 !Cl REQUIRED APPROVAL DATE: 1 if <br />Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />F <br />tional work/materials needed to meet Code requirement. <br />Attachments: (List documents support change, if any) <br />Increase/(Decrease) from previously approved Change Order(s): Categories (Pick One): <br />$9550.77 (Change order 1) $1828.81 (Change order 2) <br />L__`JI Scope of Work <br />DatelTime Added: <br />Differing Site Conditions, Changed <br />Conditions <br />Conflicted Specifications and Drawings <br />n/ <br />Failed Materials <br />New Contract Sum with This Change Order: <br />Errors and Omissions <br />$82679.58 <br />Incentive/Disincentive <br />Percent of Change Order: 2.26 % (15.96% total) <br />Final Quantity Adjustment <br />Im_ ENDORSEMENTS/APPROVALS <br />SUBMITTED/PREPARED BY: <br />Resident Project Representative (Print Name) <br />(Signature) <br />(Date) <br />RECOMMENDED: <br />4. <br />Construction Manager ( rint Name) <br />(Signature) <br />(Date) <br />RECOMMENDED: <br />bQ. ok Plm-q <br />Project Manager (Print Name) <br />(Signature) <br />(Date) <br />REVIEWED: <br />.,_ <br />Project Manager, Venue, Parks and Ats (Print Name) <br />(Signature) <br />(Date) <br />RECOMMENDED FOR APPROVAL: <br />/ - <br />� <br />Director, Venue, Parks and Arts (Print Name) <br />„ <br />(Date)���� <br />