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,y�MN'NC+W <br />�DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 118-055 Project Name: Colfax Water Works Building Repainting Change Order #: � <br />[DATE INITIATED: 6/6/19 BPW DATE. <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.),. <br />-Added Contract Days Due to Weather. <br />Attachments: (List documents support change — required) <br />-March, April, & May Climate Data. <br />........... <br />Amount of ❑ Increase / ❑ Decrease: $, 0., <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0 ❑ Scope of Work <br />❑ Differing Site Conditions, Changed Conditions <br />Current Percent of Change: % ❑ Conflicted Specifications and Drawings <br />❑ Failed Materials <br />New Total Amount: $ 9153.85 <br />__...----------------- ❑Error <br />El Omission <br />Total Percent of Change: ......... ................ ___ % ❑ Final Quantity Adjustment <br />Funding Secured From; IT�ITITIT <br />0 <br />(filled out by PM) <br />RECOMMENDED BY: <br />Josh Ehmer"6/18/19 <br />Project Inspector (Print Name) (Signatu (Date) <br />REVIEWED BY: <br />........... _.................. <br />Construction Ma ger (Print Name) (Signature)CJ (Date) <br />APPROVED BY: , <br />Engineering Project Ma ger (Print Name) (s gan<ature) - (Date) <br />APPRo�ED BY: <br />-" <br />City Engineer (Print Name) (Signature) (tea A-) <br />