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l� 0i <br />Z, '����� DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 118-305A Project Name: East Bank sinkhole Repairs (Base + Altz) Change Order #: 1 <br />DATE INITIATED:5/30/19 <br />BPW DATE: .., ...... �..... m.� <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />The original design to repair the sink hole was found to be insufficient after excavating and further <br />investigation. <br />Attachments: (List documents support change — required) <br />Contractors proposal. <br />Amount of Blncrease / ❑ Decrease: $14482.75 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0 <br />® Scope of Work <br />8 Differing Site Conditions, Changed Conditions <br />Current Percent of Change: 2 '07 % <br />❑ Conflicted Specifications and Drawings <br />....... <br />New Total Amount: $ 83210.75 <br />❑ Failed Materials <br />❑ Error <br />................................................................................. <br />Total Percent 21.07 <br />Changer % <br />I--] Omission <br />of <br />❑ Final Quantity Adjustment <br />Funding Secured From: <br />(filled out by PM) <br />RECOMMENDED BY: <br />Josh Ehmer <br />6/18/19 <br />Project Inspector (Print Name) <br />(Signature) (Date) <br />REVIEWED BY: <br />� <br />^1 <br />Construction Manager (Print Name) <br />(Signature) (Date) <br />APPROVED BY: <br />ALAO <br />� N i <br />Engineering Project Mash ger (Print Name) <br />(Sig alure) (Date) <br />APPROVED BY: <br />City Engineer (Print Name) <br />(Signature) (Date) <br />