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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 118-008 Project Name: St. Joseph Street Improvement Change Order #: 1 <br />DATE INITIATED: 7-11 mm19 BPW DATE: 7-23-19 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc,). <br />-Lack of survey points failed to identify a higher road elevation than shown on the plans. This <br />created a need to perform more full depth patching and subgrade treatment in lieu of mill/surface <br />to allow for a proper crown and proper drainage to the curb line. <br />-Borrow was needed to establish a 4:1 slope along the backside of the western sidewalk. <br />Attachments: (List documents support change - required) <br />Price breakdown <br />Amount of ®Increase / El Decrease: $ 26,436.52 <br />---- ` Categories (Pick One): <br />Previously approved Change Order(s): $ 0.00 ❑ Scope of Work <br />`®®®®®®".... """" "" .... ® Differing Site Conditions, Changed Conditions <br />Current Percent of Change: 6.25 <br />❑ Conflicted Specifications and Drawings <br />..New ..Total <br />..Amo...0 .nt:"$................44._.............,,............................................. <br />9,436.52 ❑ Failed Materials <br />...............................� ®Error <br />Total Percent of <br />6 25 ❑omission <br />Change: ........_ % 8 Final Quantity Adjustment <br />Funding Secured From: _ 3D-I450-Aj,�Oww,-wwqZ.w07 <br />(filled out by PM) <br />RECOMMENDED BY: <br />Dan Jones—�� <br />Project Inspector (Print Name) (Signatu ) (Date) <br />REVIEWED BY: <br />Toy Villa <br />Construction Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Kyle Silveus <br />Engineering Project Manager (Print Name) (Sigoat (Date) <br />APPROVED BY: <br />Kara Boyles <br />City Engineer (Print Name) (Signatur (Dat ) <br />