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5DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />118-0356 Century Center Site Signs 1 <br />Project Number: Project Name: Change Order #: <br />DATE INITIATED:7/25/19 - BPW DATE' <br />Brief Summary of Change Order; (Construction Change, Alternative, tive, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Out of Scope- Additional materials required for installation of skywalk sign. <br />Attachments: (List documents support change — required) <br />1- Cost and explanation from Contractor. <br />2- PCR #1 - signed by Contractor. <br />Amount of OIncrease / ❑ Decrease: $ 2600.00 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0 [s] Scope of Work <br />.._ _............ El Differing Site Conditions, Changed Conditions <br />Current Percent of Change: 1.74 <br />❑Conflicted Specifications and Drawings <br />El Failed Materials <br />New Total Amount: $152,030.00 <br />.................. .. ❑ Error <br />� El Omission <br />Total Perce <br />nt of Change„ 1.74 <br />❑ Final Quantity Adjustment <br />Funding Secured From. .'_""" <br />(Filled out by PM) <br />RECOMMENDED BY: <br />Greg McGowan �- 8/7/19 <br />Project Inspector (Print Name) Jgn� ture) (Date) <br />REVIEWED BY: <br />0 LA at <br />Manager (Print Name) (Si -- <br />_._ <br />Construction Mali (Signature) (Date) <br />APPROVED BY: <br />Engineering Project Manager (Print Name) _ (Signature) _ (D .tet r) <br />APPRO ED BY: <br />City Engineer (Print N me) (Sign tt re) ((7at ) <br />