Laserfiche WebLink
�r <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 118-104AR Project Name: Century Center Upgrades &Renovations Change Order #: ? <br />DATE INITIATED:8/01/2019 BPW DATE:1V <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Cost for additional/unforeseen flooring materials. <br />Attachments: (List documents support change — required) <br />Contractor's cost estimate. <br />Signed PCR #2 <br />Amount of B Increase / ❑ Decrease: $ 6, 605.00 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 8,075.00 8 Scope of Work <br />❑ Differing Site Conditions, Changed Conditions <br />Current Percent of Change: 6.77 % ❑ Conflicted Specifications and Drawings <br />�El Failed Materials <br />New Total Amount: $104,180.00 <br />❑ Error <br />16.40 El Omission <br />Total Percent of Change: _ _...._ % ❑ Final Quantity Adjustment <br />Funding Secured From: ❑ <br />(filled out by PM) <br />RECOMMENDED BY: <br />CroJAW Iq-�q <br />Project Inspector (Print Name) nature) (Date) <br />REVIEWED BY: <br />Construction Manager (Print Name) (Signature) _ (Date) <br />APPROVED BY: <br />be-U& — z 9:: � L 61, e-1 <br />Engineering Project Manager (Print Name) (Signature) (Date) <br />APPROVE BY: <br />City Engineer (Print Name) (Signatur) (Date <br />