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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />/yµM <br />Project Number: 1 18-010A Project Name: Historic Leeper Park Improvementfs Change Order #: 3 <br />...... ������ <br />DATE INITIATED: 9/16/19 gPW DATE: <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Contract quantity additions, credit, and scope adjustments. <br />Attachments: (List documents support change - required) <br />Amount of Blncrease / ❑Decrease: $ 27,017.29 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 37,668.04 ® Scope of Work <br />- ❑ Differing Site Conditions, Changed Conditions <br />Current Percent of Change: 2.0 1 % ❑ Conflicted Specifications and Drawings <br />1,372,814.36 El Failed Materials <br />New Total Amount: $❑ Error <br />............ .._._._._. <br />A 94 ❑ Omission <br />Total Percent of Change: m % ❑ Final Quantity Adjustment <br />Funding Secured From: 11p1 -y�-ja -31.0 <br />(filled out by PM) <br />RECOMMENDED BY: <br />Greg McGowan 9/17/19 <br />Project Inspector (Print Name) (Signature) (Date) <br />REVIEWED BY: <br />1 <br />Construction Manag (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Engineering Project Manager (Print Name) (Sign re) (Date) <br />APPROVE B, <br />.R <br />City Engineer (Print Nana) (Signature) (Date) <br />