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A14. r1A Yp. <br />wyti {� <br />.:„ . DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: Project Name: Change Order #: <br />118-113 E Longfellow Ave & N Riverside Dr. Traffic Calming 1 <br />DATE INITIATED: 9-5-19 BPW DATE. 9-24-19 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />-Borrow was needed at the speed humps along Longfellow. The existing pavement was thicker <br />than the replacement concrete was specified so it was needing to be brought up to grade. <br />-One speed hump on Riverside Dr did not contain tree lawn and there was only 2" curb exposure. <br />Twenty five feet of sidewalk was removed and replaced in order to get 6" curb exposure on the <br />new speed hump. <br />Attachments: (List documents support change - required) <br />Attached price breakdown <br />Amount of B Increase / ❑Decrease.. $ 3,473.94 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0.00 8 Scope of Work <br />­-,_.- ................... .... ......... ,_........ ..... a Differing Site Conditions, Changed Conditions <br />Current Percent of Change; 4.77 % ❑ Conflicted Specifications and Drawings <br />❑ Failed Materials <br />New Total Amount: $ 76,323.94 <br />❑ Error <br />❑ Omission <br />Total Percent of Change, 4.77 <br />❑ Final Quantity Adjustment <br />Funding� .,, Secured From: 0 <br />�.. �"�" <br />(filled out by <br />PM) <br />RECOMMENDED BY: <br />Dan Jones <br />Protect Inspector (Print Name) (Signatt ey (Date) <br />REVIEWED BY: <br />Toy Villa Q. 13 •19 <br />...................... _ - _ �........_ . <br />Construction Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Theresa Harrison <br />Engineering Project Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Kara Boyles <br />City Engineer (Print Name) (Signature) (Date) <br />