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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 119-006 Project Name: 2019 Lamppost Program Change Order #: 1 <br />DATE INITIATED: 10/02/19 � � BPW DATE: 10/22/19 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Additional eight (8) Solar Lamppost with Hand Auger Base. <br />Attachments: (List documents support change — required) <br />Invoice from Gama Sonic <br />Amount of Blncrease/ ❑Decrease: $4,239.76 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0 ❑ Scope of Work <br />El Site Conditions, Changed Conditions <br />Current Percent of Change° 8'89 % ❑ Conflicted Specifications and Drawings <br />❑Failed Materials <br />New Total Amount: $ 51,936.76 <br />❑ Error <br />8 89 El Omission <br />Total Percent of Change: % 8 Final Quantity Adjustment <br />Funding Secured From: COIT (404-0602-431.31-06) 0 <br />(filled out by PM) <br />RECOMMENDED BY: <br />"Ilkiim uu y;reM W <br />Project Inspector (Print Name) (Signature) (Date) <br />REVIEWED BY: <br />lc7 •-7 �9 <br />c <br />Construction Mana er (Print Name) (Signature) (Date) <br />APPROVED BY: <br />f IIII � <br />to Io gI;�vry�,W ,01,, <br />Engineering Project Manager (Print Name) (Signature) (Date) iN <br />APPRQ ED BY: <br />(Date) <br />City Engineer (` int Na e) (Si natu ) <br />