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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />I�dM <br />Project Number: 119-049 Project Name: Vested Interest Building Roof Repair Change Order #: 1 <br />DATE INITIATED: 11/7/19 BPW DATE: 1 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />-Leaving Roof Containing Asbestos in Place. <br />-Additional cost involved with unknown roof and structural conditions. Furnish & install plywood <br />backer to meet manufacturers warranty requirements at area drywall as discovered. <br />-Wood Deck Replacement. <br />-Installation of Roof Drains & Roof Drain Plumbing. <br />Attachments: (List documents support change — required) <br />Contractors Request for Change Order(s) and Pricing. <br />Amount of BIncrease / ❑Decrease: $ 21 ,288.10 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0 8 Scope of Work <br />8 Differing Site Conditions, Changed Conditions <br />Current Percent of Change: 9-39 % ❑ Conflicted Specifications and Drawings <br />._... _... _............ .. ❑Failed Materials <br />New Total Amount: $ 248' 088.10 <br />❑ Error <br />El Omission <br />Total Percent of Change: 9.39 <br />❑ Final Quantity Adjustment <br />Funding Secured From: ILI <br />.... ... <br />(filled out by PM) m,, <br />RECOMMENDED BY: <br />Josh Ehmer _ 12/9/19 <br />Project Inspector (Print Name) (Date) <br />REVIEWED BY: <br />1Z.Io-%q <br />Construction Manager Print Name) (Signature) (Date) <br />APPROVED BY: <br />Engineering Project Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />r4 <br />City Engineer (Print Name (Srna ra) (Date) <br />