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Project Number: 119-077A <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Name: Change Order #: <br />Olive Street Station Office HVAC Upgrades 1 <br />_ <br />DATE INITIATED: 3-24-20 BPW DATE: 4-9-20 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Existing boiler hookup conditions were unknown at the time of rework. Once the original scope <br />was completed it was found that the boiler would continuously trip the breaker. Troubleshooting <br />and breaker upgrades were needed to fix the issue. <br />Attachments: (List documents support change — required) <br />Troubleshooting and added work is $2,000.00 <br />Amount of DIncrease / El Decrease: $ 2,000.00 <br />Previously approved Change Order(s): $ 0.00 <br />Current Percent of Change: " <br />New Total Amount: $ 58,500.00 <br />Total Percent of Change: 3.54 <br />Funding Secured From: <br />(filled out by PM) <br />RECOMMENDED BY: <br />Dan Jones <br />Project Inspector (Print Name) <br />REVIEWED BY: <br />Toy Villa <br />Construction Manager (Print Name) <br />APPROVED BY: <br />Zach Hurst <br />Engineering Project Manager (Print Name) <br />APPROVED BY: <br />Kara Boyles <br />City Engineer (Print Name) <br />Categories (Pick One): <br />❑ Scope of Work <br />0 Differing Site Conditions, Changed Conditions <br />❑ Conflicted Specifications and Drawings <br />❑ Failed Materials <br />❑ Error <br />❑ Omission <br />❑ Final Quantity Adjustment <br />11 <br />(Signature) <br />(Signature) <br />(Signature) <br />(Signature) <br />M • 1 <br />(Date) <br />04/06/20 <br />(Date) <br />04/06/2020 <br />(Date) <br />04/07/2020 <br />(Date) <br />