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Project Number: 119-064 <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />315 & 319 W. Jefferson Exterior Renovations <br />Project Name: Change Order #: _ <br />DATE INITIATED: 9-10-20 BPW DATE: 9-22-20 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Curb and sidewalk work eliminated from the contract because one of the utility companies <br />replaced it while doing alley work. <br />Attachments: (List documents support change — required) <br />N/A <br />Amount of ❑ Increase / O Decrease: $ 4, 770.00 <br />Previously approved Change Order(s): $ 1 ,856.00 <br />Current Percent of Change: -9.97 <br />New Total Amount: $ 43,075.00 <br />Total Percent of Change: -6.34 <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 />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 />0 Final Quantity Adjustment <br />11 <br />(Signature) <br />(Signat e) <br />(Signature) <br />9-14-20 <br />(Date) <br />09/14/2020 <br />(ware) <br />(care) <br />City Engineer (Print Name) <br />(Signature) <br />(uate) <br />