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Project Number: 119-065 <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Name: 2019 Community Crossings Round 2 Change Order #: 1 <br />DATE INITIATED: 8/17/2020 BPW DATE: <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Adjustment to final quantities. <br />Attachments: (List documents support change — required) <br />Amount of El Increase / ODecrease: $ 7,467.97 <br />Previously approved Change Order(s): $ 0 <br />Current Percent of Change: 96 <br />New Total Amount: $ 773,982.03 <br />Total Percent of Change: '96 <br />Funding Secured From: <br />(filled out by PM) <br />RECOMMENDED BY: <br />Josh Ehmer <br />Project Inspector (Print Name) <br />REVIEWED BY: <br />Toy Villa <br />Construction Manager (Print Name) <br />APPROVED BY: <br />Engineering Project Manager (Print Name) <br />APPROVED BY: <br />Categories (Pick One): <br />❑ Scope of Work <br />❑ 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 />Av�� 8/20/2020 <br />(Signature) (Date) <br />Ilk - <br />(Signature) I/4&� <br />(Signature) <br />09/08/2020 <br />(ware) <br />(care) <br />City Engineer (Print Name) <br />(Signature) <br />(uate) <br />