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Project Number: 120-001 <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />2020 Curb & Sidewalk (Divisions B1, B2, B3, C1, & D1) <br />Project Name: 1 <br />Change Order #. _ <br />DATE INITIATED: 10/2/2020 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 />None <br />Amount of El Increase / ODecrease: $ 5,803.55 <br />Previously approved Change Order(s): $ 0 <br />Current Percent of Change: -2.87 <br />New Total Amount: $ 196,409.45 <br />Total Percent of Change: -2.87 <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 />M Final Quantity Adjustment <br />4--� <br />(Signature) <br />10/2/2020 <br />(Date) <br />t1d& 10/02/2020 <br />(Signature (Date) <br />(Signature) <br />(care/ <br />City Engineer (Print Name) <br />(Signature) <br />(uare) <br />