Laserfiche WebLink
,� ypti I H "e4;v <br />180 <br />Project Number: 119-071 <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Name: <br />Walnut Grove and North Riverside Drive Traffic Calming Change Order #: 1 <br />_ <br />DATE INITIATED: 9/30/2020 BPW DATE: 10/13/2020 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />There was concrete pavement underneath the existing asphalt along Riverside Dr. The concrete <br />was removed and backfilled with stone to the proper grade. <br />Attachments: (List documents support change — required) <br />N/A <br />Amount of Dlncrease / El Decrease: $ 3,836.00 <br />Previously approved Change Order(s): $ 0.00 <br />Current Percent of Change: 4.95 <br />New Total Amount: $ 81 , 336.00 <br />Total Percent of Change: 4.95 <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 />Theresa Harrison <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 />❑ Final Quantity Adjustment <br />G� <br />(Signature) <br />�1 WTI Will <br />(L)ate) <br />Z� j/4& 09/30/2020 <br />(Signatu ) (Date) <br />TA&rff0, e. HGLf"f^liSrU'f'li <br />(Signature) <br />(care) <br />City Engineer (Print Name) <br />(Signature) <br />(care) <br />