HomeMy WebLinkAboutChange Order No 1 - Liberty Tower Exterior Renovations, Phase II Proj No. 120-047 - Slatile Roofing & Sheet Metal Co., Inc.
ELIZABETH A. MARADIK GARY A. GILOT JORDAN V. GATHERS JOSEPH R. MOLNAR MURRAY L. MILLER
1316 COUNTY-CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/ 235-9251
FAX 574/ 235-9171
CITY OF SOUTH BEND JAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
September 28, 2021
Mr. Gerald Longerot
Slatile Roofing and Sheet Metal Co., Inc.
1703 S. Ironwood Dr.
South Bend, IN 46613
michael.albert@slatile.com
RE: Change Order No. 1 – Liberty Tower Exterior Renovations, Phase II
Project No. 120-047
Dear Mr. Longerot:
At its September 28, 2021 meeting, the Board of Public Works approved the above
referenced Change Order for an increase of $2,882, bringing the revised contract amount to
$121,100.
Enclosed is a copy of the Change Order for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-9251.
Sincerely,
/s/ Anne Fuchs
Anne Fuchs, Clerk
Enclosures
AF/lh
September 28, 2021
City of South Bend
Department of Administration & Finance
Change Order Request Form
Multiple PO lines:
Project POs:
PO Number PO-0006614
Line Number
Original Dollar Amount $118,218.00
New Dollar Amount
(For liquidation request, enter $0)$121,100.00
Reason Code (if changed)
Financial Dimensions (fund-dept-
division-subdivision-main account)324-10-102-121-443001
Project Code (if applicable)PROJ00000044
Description of change (include
budget impact)
Quantity adjustments, 7th floor roof drain replacement, SE corner roof replacement
on 1st floor, steel kickplates to protect EFIS
APPROVED BY PROJECT
ACCOUNTING TEAM (if applicable)(PAT member's name and date to be completed by PAT member)
PO Number
Line Number
Original Dollar Amount
New Dollar Amount
(For liquidation request, enter $0)
Reason Code (if changed)
Financial Dimensions (fund-dept-
division-subdivision-main account)
Project Code (if applicable)
Description of change (include
budget impact)
APPROVED BY PROJECT
ACCOUNTING TEAM (if applicable)(PAT member's name and date to be completed by PAT member)
PO Number
Line Number
Original Dollar Amount
Changing the line amount:
You can only change a line amount if it has NOT been invoiced against.
• If the line has NOT been invoiced – reduce the line amount to equal what it should be.
• If the line has been invoiced – cancel the delivery remainder and finalize the individual line, then add a new line for the
amount that should be remaining.
If you have changes to more than one line on the same PO, fill out a separate section for each line affected by the change
order.
For change orders on project-related POs, this form must be approved by the Project Accounting Team as described in
Supplement 508.
CO1_Supplement 508 Form - Change Order Request Form 1 of 3