Laserfiche WebLink
SOUTH BEND PARKS PROGRAM <br />CHANGE ORDER NO. 4 COVER SHEET <br />1965 <br />DATE INITIATED: 1-28-19 REQUIRED APPROVAL DATE: <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Item #1 Change request 16 — Changed Dasher board width <br />Item # 2 Change request 17- Removed Litter and Recycle cans from Contract <br />Item # 3 Change Request 18Change Fire line location to community building <br />Attachments: (List documents support change, if any) <br />Decrease .. <br />Increase/ ��sly_ � � � Categories __-_ <br />( )from previously approved Change Order(s). 9 ies (Pick One): <br />$ (38,787.14) _ J Scope of Work <br />�.... —_ ..- "u. °°°"""""' "' Differing Site Conditions, Changed Conditions <br />Date/Time Added: I <br />Conflicted Specifications and Drawings <br />Failed Materials <br />New Contract Sum with This Change Order <br />-- -- <br />g der: El Errors and Omissions <br />$ 17 855 539.44 Incentive/Disincentive <br />....._ .... �—_ . ........ Final Quantity Adjustment <br />Perc <br />ent of Change Order: E <br />ar� -Owner Directed - <br />.--- .-... ......... <br />ENDORSEMENTS/APPROVALS <br />SUBMITTED/PREPARED BY: <br />u <br />Resid nt Project Representative (Print Name) (S nature) (Date) <br />RECOMMENDED: <br />9-1 <br />Construction der (Print Name) (Signature) (Date) <br />IS <br />RECOMMENDED: <br />X <br />Project Manager (Print Name) (ign e) (Date) <br />REVIEWED: <br />_... 7 111 <br />Project Manager, Venue, Parks and Arts (Print Name) (Signature) (Date) <br />REC MENDED FOR APPROVAL: <br />Director, Venue, Parks and Arts (Print Name) (Si,cgn�)k (Date) <br />