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" DEPARTMENT OF PUBLIC WORKS <br />- DIVISION OF ENGINEERING <br />Project Number: 118-104AR Project Name: Century Center Upgrades & Renovations Change Order #: 1 <br />DATE INITIATED!; 7/1/2019 BPW DATE: <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Construction Change: Additional floor covering and sub -floor repair,. <br />Attachments: (List documents support change — required) <br />VPA's cost acceptance - floor covering <br />VPA's cost acceptance - sub -floor repair <br />Amount of ® Increase / ❑Decrease; $8,075.00 <br />- Categories (Pick One): <br />y pp g ) 0 B Scope of Work <br />Previous) approved Change Order(s : $,IT,_,__,_ ------IT_,_,_,_____ <br />•••• ................................---- ❑ Differing Site Conditions, Changed Conditions <br />Current Percent of Change. 9'02 % ❑ Conflicted Specifications and Drawings <br />. <br />NewTotal Amount....$..9.7..5.7.5.�0............................................................................................... <br />� <br />0 El Failed Materials <br />❑ Error <br />........... <br />❑ Omission <br />Total Percent of Change: 9.02 % ❑ Final Quantity Adjustment <br />Funding Secured From: L <br />(filled out by PM) <br />RECOMMENDED BY: <br />r /� <br />°e r C � 0 W er <br />Project Inspector (Print Name) Signature) _ (Date) <br />REVIEWED BY: <br />Construction Manager (Print Name) (Signature)--ITmmmmmmmm mmmmmmmmmmmmm (Date) <br />APPROVED BY: <br />Engineering Project Manager (Print Name) (Signature) (Date) <br />APPRF; BY: <br />�1+( <br />City Engineer (Print Name) (Signa mre,) (Date) <br />