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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 1 18-086R Project Name: Liberty Tower Improvements DivC Change Order #: 3 <br />DATE INITIATED; 8/20/19 <br />BPW DATE; <br />.... <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Providing (3) power supplies & electrician to install power supplies, & auto operators. <br />Attachments: (List documents support change — required) <br />Contractors Pricing & Submittal. <br />Amount of ® Increase / ❑ Decrease: $ 3813.31 <br />Categories (Pick One): <br />Previously approved Change Order(s): $-2007.54 <br />8 Scope of Work <br />- <br />Current Percent Change: '26 % <br />•--•. El Differing Site Conditions, Changed Conditions <br />of <br />❑ Conflicted Specifications and Drawings <br />305805.77 ... <br />New Total Amount: $ <br />I] Failed Materials <br />❑ Error <br />............ ..Rol ............. <br />"' <br />❑ Omission <br />Total Percent of Change: % <br />❑ Final Quantity Adjustment <br />Funding Secured From: '32.q-1050 - Lk60 —WL -d2 11 <br />(filled out by PM) <br />RECOMMENDED BY: <br />Josh Ehmer <br />/2011 <br />Project Inspector (Print Name) <br />(Signa It <br />(Date) <br />REVIEWED BY: <br />.._. <br />.... <br />Construction Mana er (Print Name) <br />(Signature) <br />(Date) <br />APPROVED BY: <br />Engineering Project Manager (Print Name) <br />(Signatu <br />(Date) <br />APPROVE BY: <br />Y", 4 <br />City Engineer (Print Name) <br />(Signature) <br />(Da <br />