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Ouse rar <br />DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 119-084 Project Name: 10 S, Mais" Street Bundling Improvements Change Order #: 1 <br />DATE INITIATED: 10-5-19 BPW DATE; 10-22-19 <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Plumbing was in need of unforeseen repairs due to vandals stealing pipes. Water damage was <br />found behind existing walls and was repaired. Downspouts need replacement after existing <br />materials were stolen. A window is needed within an interior doorway for safety purposes. Missing <br />trim and sheathing is needed to properly seal and waterproof the roof. <br />Attachments: (List documents support change — required) <br />Plumbing repair - $2,762.46 <br />Celotex repairs - $1,254.00 <br />Trim/Sheathing - $786.00 <br />Add Window - $417.00 <br />Amount of ® Increase / ❑ Decrease: $ 5,219.46 <br />Categories (Pick One): <br />Previously approved Change Order(s): $ 0.00 ❑ Scope of Work <br />8 Differing Site Conditions, Changed Conditions <br />Current Percent of Change:."' 9 <br />❑ Conflicted Specifications and Drawings <br />...............����� <br />NewTota...Amo...................................._____ �,,,...................................�................................ <br />.❑ Failed Materials <br />Amount: $154�' 70446 ❑ Error <br />El Omission <br />Total Percent of Change: 3'49 % ❑ Final Quantity Adjustment <br />Funding Secured From: 0 <br />(filled out by PM)� TFn­ <br />t� <br />mn <br />RECOMMENDED BY: <br />Dan Jones <br />Project Inspector (Print Name) (Signatu e) (Date) <br />REVIEWED BY: <br />Toy Villa <br />__.............WWu. <br />Construction Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Alicia Czarnecki <br />Engineering Project Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Kara Boyles �� �"" 10, �14. <br />City Engineer (Print Name) (Signalui (Date) <br />