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DEPARTMENT OF PUBLIC WORKS <br />DIVISION OF ENGINEERING <br />Project Number: 118-076 Project Name: Western Avenue streetscape Phase III Change Order #: 3 <br />DATE INITIATED: 12/16/19 BPW DATE: <br />Brief Summary of Change Order; (Construction Change, Alternative, Substitution, Differing Instructions, Out of Scope, Etc.). <br />Added days due to weather & utility delays. <br />Attachments: (List documents support change — required) <br />Contractors request (only partially approved). <br />Amount of ❑ Increase / ❑ Decrease: $ <br />Categories (Pick One): <br />Previously approved Change Order(s): $175,155.31 ❑ Scope of Work <br />--- 8 Differing Site Conditions, Changed Conditions <br />Current Percent of Change: _ % ❑ Conflicted Specifications and Drawings <br />..... .... . . .... ....... ............................... <br />New Total Amount:..... <br />2,809,540.66 ❑ Failed Materials <br />$ ❑ Error <br />El Omission <br />Total Percent of Change: 6.65 <br />❑ Final Quantity Adjustment <br />Funding Secured From: <br />(filled out by PM) <br />0 <br />RECOMMENDED BY: <br />Josh Ehmer ����``"��y �� <br />12/16/19 <br />Project Inspector (Print Name) (Si;gnatur) (Date) <br />REVIEWED BY: <br />_........ m._.. <br />Construction Manager (Print Name) (Signature) (Date) <br />APPROVED BY: <br />Engineering <br />Project Manager (Print Name) (Signature- � (Date) <br />APPROVED BY: <br />�02, W <br />City Engineer (Prin Name) (Signature) (Date) <br />