HomeMy WebLinkAboutCHANGE ORDER - REQUISITION - 27652SEP-29-2006 FRI 01:29 PM CFC ENG,
Rn8lneering Department
FAX NO, 9702216378
Change Order Form
PROJECT TITI-E� E, Prospect Rd. improvements
PROJECT NUMBER: 30521700.E (Sic #5958)
CONTRACTOR: Don Kohn Construction, Inc, (PO #5601846
CHANGE ORDER NUMBER: 3
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1. Reason for change. 2. Description of change.
3. Change in contract cost. 4- Change in contract time.
1 &2. See attached sheet for detail.
3. The contract cost will increase by $15.904.00
4, There will be no change in contract time.
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ORIGINAL CONTRACT COST
$3,767,538.35
TOTAL APPROVED CHANGE ORDERS
$30,558,32
TOTAL PENDING CHANGE ORDERS
$0.00
TOTAL THIS CHANGE ORDER
_ $15,904,OD
TOTAL % OF THIS CHANGE ORDER
0.42%
TOTAL_ C,O. P/o OF ORIGINAL CONTRACT
1,24%
ADJUSTED CONTRACT COST
;3,80a,000.87
(Assuming all change orders approved)
ACCEPTED BY: DATE:_
(Contractor's a rosentativ
ACCEPTED BY: _ _DATE:
(Project Manager) q /.
REVIEWED BY, - kI� r — — — DATE:_ !is Q� — --
APPROVED pY; _ LQ S�C1,1_2)kEdd, DATE:
IJ(Department Head) �^
APPROVED BY: __ __ _DATE;
(Purchasing Agent over $30,000)
cc: Contractur
Pprchesirlg
Project File
r1neAPtment • 281 North College Avenue • R.O. Box 580 • Fort Collins, CO 80522-0530 • (970) 221-6606
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