HomeMy WebLinkAboutCHANGE ORDER - REQUISITION - 27726OCT-10-2006 TUE 11:03 AM CFO ENG. FAX NO. 9702216378 P, 01
Change Order Form
Englueertng Department
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PROJECT TITLE: Lemay Ave.. Trilby to Carpenter y C T a
PROJECT NUMBER. 30523255.E (bid No. 5883) ,R
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CONTRACTOR: Lafarge Northern, Inc, (PO #6604268)
CHANGE: ORDER NUMBER: 1
n Preparing Gitange orders show In or er as separate MmIcAred paragraphs Ie o owing:
1. Reas6n for change. 2. Descriptlon of change, o
3. Change in contract cost, 4. Change in contract time. ap+
166
1 &2. See attached Sheet for detail. 9 _!
3, The contract cast will increase by $ 5,253.82
4. There will be no change in contract time.
ORIGINAL CONTRACT COST
TOTAL APPROVED CHANGE ORDERS
TOTAL PENDING CHANGE ORDERS
TOTAL THIS CHANGE ORDER
TOTAL % OF THIS CHANGE ORDER
TOTAL C.O. % OF ORIGINAL CONTRACT
ADJUSTED CONTRACT COST
(Assuming ail change orders approved)
ACCEPTED BY;
0.40%
0,40%
$1,299,338.60
$0.00
$0.00
$5,253,82
$1,304,592.42
DATE: _zv����
APPROVED BY: t •� � �_ DATE:
Project Engineer
APPROVED BY: _ DATE'
Project Ma ar
APPROVED BY: � QdQ�i ,���_. ---DATE:
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apartment Head
APPROVED BY:
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Comrectof
Project File
DATE:
(Purchasing Agent over $30,000)
Denartment - 281 North College Avenue - P-O. BOX 5S0 • Fart Collins, CO 80522 4SSD • (970) ,Z21 605
OCT-10-2006 TUE 11:03 AM CFO ENG. FAX NO. 9702216378 P. 02
LaForge
CHANGE ORDER NOA
SOUTH LEMAY WIDENING PROJECT BETWEEN TRILISY AND CARPENTER
SUMMARY OF WORK
Sca attoohad supmitlal
REASON FOR CNANOE
Modifwd Underdrain sVstam to minim=e disturaellca to astapllshed landsmpaing at dw
Shrill sawar lie -In location, Sea attached statement for Ilimiud Costs assoelaled With Ulls
nwilillacti0a,
WHEN POSTED
Posted la Pay Eetlmate Nol