HomeMy WebLinkAboutCHANGE ORDER - REQUISITION - 2139211/12/2004 FRI 16:39 FAX 970 221 6586 CITY OF FT COLLINS CLRS
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PROJECY TITLE:
CONTRACTOR-
PROJECT NURSER:
PURCHASE ORDER NO.:
OESCRIPTiON:
1. Ream for ahangw
CHANGE MOM No. 2
Poudre Trail EMnsfon - W. or Taft HIII Road
Colorada Constructors Inc
4946
4402037
Minor changes to scope of work
auantily adjuetmenta and additional work required
2. Deecriptian of Change: SAA Payment Applleation aqt shad forOetails
A.DD - AdOt<i0nel Sb Calprad Commm Paving aAM €f 8 V1.401
lC� la.o�
3. Change in Contract Cost $
4. Mom In Centract rime: NIA
... %Wv,vw wit I "FSW 1 Mvv,
TOTAL APPROVED CHANGE ORDER
TOTAL PENWNO CHANGE ORDER
TOTAL THIS CHANGE ORDER
TOTAL % OF ORIGINAL CONTRACT, THI$ C.O.
TOTAL % OF ORIGINAL CONTRACT, ALL C-O.'S
ADJUSTED CONTRACT COST
5 %mom
6�"�00
L
ACCEPTED UY:
�r ,
DATE: I � ay a 4
Contractor's Representati
ACCEPTED BY:
DATE: a
Project Manager
REVIEWED BY:
DATE:
Tine:
APPROVED RY:
DATE:
TOW
APPRONEp 13Y:
pAT6:
Purchasing Agent over 13333
M
oG city Cie* Architect
" Comraotor Englr4of
Pr4md FRO Pv,chuln9