HomeMy WebLinkAboutCHANGE ORDER - REQUISITION - 23162APR-14-2005 THU 07:44 AM CFO ENG, FAX NO, 9702216378 P. 05
Change Order Form
City of Fort couins
Engineering Department
PROJECT TITLE: Arthur Ditch Concrete Box Culvert (Bid No. 5670)
PROJECT NUMBER: 30525002.6
CONTRACTOR: Panhandle Concrete Products, Inc.
CHANGE ORDER NUMBER: 1
n preparing change orders show in order a�fe num ere paragraphs -the following:
1. Reason for change. 2. Description of change.
3. Change in contract cost. 4. Change in contract time.
1,8:2. See attached invoice for details
3. The contract cost will decrease by ($866.88)
4. The substantial completion date for the project will now be March 31, 2005, and the final completion date
will also be March 31, 2005.-
ORIGINAL CONTRACT COST
TOTAL APPROVED CHANGE ORDERS
TOTAL PENDING CHANGE ORDERS
TOTAL THIS CHANGE ORDER
TOTAL % OF THIS CHANGE ORDER
TOTAL C.O. `yo OF ORIGINAL CONTRACT
ADJUSTED CONTRACT COST
(Assuming all change orders approved)
ACCEPTED BY:
REVIEWD BY:
APPROVED BY:
cc: City Clerk
ConlreGnr
Purchasing
Projoct file
(Engineer or
Manager -
$115,584, 00
$0.00
$0.00
($866.88)
-0.75%
-0.75%
$114,717.12
DATE:
DATE: Z L7
Engineering (S866.89)
1 2 2005
Engineering Department • 281 North College Avenue • k,O. Box 580 • Fort Collins, CO 80522-0580 , (970) 221-6605