HomeMy WebLinkAboutCHANGE ORDER - BID - 5839 ASPHALT OVERLAY PROJECT 2004JUN-13-2005 NON 07:57 AN CFO ENG,
FAX NO. 9702216378 P. 01
auR,neeriug DgMrtment
Change Order Form
PROJECT NUMB
PROJECT NUMB2005 Street Maintenance Program
ER: 320200 (Bid #5839)
CONTRACTOR: Lafarge Northern, Inc. (PO #5502237)
CHANGE ORDER NUMBER: 2
n preparing c once 1. Reason for change ers s ow In o eras separa a num erec. 2, Description of change.
3. Change in contract cost. 4. Change in contract time.
1 U. See attached sheet for detail.
3. The contract cost will increase by
$ 222,p0
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. % OE ORIGINAL CONTRACT
ADJUSTED CONTRACT COST
(Assuming all change orders approved)
ACCEPTED BY. —
Vector's Repre;
SUBMITTED BY:
APPROVED BY;
ACCEPTED SY:
Department Head
APPROVED By; `
CC: Purchasing
Accounting
Contractor
Project F;ia
(Purchasing Agent over $30,000)
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$2,230,388.32
$444.00
$0.00
$222.00
0.01%
0.03%
$2,231,054.32
DATE:
DATE:
DATE;:
DATE:
DATE:
"'"`• •'•6 LCNVrrmeat 281 North College 1venue • P,p, pox 580 , Fort Collin. rn
JUN-13-2005 MON 07:58 AM CFC ENG. FAX NO. 9702216378 P. 02
Change Order No.: 2
Date: 5/7/2005
1
2
3
a
Reason For Change:
a. Additional work not included in the original contract.
Description Of Change:
a. Supply Manhole Ring and Cover.
Change In Contract Amount:
Item
a. Standard Manhole Ring & Cover (8-)
TOTAL CHANGE IN CONTRACT AMOUNT
Change In Contract Time
TOTAL CHANGE IN CONTRACT TIME
Qty Unit Unit COst Total Cost
1.00 EA 3 222.00 5 222.00
T '22`2,00
None
None