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CHANGE ORDER - REQUISITION - 26854
06/14/2006 WED 09:22 FAX 970 221 6586 CITY OF FT COLLINS CLRS 1@001/004 06/13/2009 06:67 3036379470 NORRA CONCRETE PAGE 02 CHANCE ORDER NO.1 PROJECT TITLE; Fwam Creek Tran Underpass a Hyyi 287 CONTRACTOR: NORAA Concrete Construction Corp. PROJECT NUMBER: S940 PURCHASE ORDER NO.: DESCRIPTION; Additional to scope of work 1. Reason for dmge: Quarfity adjustments and additional work rewired due to unforeseen subsurface graurxMmler conditions. 2. Description of Change: See the following for details Original P.O. amauntwas far Sf,0W k= Blau bld amount ; 1.000.00 Under of im ay"em S 55,889.00 Extra Want S 19,720.20 &d rummy am"o S 13.764.43 ItamsDELMDfrom fheCartrael t (18,004.M 8. Change in Contact Cat: s 4. Change in Cafftcl Time: Q calendar days TOTAL APPROVED CHANGE ORDER TOTAL PENDING CHANG@ ORDER TOTAL THIS, CHANGE ORDER TOTAL % OF ORIGINAL CONTRACT, THIS C.O. TOTAL % OF ORIGINAL CONTRACT, ALL C.Q,'S ADJUSTED CONTRACT COST ACCEPTED BY: Conlraaur's Rep ACCEPTED BY: get, REVIEWED SY: Title: APPROVED BY: TRW APPROVED BY: Purdwaim Agent aver 58o,000 4k Ck010A A cwftdcr Ergbmr Project Fla Pa+aMby T2,359.38 DATE: DATE: DATE: DATE. 6 '-1 I `�`f'0(0 T• 3. OWMER: C14fofFtCdllm 21a N MOM SI Pt cdiw co BM24 PROJECTUM: Josomskru=rh For PROJECT: F05811 Cfttk Trlkh UnftNINS D MY 297 PROJECT NO: CONTRACTOR: Noma CorgeloCmsirmwo2n. 2527 39 Swth 44h Ave - Und 6 PAY APPLICATION NO: 3-2627 andhtod, co smi offloo no. 3M�07-9233 PAY APPLICATION BATE: may 17, 2066 %cr4.3034537-94'i0 CONTRACT STATUS hill AM, DINls k3ow 2umm Amearlf ofloinaloanluxt Fabrony 2. 2000 $ 482,300.00 Undar Dom 8ptom S. 55.888-07 3 56,89900 EAra Iffiblik S. 19,720.20 S 19,72D.2D Over RM $ 13,754.43 S 13,751-43 lberns Vdated Fmcm Cormsa $ Change Order Swwwry TOTAL WFTH ORGINAL QWWCj Mp Cgj=r ORDER 5 .758-31 Esumalp Sulltmani 1.2527 $73 S- ?.3?p- Sea 912B3 ; 3 55.912B3; ST.32 M 2627 ii4i= i 5 14,447.20 W% SIMMUD $, 130.024.80 $14.447.20 3-2527 $277,845.40 ------ ---- Total $426.553-71 S 49.05.37 5445-998.34 I I BS M7,91 R2.00 AIR PAVIVIIINTSTATUB % Cognplefe4rhirr Period S 276.54&46 50% ProvkmCompsaW S 217,70a25 Tow complewbait B 494.353.71 BS% Less Relaamp to Date S 49, M37 10% TOW Lass Reftimue Lase Prowbus Paid io Da* FtETAIMMIESTATUS Total flewmage IQ o8b & TOW Rokhow Relamd RoMinap Balar" I IV& Qc*TtW BMW% MLOW11L this anti ouvotfidimrob. In scoordarm vwiih tho for PoWsso IhQ C&MOdWilieffiCad to Inw,"NS in Ins annMini.shown 8bDM. 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