HomeMy WebLinkAboutCHANGE ORDER - PURCHASE ORDER - MASON STREET TRANSPORTATION CORRIDOR07/20/2006 TH11 13:14 FAX 970 221 6586 CITY OF FT COLLINS CLRS
Q 001/001
Change Order Form
Engnneering Department
PROJECT TITLE' Mason Street Transporation Corridor
PROJECT NUMBER: 30521900.6 (Bid #5932)
CONTRACTOR: • Mountain Constructors (PO #55067(14)
CHANGE ORDER NUMBER: 5
n prepanng change orders show in order as separatenumbered paragraphs the. o owing:
1. Reason for change. 2. Description of change.
3: Change in contract cost. 4. Change in contract time.
1 &2. See attached sheet for detail.
3. The contract cost will increase by $ 25,380.00
4. Then; 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.0- % OF ORIGINAL CONTRACT
ADJUSTED CONTRACT COST
(Assuming all change orders approved)
ACCEPTED BY: _
ontrai
SUBMITTED BY: _
Project
APPROVED BY:
APPROVED BY:
APPROVED BY:
on: Purchasing
Accounting
Contractor
Project File
1.82%
3.73%
$1,392,915.11
$26,601.00
$0.00
$26,380.00
$1,444,896.11
DATE: 6 1 " I0 - 0 6
DATE: 07- [Q - o G
DATE: /d Olv
DATE: z
DATE:
(Purchasing Agent over $30,000)
Parke & Rec. $25,300,00
Engineering $0.00
EaglMeering Department - 281 North Collage Avenue - P.O. Box 180 • Fort Collins, CO S05E2-0580 • (970) 221-%W