HomeMy WebLinkAboutCHANGE ORDER - REQUISITION - 27145JUL-21-2006 FRI 09i16 AM CFO ENG, FAX N0, 970221637B P. 05
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Change Order Form
Eayieeadng Department
PROJECT TITLE: Timberline Rd. Widening Project
PROJECT NUMBER; 30623270.6 (bid #5954)
CONTRACTOR'. Connell Resources, Ina (PO #6601742)
CHANGE ORDER NUMBER: 4
n preparing cnango orders snow in Order a5 separate numpered paragrapns the tollowing:
1. Reasonfor change. 2. Description of change,
3. Change in contract cost. 4, Change in contract time.
1 &2. Soe attached sheet for detail,
3. The contract cost will increase by $6,233,00
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,p. "A OF ORIGINAL, CONTRACT
ADJUSTED CONTRACT COST
(A.vsuming all change orders approved)
ACCEPTED BY:
ACCEPTED BY:
REVIEWED BY:
APPROVED BY:
0.12Y
1.919e
$5,277,645,27
694,887ZO
$0.00
$8,233.00
$5,9i9,565.B7
DATE; ']
)ATE: 7 17 QG
—,/J<r t -1 L� ATE:
(Engineer) fJ
DATE 7 r'
apartment a det)
APPROVED BY: _ _ DATE:
(Purchasing Agent over $30.000)
cc. contractor
Purchasnp
Project Ric
JUL-21-2006 FRI 09:16 AM CFO ENG, FAX NO, 9702216378 P. 06
CHANGE ORDER NO.4
TIMBPRLINE ROAD WIDENING PROJECT • INTERM
SUMMARY OF WORK
Connell Resources Inc.
Surveying Additions to the project
Additional Concrete
See attached submittal
Item
esign Change
Unit 1 $1 Unit 1 Total
connen rcasouross Inc. twamonai surveying i IS 2,127.50$ 2127.50
TOTAL _ $ 0!233.00
REASON FOR CHANGE
Mix Design change on Concrete to a heavier strength
Surveyors had to restake several areas for traffic pole locations, Electric.
WHEN PORTED
Posted to Pay Estimate No.4