HomeMy WebLinkAboutCHANGE ORDER - REQUISITION - 2734308/21/2006 MON 09:02 FAX 970 221 6586 CITY OF FT COLLINS CLRS
Q 001/001
PROJECT TITLE:
CONTRACTOR:
PROJECT NUMBER:
PURCHASE ORDER NO.:
DESCRIPTION:
1. Reason for change:
2. Description of Change:
CHANGE ORDIRR NO.2
Fossil Creek Trail Underpass @ HWY 287
NORAA Concrete Construction Corp.
som
Additional to scope of work
Quantity adjustments and additional work required due to unforeseen subsufface
groundwater Conditions
See the following far details
Exua Work
8:n Quantity overruns
Imms Peconciled trom Contract
3. Change in Contract Cost 5
4- Change in Contract Time-20 calendar days
Ss.
TOTAL APPROVED CHANGE ORDER
TOTAL PENDING CHANGE ORDER
TOTAL THIS CHANGE ORDER
TOTAL % OF ORIGINAL CONTRACT, THIS C.O.
TOTAL % OF ORIGINAL CONTRACT, ALL C.O.'S
ADJUSTED CONTRACT COST
{Assuming all change orders
' 1i01 . L,A-k L a� (aea
ACCEPTED
Contractor's
ACCEPTED
Project Mangy
REVIEWED
Title-
APPROVED BY:
Title' — - —
s A,606,50
5 9,740.63
5 f35.117 50i
(20.770.78)
SO-00
S (20.770.781
-431%
10A 0
$53�2,8 7.611—
DATE: JL- L5,bLg
DATE: Qlz 1 ] 1
DATE:
DATE:
APPROVED BY: DATE:
Purchasing Agent over $30,000
ca coy dent ardlitea V\
Caruaaw Engineer
Prolml Fie Purchasing
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