HomeMy WebLinkAboutCHANGE ORDER - RFP - P1116 SH 392 I25 INTERCHANGECRY
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Planning, Development & Transportation
Engineering
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P.O. Box 580
Fort
For Collins, G 80522. 8
Fort Collins, CO 80522,00D0
970.221.0006
970.221.6370 - faX
fcgov.com/englneering
Change Order Form
PROJECT TITLE: 1-25 & SH392 Interchange & Improvements
PROJECT NUMBER: 400001900.0
CONTRACTOR: D M J M/Harris (PO #8855819)
CHANGE ORDER NUMBER: 1
n prepar n—g change orders show in order as separate numnered paragraphs me rouowmg
1. Reason for change. 2. Description of change.
3. Change in contract cost. 4. Change in contract time.
1&2. See attached sheet for detall.
3. The contract cost will increase by $ 35,000.00
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.O. % OF ORIGINAL CONTRACT
ADJUSTED CONTRACT COST
(Assuming all change orders approved)
40.22%
4M22%
$87,031.50
$0.00
$0,00
$35,000.00
$122,031.50
ACCEPTED BY' C mb"- _. DATE: 17 (S t0 8
(Co tr ctor's Re s ntative)
REVIEWED BY: _, �T� DATE:
(-rr01R er)
SUBMITTED BY.*- ...:.f='-- -,W._. _ DATE: �Z. ) ? -
(ProJaet Manage
APPROVED BY:
(Department Head)
APPROVED BY:
(Purchasing Agent over$80,000)
co. Contractor
Purchasing
Project File