HomeMy WebLinkAboutCHANGE ORDER - PURCHASE ORDER - 9111536CHANGE ORDER NO. 1
PROJECT TITLE: Grasscrete Construction Services at MWRF
CONTRACTOR: Sipes Concrete Construction, Inc.
P.O. NUMBER: 9111536
VENDOR NUMBER: 102180
CHARGE NUMBER: 5030373616.529999.6
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In preparing change orders show inorder as separate numbered paragraphs the
following:
1. Reason for change. 2. Description of change.
3. Change in contract cost. 4. Change in contract time
1. Work beyond original scope of contract
2. Additional labor to clean out cardboard forms
3. $995.00
4. No change in contract time.
(Attach additional sheets as required)
ORIGINAL CONTRACT COST
TOTAL APPROVED CHANGE ORDERS
TOTAL PENDING CHANGE ORDERS
TOTAL THIS CHANGE ORDER
TOTAL % OF ORIGINAL CONTRACT, THIS CO:
TOTAL % OF ORIGINAL CONTRACT, ALL CO'S:
ADJUSTED CONTRAfT COST
(Assuming all change ders a6n?ovedl
8.31 %
$10,972.00
$0.00
$0.00
$995.00
$11,967.00
ACCEPTED BY: � o� 1/�� DATE: S
(Contractor's Representative)
REVIEWED BY: //s% DATE:
(Project Manager)
APPROVED BY: DATE: - 9
(Water Resources and Treatmenl Operations Manager)
CC: City Clerk Purchasing NOTE: Signature of Contractor indicates
Contractor Project File agreement herewithin, including any adjustment
in contract sum or contract time.
Sipes Concrete Construction Inc.
P.0.Box 272455
Fort Collins, CO 80527
Larimer
Voice: 970-206-1110
Fax: 970-206-1113
Customer ID', ,
City of Fort Collins
Sales.Rep ID �'•
Check/Credit Memo No:
1VI
Invoice Number: m127
Invoice Dale: Apr 1, 2011
Page: 1
;Shrp to:`.
City of Fort Collins
920 E Mulberry
Customer PO -
- - - Payment Terms .
Net15 Days
Shipping Method
Ship Date
Due Date,
Courier
4/16/11
•Description>,`
UnitPriceAmount
April work
Grasscrete
Labor to remove the containers for the
sides /not in quote
10,972.00
995.00
Subtotal
11,967.00
Sales Tax
Total Invoice Amount
11,967.00
Payme nt/C red it Applied
TOTAL
11,967.00