HomeMy WebLinkAboutCHANGE ORDER - AGREEMENT MISC - FORD AUDIO-VIDEO SYSTEMS INCPROJECT: Canyon West
QUOTE: onI5982a
CUSTOMER: Cib; of For Colins
SCOPE OF WORK
The Agreement Scope of Work shall be changed as follows:
Ford AV shall install one (1) rack mountable XL. , out.ow on tho equipinent rack.
The Agreement Equipment List shall be changed as follows:
CUSTOMER CHANGE ORDE—R
1/ s 6 �b
TOD�.1" S DATE:
11/22/11
_'0R NUA-IBER:
110 135 i
CH AN E ORDER NUMBER:
0001
.CRE�i,IENT DATE:
10/27/11
LINE NO
CITY
I ITEM NO DESCRIPTION
UOM
PRICE
EXTENSION
1
1
Ifay.rnisc5l (custom rack panel xlr output
ea
80.00
80.00
3
e.e0
0.00
0.00
C.00
0110
I
I
om
I a.Co i
3
I
�
0.00
0.00
0.0o
O.G�
I o.ne
_ nT
� t0
I
J.JO
� O.GG
;aer:ii.andise S b Total
L bor
JFreight
—'a es -Tax
Change Grder Total;
S 80.00
o0I
0.00
0.00)
0.00
$ 8C.G0
The oricina! Agreement sum Was ................. .
Net change by previous Change Orders ..... . ...................... _..............._.........................................
i ne revised Agreement sum prior to this Change Order ............ .
The Acreement sum shall (ircreaserdecreas=) by this Change Order in the amounr of.. . .........................
The nevi Agreement sum including :his Chance Order is ...... . ...... . .......... ....... _...,..-......... .......
the Acreernerr rime will be (increased%decreased unchanged) by_..... _..... _....... 0 days.
The date of Substantial Completion as of the date of this Change Order is.-.......... 0 days.
FORD AUDIO -VIDEO SYSTEMS, INC. CUSANI�R
Account Manager Cu"stomzr S`eTraccr
Division Manager
Date
25.287.00
S 25.287-00
S 680.00
S 25,967.00
I
Print Name/ and Title
Date � ---
Dale
I
(T:\SalcslDEN". HYOPdE'.2011 Projecrs `.`%oni^ity of Ft. Collins - CFCOFOW.uncoln Center Conference Room - 1159821Can.yen 'c`1=et CCO
001.x!s. 1 l.22'20' i, 2:10 Pt.;) This document is for use by authorized ,ersonnel erly and is not ;o intender; for gen-rai di;semir2t