HomeMy WebLinkAbout130088 ICON ENGINEERING INC - PURCHASE ORDER - 9184173Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. CO-01
PROJECT TITLE: L-PATH Erosion Protection and Conceptual Design
SERVICE PROVIDER: ICON Engineering, Inc.
WORK ORDER NUMBER:BLA-2018-01
PO NUMBER: 9184173
DESCRIPTION:
1. Reason for Change: Work order set to expire on 12/31/2018
2. Description of Change: Extension in work order completion date
3. Change in Work Order Price: N/A
4. Change in Work Order Time: 7 month extension, new completion date 7/1/2019
ORIGINAL WORK ORDER PRICE $ 91,870.00
TOTAL APPROVED CHANGE ORDER 0.00
TOTAL PENDING CHANGE ORDER 0.00
TOTAL THIS CHANGE ORDER 0.00
TOTAL % OF THIS CHANGE ORDER 0%
TOTAL C.O.% OF ORIGINAL WORK ORDER 0%
ADJUSTED WORK ORDER COST $ 91,870.00
SERVICE PROVIDER: Date:
Name, Title
ACCEPTANCE: Date:
Name, Project Manager
REVIEWED: Date:
Name, Buyer or Senior Buyer
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 624FEAD1-5606-438B-8340-434CC93B4B40
December 13, 2018
December 13, 2018
December 13, 2018