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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8745 CONSULTING ENGINEERING SERVICES FOR FUTURE WATER WW & STORMWATER FACILITIES CAPITAL IMPROVEMENTS (5)Change Order Form (for Work Orders) Official Purchasing Form Last updated 10/2017 CHANGE ORDER NO. 1 PROJECT TITLE: DWRF Project Management Support CONTRACTOR: Ditesco WORK ORDER NUMBER: D-WRF-2018-23 PO NUMBER: 9185224 DESCRIPTION: 1. Reason for Change: Work Order time extension. 2. Description of Change: Time extension, due to delays related to centrifuge start-up. 3. Change in Work Order Price: NA 4. Completion Date (if changed): July 31, 2019 ORIGINAL WORK ORDER PRICE $ 61,890.00 TOTAL APPROVED CHANGE ORDER 00.00 TOTAL PENDING CHANGE ORDER 00.00 TOTAL THIS CHANGE ORDER 00.00 TOTAL % OF THIS CHANGE ORDER 00% TOTAL C.O.% OF ORIGINAL WORK ORDER 00% ADJUSTED WORK ORDER COST $ 61,890.00 CONTRACTOR: Ditesco By: Date: Name: Title: ACCEPTANCE: Date: Eileen Dornfest, Civil Engineer II REVIEWED: Date: Pat Johnson, Senior Buyer ACCEPTANCE: Date: Owen Randall, Director – Civil Engineering ACCEPTANCE: Date: Jason Graham, Director – Water Reclamation & Biosolids DocuSign Envelope ID: 8E91FAED-537F-430F-B1F1-1F0BFC947E07 March 26, 2019 March 26, 2019 March 26, 2019 KEITH MEYER Owner/Manager March 26, 2019 March 26, 2019 Change Order Form (for Work Orders) Official Purchasing Form Last updated 10/2017 ACCEPTANCE: Date: Theresa Connor, Deputy Director – Water Engineering & Field Services ACCEPTANCE: Date: Carol Webb, Deputy Director – Water Resources & Treatment Operations ACCEPTANCE: Date: Gerry Paul, Purchasing Director (if greater than $60,000) DocuSign Envelope ID: 8E91FAED-537F-430F-B1F1-1F0BFC947E07 March 26, 2019 March 26, 2019