HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8513 LABORATORY INFORMATION SYSTEMChange Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 002
PROJECT TITLE: 8513 Laboratory Information Management System
CONTRACTOR: Ethosoft, Inc.
WORK ORDER NUMBER:
PO NUMBER: 9176806
DESCRIPTION:
1. Reason for Change: Project was not completed in 2018.
2. Description of Change: Change to project timeline.
3. Change in Work Order Price: $0.00
4. Completion Date (if changed): 12/31/2019
ORIGINAL WORK ORDER PRICE $ 269,300.00
TOTAL APPROVED CHANGE ORDER 8,740.00
TOTAL PENDING CHANGE ORDER .00
TOTAL THIS CHANGE ORDER .00
TOTAL % OF THIS CHANGE ORDER 0%
TOTAL C.O.% OF ORIGINAL WORK ORDER 0%
ADJUSTED WORK ORDER COST $ 278,040.00
CONTRACTOR: Ethosoft, Inc.
By: Date:
Name: Bill Moss Title: President
ACCEPTANCE: Date:
Leslie Hill, Project Manager
REVIEWED: Date:
Pat Johnson, Senior Buyer
ACCEPTANCE: Date:
Jill Oropeza, Sciences Director
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 81EA69E9-DEAA-43E0-BC5A-EA89FA30FFC8
2/11/2019
2/11/2019
2/11/2019
2/11/2019