HomeMy WebLinkAboutCORRESPONDENCE - BID - 7658 MISCELLANEOUS CONCRETE ANNUAL (33)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 1
PROJECT TITLE: 2018-5200 Blk Parkway Circle
CONTRACTOR: Lightfield Enterprises, Inc.
WORK ORDER NUMBER: 2019-01
PO NUMBER: 9190317
DESCRIPTION:
1. Reason for Change: Additional work required due to field conditions
2. Description of Change: Concrete headwall had to be increased in size due to unforeseen
field conditions. Additional structure added to scope of work to improve the grades adjacent
to private property.
3. Change in Work Order Price: $13,389.37
4. Completion Date (if changed): February 15, 2019
ORIGINAL WORK ORDER PRICE $ 9,294.06
TOTAL APPROVED CHANGE ORDER 00.00
TOTAL PENDING CHANGE ORDER 00.00
TOTAL THIS CHANGE ORDER $13,389.37
TOTAL % OF THIS CHANGE ORDER 144%
TOTAL C.O.% OF ORIGINAL WORK ORDER 144%
ADJUSTED WORK ORDER COST $ 22,683.43
CONTRACTOR: Lightfield Enterprises, Inc.
By: Date:
Name: Title:
ACCEPTANCE: Date:
Sandra Bratlie, Civil Engineer III
REVIEWED: Date:
Dale Elliot, Senior Buyer
ACCEPTANCE: Date:
Andrew Gingerich, Director, Water Field Services
DocuSign Envelope ID: B7BD1D20-BBB3-4F3E-BEE3-8632F5E2EF95
May 2, 2019
Keith R. Lightfield
May 2, 2019
Executive Vice President
May 2, 2019
May 2, 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:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: B7BD1D20-BBB3-4F3E-BEE3-8632F5E2EF95
May 2, 2019