HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9184719 (4)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. #5
PROJECT TITLE: Consulting Support for Asset Register and Work Order Management System
CONTRACTOR: Excergy Corporation
WORK ORDER NUMBER:#12
PO NUMBER: 9184719
DESCRIPTION: Additional scope has been requested for this work order.
1. Reason for Change: Additional funds for this work order.
2. Description of Change: Additional funds have been found for this work order, as a result the
completion date needs to be extended until said funds have been exhausted.
3. Change in Work Order Price:
4. Completion Date (if changed): July 26, 2019
ORIGINAL WORK ORDER PRICE $ 35,338.00
TOTAL APPROVED CHANGE ORDER $ 11,331.97
TOTAL PENDING CHANGE ORDER $ 0.00
TOTAL THIS CHANGE ORDER $ 0.00
TOTAL % OF THIS CHANGE ORDER %
TOTAL C.O.% OF ORIGINAL WORK ORDER %
ADJUSTED WORK ORDER COST $ 46,669.97.00
CONTRACTOR: Excergy Corporation
By: Date:
Name: James Ketchledge Title: President & CEO
REVIEWED: Date:
Pat Johnson, Buyer or Senior Buyer
ACCEPTANCE: Date:
Theresa Connor, Deputy Director, Utilities
ACCEPTANCE: Date:
Coy Althoff, Utilities Asset Manager
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: E6900257-2C7A-408E-A69A-6D93D093D969
4/22/2019
4/22/2019
4/22/2019
4/22/2019
Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
ACCEPTANCE: Date:
Rick Morford, Project Manager
Change Order Comments:
A requisition approved on 10/4/2018 had not gotten entered into the financial system. The
requisition had already been included into the total funds encumbered for this work order. To
correct this mistake the previously approved requisition was sent back out for updated signatures
then put into the financial system on 4/17/2019.
A result of these added funds this work order Completion Date is being moved out to July 26,
2019 to allow those additional fund to be exhausted before officially closing this work order.
DocuSign Envelope ID: E6900257-2C7A-408E-A69A-6D93D093D969
4/22/2019