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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8225 MAXIMO CONSULTING SERVICES (13)Change Order Form (for Work Orders) Official Purchasing Form Last updated 10/2017 CHANGE ORDER NO. #6 PROJECT TITLE: Consulting Support for Asset Register and Work Order Management System CONTRACTOR: Excergy Corporation WORK ORDER NUMBER:#10 PO NUMBER: 9182546 DESCRIPTION: 1. Reason for Change: Work Order Closure 2. Description of Change: Fort Collins Utilities is closing this Excergy work order. Any remaining funds will be returned to their respective capital project account(s) (Please see Comments / Attachments section). 3. Change in Work Order Price: $ 0.00 4. Completion Date (if changed): June 14, 2019 ORIGINAL WORK ORDER PRICE $ 0.00 TOTAL APPROVED CHANGE ORDER $ 0.00 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 $ 0.00 CONTRACTOR: Excergy Corporation By: Date: Name: James Ketchledge Title: CEO & President 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: 663A95D9-3655-4C7D-83E5-5D471B2D35B4 6/13/2019 6/14/2019 6/17/2019 6/17/2019 Change Order Form (for Work Orders) Official Purchasing Form Last updated 10/2017 ACCEPTANCE: Date: Rick Morford, Project Manager Excergy Work Order #10 Change Order #6 Comments / Attachments With the closure of this work order any remaining funds shall be returned to the following capital project account(s). Storm Water capital project account: 5040453300.521210.6 DocuSign Envelope ID: 663A95D9-3655-4C7D-83E5-5D471B2D35B4 6/17/2019