HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9184719 (5)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:#12
PO NUMBER: 9184719
DESCRIPTION: Additional scope has been requested for this work order.
1. Reason for Change: Work Order Closure
2. Description of Change: Fort Collins Utilities is closing this Excergy work order, all Scope Of Work
for this work order has been completed. 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: 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: D7E3363A-4364-4755-B28B-274418E7A287
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 #12
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).
Water capital project account: 5020200000.521210.6
DocuSign Envelope ID: D7E3363A-4364-4755-B28B-274418E7A287
6/17/2019