HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8225 MAXIMO CONSULTING SERVICES (16)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. #4
PROJECT TITLE: Consulting Support for Asset Register and Work Order Management
CONTRACTOR: Excergy Corporation
WORK ORDER NUMBER:#13
PO NUMBER: 9185142
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: President Excergy Corporation
REVIEWED: Date:
Pat Johnson, Senior Buyer
ACCEPTANCE: Date:
Carol Webb, Deputy Director, Utilities
ACCEPTANCE: Date:
Coy Althoff, Utilities Asset Manager
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 37C56F70-38DB-4626-8418-CC08C4952B73
6/13/2019
6/14/2019
6/17/2019
6/19/2019
Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
ACCEPTANCE: Date:
Rick Morford, Project Manager
Excergy WR&T Work Order #13
Change Order #3 Comments / Attachments:
With the closure of this work order any remaining funds shall be returned to the following capital project
account(s). Divide remaining funds evenly between both accounts
Water capital project account: 5020200000.521210.6
Wastewater capital project account: 5030200000.521210.6
DocuSign Envelope ID: 37C56F70-38DB-4626-8418-CC08C4952B73
6/19/2019