HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9184719 (6)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. #7
PROJECT TITLE: Consulting Support for Asset Register and Work Order Management System
CONTRACTOR: Excergy Corporation
WORK ORDER NUMBER: #12
PO NUMBER: 9184719
DESCRIPTION:
1. Reason for Change: Excergy Work Order #12 Closure.
2. Description of Change: Excergy Work Order #12 and assigned Purchase Order is now closed. All
remaining funds are to be returned to project account(s) (Please see Comments / Attachments for details)
3. Change in Work Order Price: $-3,690.00
4. Completion Date (if changed):
ORIGINAL WORK ORDER PRICE $ 35,338.19
TOTAL APPROVED CHANGE ORDER $ 11,331.97
TOTAL PENDING CHANGE ORDER $ 0.00
TOTAL THIS CHANGE ORDER $ -3,690.00
TOTAL % OF THIS CHANGE ORDER %
TOTAL C.O.% OF ORIGINAL WORK ORDER %
ADJUSTED WORK ORDER COST $ 42,979.97
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: 482C2738-7647-441C-AB6F-B5D25940DC9B
7/29/2019
7/30/2019
7/30/2019
7/30/2019
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 #7 Comments / Attachments
Purchase Order number: 9184719 for Excergy Work Order #12 is now closed. All remaining funds
encumbered to Purchase Order 9184719 shall be returned to the following capital project account(s).
Water capital project account: 5020200000.521210.6
DocuSign Envelope ID: 482C2738-7647-441C-AB6F-B5D25940DC9B
7/30/2019