HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8225 MAXIMO CONSULTING SERVICES (20)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. #3
PROJECT TITLE: Consulting Support for Asset Register and Work Order Management System
CONTRACTOR: Excergy Corporation
WORK ORDER NUMBER:WEFS_WWS
PO NUMBER: 9190417
DESCRIPTION:
1. Reason for Change: Work Order WEFS_WWS Closure.
2. Description of Change: Excergy Work Order WEFS_WWS 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: $-27,070.00
4. Completion Date (if changed):
ORIGINAL WORK ORDER PRICE $ 43,878.00
TOTAL APPROVED CHANGE ORDER $ -7,093.00
TOTAL PENDING CHANGE ORDER $ 0.00
TOTAL THIS CHANGE ORDER $ -27,070.00
TOTAL % OF THIS CHANGE ORDER %
TOTAL C.O.% OF ORIGINAL WORK ORDER %
ADJUSTED WORK ORDER COST $ 9,715.00
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: 054A4DAF-AD24-4B33-8AF5-5F046D4FDC7A
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 WEFS_WWS
Change Order #3 Comments / Attachments
Purchase Order number: 9190417 for Excergy Work Order WEFS_WWS is now closed. All remaining
funds encumbered to Purchase Order 9190417 shall be returned to the following capital project
account(s).
Wastewater capital account: 5030200000.521210.6
DocuSign Envelope ID: 054A4DAF-AD24-4B33-8AF5-5F046D4FDC7A
7/30/2019