HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8859 CM/CG SERVICES FOR WILLOW STREET IMPROVEMENTSChange Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 01
PROJECT TITLE: Willow Street Improvements – 8859
CONTRACTOR: Connell
WORK ORDER NUMBER:03
PO NUMBER:
DESCRIPTION:
1. Reason for Change: This change order accounts for the overrun of the 8"x 3/4" water service,
meter pit and service extension as requested by the Utilities department. The original service was
located in an area with a variety of utility conflicts.
2. Description of Change: overrun of the 8"x 3/4" water service
3. Change in Work Order Price: The contract value is an increase of $2,340.
4. Completion Date (if changed): No change in contract time is awarded.
ORIGINAL WORK ORDER PRICE $ 135,812.00
TOTAL APPROVED CHANGE ORDER 2,340.00
TOTAL PENDING CHANGE ORDER .00
TOTAL THIS CHANGE ORDER 2,340.00
TOTAL % OF THIS CHANGE ORDER 1.7
TOTAL C.O.% OF ORIGINAL WORK ORDER 1.7%
ADJUSTED WORK ORDER COST $ 138,152.00
CONTRACTOR: Connell
By: Date: 8/15/19
Name: Roland Tremble Title: Project Manager
ACCEPTANCE: Nicole Hahn Date:
Project Manager
REVIEWED: Date:
Pat Johnson, Senior Buyer
ACCEPTANCE: Date:
Andrew Gingrich, Water Field Operations
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 73741CD5-C6D8-4785-AFDB-B668250C6F26
8/15/2019
8/15/2019
8/16/2019