HomeMy WebLinkAboutCHANGE ORDER - PURCHASE ORDER - 9185297Change Order Form (for Work Orders) Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 1
PROJECT TITLE: 2018 Cured in place pipe
CONTRACTOR: Granite Inliner
WORK ORDER NUMBER: 1-09112018
PO NUMBER: 9185297
DESCRIPTION:
1. Reason for Change: Cost – Project Close-out
2. Description of Change: The work has been completed with Granite Inliner and we would like to
unencumber the funds back to the 5036490002 project/
3. Change in Work Order Price: $55,981.00
4. Completion Date (if changed): NA
ORIGINAL WORK ORDER PRICE $ 429,560.00
TOTAL APPROVED CHANGE ORDER 00.00
TOTAL PENDING CHANGE ORDER 00.00
TOTAL THIS CHANGE ORDER $ 55,981.00
TOTAL % OF THIS CHANGE ORDER 13.0%
TOTAL C.O.% OF ORIGINAL WORK ORDER 13.0%%
ADJUSTED WORK ORDER COST $ 373,579.00
CONTRACTOR: Granite Inliner
By: Date:
Name: Title:
ACCEPTANCE: Date:
Ray Fisher, Collection Operations Manager
REVIEWED: Date:
Pat Johnson, Senior Buyer
DocuSign Envelope ID: 27A0E6EC-BC6B-49F7-8190-8442528CDC21
October 21, 2019
District Manager
October 22, 2019
Mark Slack
October 21, 2019
Change Order Form (for Work Orders) Official Purchasing Form
Last updated 10/2017
ACCEPTANCE: Date:
Sandra Bratlie, Civil Engineer III
ACCEPTANCE: Date:
Andrew Gingerich, Director, Water Field Operations
ACCEPTANCE: Date:
Theresa Connor, Deputy Director, Water Engineering & Field Services
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 27A0E6EC-BC6B-49F7-8190-8442528CDC21
October 21, 2019
October 24, 2019
October 24, 2019