HomeMy WebLinkAboutCORRESPONDENCE - BID - 8844 MISCELLANEOUS CONCRETE (38)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 1
PROJECT TITLE: Garfield St. Inlet & Concrete Replacement Project
CONTRACTOR: Lightfield Enterprises, Inc.
WORK ORDER NUMBER: 2019-05232019
PO NUMBER: 9190956
DESCRIPTION:
1. Reason for Change: Cost
2. Description of Change: The project scope did not change during the project. Actual work
complete was paid at contract unit prices per the work order. The reduction in the PO
amount reflects the difference between the estimated and actual quantities necessary to
complete the work including the contingency amount.
3. Change in Work Order Price: $11,558.90
4. Completion Date (if changed): NA
ORIGINAL WORK ORDER PRICE $ 42,481.25
TOTAL APPROVED CHANGE ORDER 00.00
TOTAL PENDING CHANGE ORDER 00.00
TOTAL THIS CHANGE ORDER $ 11,558.90
TOTAL % OF THIS CHANGE ORDER 27.2%
TOTAL C.O.% OF ORIGINAL WORK ORDER 27.2%
ADJUSTED WORK ORDER COST $ 30,922.35
CONTRACTOR: Lightfield Enterprises, Inc.
By: Date:
Name: Title:
ACCEPTANCE: Date:
Douglas Groves, Stormwater Maintenance Operations Manager
REVIEWED: Date:
Dale Elliot, Senior Buyer
DocuSign Envelope ID: 03A3593C-D2EA-4BAF-AA6E-E576E33B3930
November 14, 2019
November 14, 2019
November 15, 2019
Keith R. Lightfield Executive Vice President
Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
APPROVED AS TO FORM: Date:
Name,City Attorney's Title
(if greater than $1,000,000)
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: 03A3593C-D2EA-4BAF-AA6E-E576E33B3930
November 14, 2019
November 16, 2019
November 19, 2019