HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9191216 (2)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 1
PROJECT TITLE: Laporte Ave. Phase II Storm Drainage Improvements Concrete Work
CONTRACTOR: Lightfield Enterprises, Inc
WORK ORDER NUMBER: 2019-0626
PO NUMBER: 9191216
DESCRIPTION:
1. Reason for Change: Cost
2. Description of Change: Actual work completed 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: $11,852.39
4. Completion Date (if changed): NA
ORIGINAL WORK ORDER PRICE $ 49,791.88
TOTAL APPROVED CHANGE ORDER 00.00
TOTAL PENDING CHANGE ORDER 00.00
TOTAL THIS CHANGE ORDER $ 11,852.39
TOTAL % OF THIS CHANGE ORDER 23.8%
TOTAL C.O.% OF ORIGINAL WORK ORDER 23.8%
ADJUSTED WORK ORDER COST $ 37,939.49
CONTRACTOR: Lightfield Enterprises, Inc
By: Date:
Name: Title:
ACCEPTANCE: Date:
Douglas Groves, Drainage Operations Manager
REVIEWED: Date:
Dale Elliot, Senior Buyer
DocuSign Envelope ID: 06A164A6-8820-475B-80A4-819AFE22EFA4
December 9, 2019
General Manager
Chris Hansen
December 16, 2019
December 9, 2019
Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
ACCEPTANCE: Date:
Sandra Bratlie, Special Projects Manager
ACCEPTANCE: Date:
Andrew Gingerich, 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: 06A164A6-8820-475B-80A4-819AFE22EFA4
December 9, 2019
December 16, 2019
December 16, 2019