HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8631 GENERAL ENVIRONMENTAL SERVICES (14)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 1
PROJECT TITLE: SCR and Investigation of Petroleum
Contamination at 835 Wood Street
CONTRACTOR: CGRS
WORK ORDER NUMBER: 2019 - 6.20
PO NUMBER: 9191200
DESCRIPTION:
1. Reason for Change: Need to extend the completion date of project
2. Description of Change: The scope of work remains the same
3. Change in Work Order Price: 0
4. Completion Date (if changed): October 31,2019
ORIGINAL WORK ORDER PRICE $ 23710.00
TOTAL APPROVED CHANGE ORDER 0.00
TOTAL PENDING CHANGE ORDER 0.00
TOTAL THIS CHANGE ORDER 0.00
TOTAL % OF THIS CHANGE ORDER 0%
TOTAL C.O.% OF ORIGINAL WORK ORDER 0%
ADJUSTED WORK ORDER COST $ 23710.00
CONTRACTOR: CGRS
By: Date:
Name: Title:
ACCEPTANCE: Date:
Errin Henggeler, ERA Project Manager
REVIEWED: Date:
Pat Johnson, Senior Buyer
ACCEPTANCE: Date:
Shane Armfield, Project Manager
DocuSign Envelope ID: 12003ED7-6692-4B55-AC9F-7A8EA13D7AC4
10/11/2019
Principal
10/14/2019
Glen Vallance
10/21/2019