HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9191302 (2)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 1
PROJECT TITLE: Laporte Phase 2
SERVICE PROVIDER: Lightfield Enterprises
WORK ORDER NUMBER:192677 / STS 2019-00
PO NUMBER: 9191302
DESCRIPTION:
1. Reason for Change: Increased Removals
2. Description of Change: Due to time constraints, LEI was asked to remove additional concrete not
originally planned for. This was done to ensure project delivery and allow the road and project to be
complete before the Labor Day weekend.
3. Change in Work Order Price: From original $97,000 to $107,791.07 = $10,791.07
4. Change in Work Order Time: 0
ORIGINAL WORK ORDER PRICE $ 97,000.00
TOTAL APPROVED CHANGE ORDER $0.00
TOTAL PENDING CHANGE ORDER $ 0.00
TOTAL THIS CHANGE ORDER $10,791.07
TOTAL % OF THIS CHANGE ORDER 11.11%
TOTAL C.O.% OF ORIGINAL WORK ORDER 11.11%
ADJUSTED WORK ORDER COST $107,791.07
SERVICE PROVIDER: Date:
Keith Lightfield, Owner
ACCEPTANCE: Date:
Bill Wellborn, Project Manager
REVIEWED: Date:
Elliot Dale, Senior Buyer
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: BAE2F56A-2A9B-4863-BB08-855B9EBB1888
10/23/2019
10/23/2019
10/23/2019
10/23/2019
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DocuSign Envelope ID: BAE2F56A-2A9B-4863-BB08-855B9EBB1888
DocuSign Envelope ID: BAE2F56A-2A9B-4863-BB08-855B9EBB1888