HomeMy WebLinkAboutCORRESPONDENCE - BID - 8844 MISCELLANEOUS CONCRETE (5)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 1
PROJECT TITLE: W. Elizabeth Bus Stop 3137
SERVICE PROVIDER: Lightfield Enterprises Inc.
WORK ORDER NUMBER: STS 2019-39
PO NUMBER: 9191951
DESCRIPTION:
1. Reason for Change: Went over the estimated quantities
2. Description of Change: Added a 10 Ft x 10 Ft piece of 8” Concrete Pavement
3. Change in Work Order Price: $2,879.03
4. Change in Work Order Time: 0
ORIGINAL WORK ORDER PRICE $ 19,050.00
TOTAL APPROVED CHANGE ORDER .00
TOTAL PENDING CHANGE ORDER 2,879.03
TOTAL THIS CHANGE ORDER $21,929.03
TOTAL % OF THIS CHANGE ORDER 15.12%
TOTAL C.O.% OF ORIGINAL WORK ORDER 15.12%
ADJUSTED WORK ORDER COST $ 21,929.03
SERVICE PROVIDER: Date:
ACCEPTANCE: Date:
Angel Ontiveros, Project Manager
REVIEWED: Date:
Elliot Dale, Senior Buyer
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 87939AA9-1EEB-4400-BC74-49789ED59C3B
12/19/2019
12/19/2019
12/19/2019