HomeMy WebLinkAboutCORRESPONDENCE - PURCHASE ORDER - 9191186Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO.
PROJECT TITLE:
SERVICE PROVIDER:
WORK ORDER NUMBER:
PO NUMBER:
DESCRIPTION:
1. Reason for Change:
2. Description of Change:
3. Change in Work Order Price:
4. Change in Work Order Time:
ORIGINAL WORK ORDER PRICE $
TOTAL APPROVED CHANGE ORDER $
TOTAL PENDING CHANGE ORDER $
TOTAL THIS CHANGE ORDER $
TOTAL % OF THIS CHANGE ORDER %
TOTAL C.O.% OF ORIGINAL WORK ORDER %
ADJUSTED WORK ORDER COST $
SERVICE PROVIDER: Date:
, Title
ACCEPTANCE: Date:
, Project Manager
REVIEWED: Date:
, Buyer or Senior Buyer
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
(if greater than $60,000)
DocuSign Envelope ID: 85562194-20DD-4C9B-B2CC-C583008716CD
cost for gap filler and installation
Jill Wuertz
field change on construction
na
1280
1,280.00
90,780.00
Better matching bridges to existing walkways
1
February 20, 2020
1
89500
9191186
Pedestrian Trail Bridge Replacements (BID 8901)
February 20, 2020
Bob Beets
Jags Enterprises
prjct mngr
March 18, 2020
Elliot Dale
DocuSign Envelope ID: 85562194-20DD-4C9B-B2CC-C583008716CD