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HomeMy WebLinkAboutCORRESPONDENCE - RFP - 8497 STORMWATER CONSULTING ENGINEERING SERVICES (5)Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
CHANGE ORDER
NO. 01
PROJECT TITLE: Upper Cooper Slough Master Plan Update
CONTRACTOR: Icon Engineering, Inc.
WORK ORDER NUMBER: DLE-2020-02
PO NUMBER: 9200298
DESCRIPTION:
1. Reason for Change: Cost, Scope and Time
2. Description of Change: Icon needs additional funding to accommodate a request by the
Larimer and Weld Irrigation Co. to evaluate different flow scenarios for their ditches. See
attached scope and fee.
3. Change in Work Order Price: $30,170
4. Completion Date (if changed): April 30, 2021
ORIGINAL WORK ORDER PRICE $40,680.00
TOTAL APPROVED CHANGE ORDER $ 0.00
TOTAL PENDING CHANGE ORDER $ 0.00
TOTAL THIS CHANGE ORDER $30,170.00
TOTAL % OF THIS CHANGE ORDER 74.1%
TOTAL C.O.% OF ORIGINAL WORK ORDER 74.1%
ADJUSTED WORK ORDER COST $70,850.00
CONTRACTOR: Icon Engineering, Inc.
By: Date:
Name: Craig Jacobson Title: Principal
ACCEPTANCE: Date:
Dan Evans, Project Manager
REVIEWED: Date:
Marisa Donegon, Buyer III
REQUISITION ENTERED BY: Date:
Melissa Walker, Finance Coordinator
DocuSign Envelope ID: E4D5F91E-D416-44F2-8561-82E0A5A10BCF
October 19, 2020
October 19, 2020
October 19, 2020
Change Order Form (for Work Orders)
Official Purchasing Form
Last updated 10/2017
ACCEPTANCE: Date:
Ken Sampley, Director, Civil Engineering
ACCEPTANCE: Date:
Matt Fater, Interim Deputy Director, Water Engineering & Field Services
ACCEPTANCE: Date:
Gerry Paul, Purchasing Director
DocuSign Envelope ID: E4D5F91E-D416-44F2-8561-82E0A5A10BCF
October 19, 2020
October 20, 2020
October 20, 2020