HomeMy WebLinkAboutChange Order 1/STREET/$2,800/JAF Property Services, Inc/Access Control for DoorsCzBmmjtpoMzodi.NdHsbuibu22;43bn-Pdu19-3135
City of Carmel Street Department
Change Order Form
Dbnfsb!Jotubmmbujpo!bu!972!O/!Sbohfmjof!SeProjectName: __________________________________________
2ChangeOrderNo.: ______________________________________
Listed items for this change order:
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Dbnfsb!Jotubmmbujpo!bu!972!O/!Sbohfmjof!Se2ChangeOrderNo. ____ isfor work completed regarding (project name) ___________________________.
59-721/51Contractpricepriortothischangeorder $ ________________________
3-911/11Contractpricewillbeincreased/decreased by this change order $ ________________________
62-521/51Newcontractpriceincludingthischangeorder$ ________________________
Cumulative % Adjusted ContractAmountChange fromPriceOriginalContract
Original ContractN/A N/A59-721/51
CO 1: 3-911/11%!62-521/516/87!&
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CO 2:
CO 3:
Docusign Envelope ID: 8AE15259-9BE8-43A0-BC6F-E5AD0CF9D37D
CITY OFCARMELTO:
2CONTRACTCHANGEORDERNO.: ______________
2101503135DATE: _______________________________________
Dbnfsb!Jotubmmbujpo!bu!972!O/!Sbohfmjof!SePROJECTNAME: ______________________________
O0BCITYREQ. NO.: _______________________________
2236:1-!223798CITYPONO.: _________________________________
19041035-1:036035CITYPODATE: _______________________________
I.
You are directed tomake the following changes inthis Contract:
2ChangeOrderNo. ____ listed below.
SCHEDULED ADJUSTMENTITEMAMOUNTOR (-) DAYS
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The following referenced Documents further describe the changes outlined inParagraph I, and are tobe
O0Btff!bddpdjbufe!gjmfO0BconsideredapartofthisChangeOrder: R.F.P.: ______ W.D.C. No.: ______ Other: __________________
The changes result inthe following adjustment ofContract Price and Contract Time:
59-721/51ContractPricepriortothisChangeOrder $ _________________
3-911/11ContractPricewillbeincreased/ decreased by this Change Order $ _________________
62-521/51NewContractPriceincludingthisChangeOrder $ _________________
220260313575ContractTimePriortothisChangeOrder: ______ Days. Completion Date: ____________
2Netincrease/decrease resulting from thisChange Order: ______ Days
220290313578CurrentContractTimeincludingthisChangeOrder: ______ Days. Completion Date: __________
Docusign Envelope ID: 8AE15259-9BE8-43A0-BC6F-E5AD0CF9D37D
This Change Order is for full and final settlement of all direct, indirect, impact costs and time
extensions incurred at any time resulting from the performance of the changed work.
DbsnfmTusffuEfqbsunfouKBGQspqfsuzTfswjdft-Jod/
Laura Campbell, Presiding Officer
4511X/242tuTu/9131CbzcspplEs
James Barlow
Dbsnfm-JO57185Joejbobqpmjt-JO57367
428.844.3112 428.513.99:1
2101503135 210803135
Docusign Envelope ID: 8AE15259-9BE8-43A0-BC6F-E5AD0CF9D37D
10/16/2024
NOT PRESENT