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��T��_ Change Order Request
{re,
Facility and
Project Police Department Aviation Division Facility City Sec No. 45463
Description:
Funding (FID) C291-541200-352090072380 City Proj. No. 00723
No.(s)
Contractor: Siruhs Commercial Construction Change Order #�3 Date: 4l8/2016
City Project Mgr. Alfonso Meza City Inspector: Mike Milam
Phone Number: (817) 392-8274 Phone Number: (817) 392-2297
OriginalConlract Amount-----------------------------------------------------------------------------------------------
Exlrasto Date---------------------------------------------------------------------------------------------------
Creditsto Date ------------------------------------------------------------------------------------------------------
Pending Change Orders (in M&C Process)------------------------------------------------------------------------
ContractCost to Date---------------------------------------------------------------------------------------------
Amount of Proposed Change Order ----------------------------------------------------------------------------
Revised Contract Amount--------------------------------------------------------------------------------------
Original Funds Available for Change Orders ---------------------------------------------------------------------
Remaining Funds Available for this CO ----------------------------------------------------------------------------
Additional Funding (if necessary) -------------------------------------------------------------------------------
CHAN�E ORDERS to DATE (INCLUDING THIS ONEJ AS % OF OR/GINAL CONTRACT
MAX ALLOWABLE CONTR,4CT AMOUNT (ORIGINAL CONTRACT COST + 25%)
Conlract Time
(CD)
00 310
00 56
33 0
00 0
67 366
s9) o
78 366
0.97 �
,937.50
JUSTIFICATION (REASONS) FOR CHANGE ORDER
Final calculation of conlract. The General Contingency Allowance for the project was $169,950.00. There was a total of $120,683.11 that was
expended from the allowance. This resulted in a deduction in the amount of $49,266.89 of the conlract due to not using all of the General
Contingency Allowance.
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It is understood and agreed that the acceptance of lhis Change Order by the contractF�o�rrc
payment in full (both time and money) for all costs arising out of, or incindental to the bo
ConUactors Com an Name Contractor Nama
Struh's Commercial Construction Tom Slruhs ��^
PMD In ec r
PMD S erintendent
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jectlqr�itept'•_ (�
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lssistant Cit Altome
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M&C Number N/A
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�itutes an accord and satisfaction and represents
Change Order.
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Date Ar ecural Services
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Date i rIP o e Mar
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Date istant Ci Mana e
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M&C Date Approved
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Date
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ina er Date
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ement De arfinent Dafe
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Darte
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N/A