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~, FACILITY MANAGEMENT CHANGE ORDER ROUTING FORM <br />Date: October 1, 2004 <br />Contract No.: 2005-03815 <br />Change Order No.: One <br />GJN: 3825 <br />Assessable? No <br />To: X Mike Penwel I For: X Initials <br />X Glen Svendsen ~ i ials Signature <br />X Mark Schoening, City Engineer ~_ Initials ~ Signature <br />Irait+al+s--- ~---- c'us ~+,,..~..~r~ <br />Dennis M. Taylor, City Manager For; Signature <br />P/ease return to Hamilton at Facility Mgt for distribution <br />Contractor: Lile /Eugene Moving and Storage <br />Title: Amtrak Station move to Eugene Depot <br />Type; PI Project Manager: Russ Mecredy <br />Begin Date: Review Date: <br />Termination Date: <br />Purpose of Change Order: Change to Scope of Work. Additional labor fees to box up benches. Facility <br />located at 433 Willamette Street. Increase to contract sum $880.00. <br />.,Budget Information: REQ. No. ~~C~~SU I y ~ Date ~~! ~~/~`~ By `-~~ <br />;Amount: $880.00 increase P.O. No.: ~C)US l OQ ~ ~j j <br />Authorization by: Debbie Clark / Peggy Hamlin <br />Line 1 Acct. Code: 311-9336-61739-905173 " Amount: $880.00 <br />Line 2 Acct. Code: <br />Line 3 Acct. Code: <br />Line 4 Acct. Code: <br />Amount: $ <br />Amount: $ <br />Amount: $ <br />_---- -_ TOTAL CONTRA-CT $2,347.50 <br />Note: Purchasing -- Please forward contract to CRO <br />Route form (Revised Apri12003) <br />