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FACILITY MANAGEMENT CHANGE ORDER ROUTING FORM <br /> Date: February 4, 2004 <br /> ;I <br /> Contract No.: 2004-03811 <br /> Change Order No.: 2 <br /> GJN: 50399 <br /> Assessable? No <br /> To: X' Glen Svendsen For: Initials Fo~~=~-,~~'gnature <br /> 0 <br /> To: Jim Carlson For: Signature n <br /> <br /> ~ ~ Si nature <br /> <br /> ~ To: Dennis Taylor For: 9 <br /> X Facility Mgt. Admin. X P.O.-Return to Gurney at Facilities <br /> <br /> 'I <br /> Contractor: Colberg Commercial <br /> Title: Amazon Ball Field Restroom 8~ Lighting Replacement <br /> _ _ _ <br /> Type: Project Manager: Ned Nabeta <br /> Begin Date: End Date: <br /> Purpose of Change Order: Increase to Scope of Work -Significant changes include providing ' <br /> power to equipment shed from new restroom building, and costs associated with relocating <br /> restroom. <br /> Budget Information: <br /> Amount: $3,198.00 (increase) P.O. No.: 2004100219 <br /> *CEORDR Authorization Name: Kathleen Matthews <br /> Acct. Code. - - 3 Amount: $ (increase) <br /> Acct. Code: 311-2999-61739-933263 Amount: $ 3, ~ ~ g ~ D 0 <br /> -Acct. Code: _ _ Amount:. <br /> New Total Contract: $363,710.00 <br /> Notes: Please forward original to CRO <br /> Routeform (Revised September 1994) <br /> _ _ _ _ <br /> <br />