ST9502-CN 960523PROJECT:
CONTRACTOR:
OWNER:
CHANGE ORDER NO.:
CITY OF COPPELL
CHANGE OR EXTRA WORK ORDER
Item
#
Town Center Drive & Town Center Blvd. / ST 95-02
Site Concrete, Inc
City of Coppell
2
DATE: May 23, 1996
CHANGE OR EXTRA WORK TO BE DONE
Description Quantity Unit Unit
Price
Total
ADD: 1
4" Bore for 27 LF 8.00
Sprinkler System
$216.00
Total Revision to Contract Amount
$216.00
Previous contract amount
Net increase in contract amount
Revised contract amount
Net increase in contract time of completion
Revised Contract time of completion
$ 447,156.75
216.00
$447,372.75
N/A
N/A
The contractor hereby accepts this Contract adjustment as a final and complete adjustment in full
accord and satisfaction of all past and future liability originating under any clause in the Contract
by reason of this revision to the Contract.
Re~Znd~~~ity Engineer:
Agreed to by the Contractor:
Date:
Accep~~the
Owner:
D ate:
Date:
SITE CONCRETE. ,,,C.
P.O. BOX 140096
IRVING, TEXAS 75014-0096
PH. 214-313-0733 FAX 214-513-0825
ADDITIONAL WORK AUTHORIZATION
OWNER'S NAME
City of Coppell C/O Larry Davis
STREET
255 Parkway Boulevard
CITY SFATE
Coppell TX 75019
: E
96-16
PHONE
304-3684
JOB NAME
To~m
STREET
T o xcn
Coppell
Center Dr.
Center Dr.
JOB NUMBER
& Blvd. 96-16
& Blvd.
STAT~X
You are hereby authorized to perform the following specifically described additional work.-
1. AP2ROX. 27 LF 4" Bore for Sprinkler System
i
@ $8.00/LF= $216.00
ADDITIONAL CHARGE FOR ABOVE WORK IS: $ 216. oo
Payment to be made as follow.~.' .~.S per original agree__m__en___t__.___
Above additional work to be performed under same conditions as ~pecifl'ed in origina; contract unless otherwise stipulated.
Date 19 Authorizing Signature
We hereby agree to furnish/abor and materials-complete In acc~e with the above specifications, at above stated price
NO= /CQN~ACTQ SIGN
NOTE: This Revision Dec~5 part of, and in conf~mance '~]th, ihe exis~n
031511
(OWNEe SIGNS HERE)
Date _
5-22 19