065-21 - Hugh G Goldsmith & Associates, Inc. - Supplement / Change Order 1II CITY OF PORT ORCHARD II
Authorization for Amendment No. 1
Date: July 30, 2021
Easement Preparation for
Project: McCormick Village Park
Contract / Job # C065-21
Contractor: Goldsmith and Associates
1215 114th Ave SE
Bellevue, WA 98004
THIS CHANGE ORDER AUTHORIZES A TIME EXTENSION ONLY. CONTRACT END DATE EXTENDED TO
October 311% 2021.
Contract History
Amount Sales Tax Total Date Appvd b
Original Contract
$3,500.00
$0.00
$3,500.00
22-Jun-21
Council
Amendment No. 1
$0.00
$0.00
$0.00
30-Jul-21
PW Director
Total Contract $3,500.00 $0.00 $3,500.00
I have reviewed the Change Order information above and certify that to the best of my knowledge descriptions and
costs are true and accurate.
(Eontractorr Approdalxzlure
��� N sl/�t/ ///mil l
Printed Narfne & Title/
Change Orders that do not exceed 10%, with a maximum of
$50,000, of either legally authorized budget limit or contract Approved:
amount established by City Council can be approved by the Public
Works Director.
Change Orders that do not exceed 10%, with a maximum of Attest:
$100,000, of either legally authorized budget limit or contract
amount established by City Council are to be approved by the
Mayor,
Change Orders over $100,000 or exceed a total of 10% require
Council Action.
Public'WqXks Director ngineer
MARK R. DORSEY, P.E.
Printed Name
Mayor
City Clerk
Council Approval Date
C:\Users\mlchre\AppData\Local\Microsoft\Wndows\lNetCachelContent 0ut1ook=660WWM1Go1dsmith amendment 1 doc
Page 1