039-20 - Northwest Cascade, Inc. - Supplement / Change Order 2CITY OF PORT ORCHARD
Authorization for Change Order No. 1
Date: 6/3/2020
4330 Bethel Road Grinder
Project: Pump/Sewer Connection
Contract / Job # C039-20
Contractor: Northwest Cascade, Inc
P.O. Box 73399
Puyallup, WA 98373
THIS CHANGE ORDER AUTHORIZES A TIME EXTENSION ONLY — EXTEND CONTRACT END DATE TO JUNE
30u', 2020.
Amount
Contract History
Sales Tax Total Date Appvd
Original Contract
$14 800.00
$1332.00
$16,132.00
15-A r-20
COUNCIL
Change Order 1
$0.00
$0.00
$0.00
03-Jun-20
PW DIRECro
Total Contract $0.00
$1,332.00 $16,132.00
I have reviewed the Change Order information above and certify that to the best of my knowledge descriptions and
costs are true and accurate.
-10
Contractor Appr6Val Signature
2-Al—R TEGS
Printed Name & Title
lklblic Works ector/City Engineer
MARK R. DORSEY, P.E.
Printed Name
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.
Mayor
City Clerk
Council Approval Date
C.alserekndmey%PWW all.ocallMicr am"rzbwaVNotCed*Contml.OudwklWfU1 D7PP%Change Order t_Northwest Cascade.doc
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