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Document G701 — 2001
Change Order
PROJECT (Name and address):
12032 City of Waterloo Clerk's Office
Renovation
TO CONTRACTOR (Name and address):
Prairie Construction Services, Inc.
321 West 18th Street
Waterloo, Iowa 50702
CHANGE ORDER NUMBER: 003
DATE: October 11, 2012
ARCHITECT'S PROJECT NUMBER: 12032
CONTRACT DATE: June 19, 2012
CONTRACT FOR: General Construction
OWNER: ❑
ARCHITECT: ❑
CONTRACTOR ❑
FIELD: D
OTHER ❑
THE CONTRACT IS CHANGED AS FOLLOWS:
(Include, where applicable, any undisputed amount attributable to previously executed Construction Change Directives)
1. Added access panel in ceiling of office per PR # 3
ADD $55.00
2. Added steel vision light kit to door
ADD $238.00
3. Added carpet transition strip at kichenette
ADD $84.00
4. Time and materials work for the skim coating of walls in office and lobby as well as the additional painting needed in the lobby
ADD $827.00
The original Contract Sum was
The net change by previously authorized Change Orders
The Contract Sum prior to this Change Order was
The Contract Sum will be increased by this Change Order in the amount of
The new Contract Sum including this Change Order will be
$ 97,800.00
$ -16,146.00
$ 81,654.00
$ 1,204.00
$ 82,858.00
The Contract Time will be increased by Zero (0) days.
The date of Substantial Completion as of the date of this Change Order therefore is
NOTE: This Change Order does not include changes in the Contract Sum, Contract Time or Guaranteed Maximum Price which have
been authorized by Construction Change Directive until the cost and time have been agreed upon by both the Owner and
Contractor, in which case a Change Order is executed to supersede the Construction Change Directive.
NOT VALID UNTIL SIGNED BY THE ARCHITECT, CONTRACTOR AND OWNER.
INVISION Architecture, LTD
ARCHITECT (Firm name)
501 Sycamore #101, PO Box 1800,
Waterloo, IA 50704-1800
Michael Broshar, FAIA
(Typed name)
(0/11111••
DATE
Prairie Construction Services, Inc.
CONTRACTOR (Firm name)
City of Waterloo
OWNER (Firm name)
321 West 18th Street, Waterloo, Iowa City Hall, 715 Mulberry Street, Waterloo,
5071 Iowa 50 03
' i' lliS it
ADD y= ; fd-7
B ignaturk) =Y (Signature)
(Typed e)
I'S(2fl
DATE
Chuck Seastrand
(Typed name)
—/40—/2 --
DATE
AIA Document G701 TM — 2001. Copyright CO 1979, 1987, 2000 and 2001 by The American Institute of Architects. All rights reserved. WARNING: This AIA°
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User Notes: (911174005)