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HOME Of PELICAN ISLAND
CITY OF SEBASTIAN CHANGE ORDER FORM
CHANGE ORDER #: 04 PROJECT NAME: SEBASTIAN AIRPORT HANGAR C
PURCHASE ORDER #: PROJECT #: 16-04
CONTRACTOR: AHRENS COMPANIES CONTACT NAME: MIKE FISHKIND
ADDRESS: 1461 KINETIC ROAD CONTRACT DATE: AUGUST 10, 2016
LAKE PARK, FL 33403
By the signature affixed below, both the City and the Contractor agree to the changes as stipulated herein. Upon
proper execution of this document, the Contractor is hereby notified to commence work. All changes stated below
are hereby incorporated and made a part of the Contract identified above, and all the terms and conditions of said
Contract are enjoined and in full force while executing the change(s) stipulated as follows:
DESCRIPTION: Increase days of contract due to permitting time and holidays.
A) CONTRACT PRICE PRIOR TO THIS CHANGE
NET INCREASE (DECREASE) RESULTING FROM THIS CHANGE
NEW CONTRACT PRICE INCLUDING THIS CHANGE ORDER
B) CONTRACT TIME PRIOR TO THIS CHANGE (NUMBER OF DAYS)
NET INCREASE (DECREASE) RESULTING FROM THIS CHANGE (NUMBER OF DAYS)
NEW COMPLETION DATE INCLUDING THIS CHANGE
AGREED:
$ 1.143531.41
$ 0.00
$ 1,143531.41
200
77
June 2, 2017
4CNTPC
Date:
CITY OF BASTIAN:
Date:
y ��
Authorized Signature
/// ///
Auf6drized phy Manager
AnorovalsAy City of Sebastian Staff:
_City Manager Authorization —cumulative amount less than 15% of contract price or $15.000 single change order.
—City Council Authorization—cumulative amount exceeds 15% of the contract price or $15,000 single change order.
(Meeting Date ) ---
CITY OF SEBA IAN ` -
City Manager Date
Project Manager VA as to engineering
Administrative Services as to budget
City Attorney --s to legal vette Williams, City Cleric—
Procurement Manager to purchasing