EMS Change Order 1 CHANGE ORDER FORM CAP701 Change Order Number: Change Order Date:
1 12/21/2017
To: Architect's Project Number: 17-001G
TOWN OF WAPPINGER Contract.for: Contract Date 11/08/2017
20 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12569 GENERAL. CONSTRUCTION
From: Our Project Code: 17-001G
J C MILLBANK CONSTRUCTION CO INC
128 DRAKE ROAD Protect_
PLEASANT VALLEY, NY 12569 EMERGENCY SERVICE BUILDING
16 MIDDLEBUSH ROAD
WAPPINGER FALLS, NY 12590
DISTRIBUTE TO:
Original Contract Sum: $563,500.00 Owner Contractor j Other
Previous Change Orders: $0.00 Architect ! FieEd Construction Manager
Contract Sum: $563,500.00 The Contract Completion date will change b:.
Value of this Change Order: $58,976.00 90
New Contract Sum: $6227476.00 The expected completion da will will be: 5/16/2018
The Contract is Changed as Follows;
Change Order#1-per plans Al, A3, and A5 dated 12/12/17
& Breakdown per J C Millbank letter dated 12/18/2017
We request an extension of 90 days due to the delay while processing this change order.
Architect Contractor Owner
MORRIS ASSOCIATES J C MILLBANK CONSTRUCTION CO INC TOWN OF WAPPINGER
9 ELKS LANE 128 DRAKE ROAD 20 MIDDLEBUSH ROAD
POUGHKEEPSIE, NY 12601 PLEASANT VALL-Y, NY 12569 WAPPINGER FALLS, NY 12569
c-�j+ °G t !d CSC /ZLr '
Signature Signature
/2_ 21-/7'
Date Date Date