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VITT- <br />1�rA�K <br />COMPANIES <br />Change Order Request <br />3335 Pennsylvania Ave N <br />Crystal MN 55427 <br />763-545-3557 <br />www.Kevitt.com <br />COR# <br />Project Name: <br />Elk River Municipal Utilities <br />Job No.: <br />2117 <br />Date: <br />Extra Work Requested By: <br />2/13/2023 <br />RJM <br />Description of Additional Work: <br />This work was done 2113/2023 to 2/1412023. Installation of dissipater and skimmers in required manholes STMH 101A, 102A, and 120. We were able to install 4 out of the five due to the size of the manhole at 102A <br />the dissipators was 4" too big for the manhole and could not be installed per manufacturers recommendations. <br />Reach out to us with any further questions on this. <br />No. of Hours <br />Labor <br />Employee <br />Reg HR <br />OT HR <br />Mark Bushard <br />11 hrs <br />Travis Gjeridal <br />11 hrs <br />Brian Blackhawk <br />11 hrs <br />Equipment KE # Reg HR <br />Foreman truck 32 11 hrs <br />Material, Subs, Outside Services Qty. Units <br />include tickets/invoices <br />Other Qty Units <br />The above conditions and circumstances (hours worked and equipment, material, subs used) are agreed to as they happened in the field. <br />GC Representative Name & Signature: / <br />Kevitt Representative Name & Signature: Mark Bushard <br />Date: 2/14/2023 <br />EXTRA WORK <br />AUTHORIZATION <br />119 <br />