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Change Order - Urban HabitatREQUEST FOR CHANGE ORDER Change Order No. 1 Project 342 HQ Landscaping Renovation (Payment or Time) NOTICE: Conditions arising that would support a request for payment for additional work or time extension must be brought to the District’s attention within ten (10) days, and a Request for Change Order for additional work/time extensions must be filed within fifteen (15) days. THIS FORM MUST BE USED. (See Contract Section 5.) Circumstances supporting payment for additional work/time: 1. Describe why payment should be granted. Attach any more detailed discussion, with backup documents as an exhibit. (Remember: damages have been contractually limited on this job. See Section 28 of the Contract.) The District requested four items of change including adding waterproofing membrane to the building wall near the southeasterly offices, Drain rock and French drain to reduce soil moisture, increasing the depth of the rainwater seep pit, and adding a concrete mow strip along side the seep pit. The District is moving forward with the first three items. a. The HQ building moisture barrier failed near the southeast building corner. The District wants the moisture barrier repaired or installed. The contractor proposed to install SEEMCO waterproofing membrane (coating) along the exposed wall, then backfill. The cost for the membrane is $5,904. b. Install a French drain along the southeasterly building wall and tie the system into the rainwater recovery drain. The cost for this work is $2,409. c. Deepen the seep pit by 18”, including additional gravel and soil/gravel separating fabric for an additional cost of $8,013. The resulting increase for this contract is $16,326. See attached Request for Change Order Quotes from the Contractor. 2. Describe the delay and why a time extension is appropriate. Provide any backup documents as may be necessary to support the request. You must demonstrate how the critical path was impacted. An additional time of 15 working days is granted so the contractor may obtain the materials and order the water membrane coating. Submitted by: M. Esquer District Project Manager Approval: District Engineer’s Approval: __________________________ By: Mark Esquer By: Mark Esquer NOTE: Approval of this request for change order is only effective upon District approval of the change order. Change Order approved/denied by: _________________________________ Scott Carroll, General Manager Digitally signed by Mark Esquer, P.E. DN: C=US, E=mesquer@cmsdca.gov, O=Costa Mesa, OU=District Engineer, CN="Mark Esquer, P.E." Reason: I am the author of this document Date: 2023.10.30 08:53:42-07'00' DocuSign Envelope ID: 871FBA05-B96C-4CE5-888C-0FD829897E2F