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CITY OF SOUTH BEND, INDIANA <br />DEPARTMENT OF PUBLIC WORKS <br />PROJECT CHANGE ORDER <br />DATE: <br />PROJECT NO: <br />PROJECT NAME: <br />CONTRACT DATE: <br />CHANGE ORDER NO: <br />SUBJECT OF CHANGE ORDER: <br />The original contract sum <br />10/24/2016 <br />116-041A (Division A) <br />Fellows Street and Dubail Street Neighborhood Improvements <br />9/13/2016 <br />1 <br />PCR #1-Additional Hydroblasting PCR #2-HMA Line Removal PCR <br />#3-Time Extension <br />Net change by previously authorized change orders <br />The contract sum prior to this change order <br />By this Change Order, the project amount is <br />The new contract sum including this change order <br />This Change Order represents a total change of <br />Total change for entire project <br />❑X Increased <br />❑ Decreased <br />Original contracted completion date/time 11/1/2016 <br />Extension of date/time by previous change orders 0 days <br />Date/time extension by this change order 14 days <br />New completion date/time 11/15/2016 <br />CONT - CTOR <br />r <br />�Ccinnttjractt gnature <br />Printed Name and Title <br />_Airmarking Co. Inc. <br />Company Name <br />P.O. Box 526 <br />Address <br />Rochester, IN 46975 <br />City, State, Zip <br />L <br />$ 52,514.15 <br />$ 0.00 <br />$ 52,514.15 <br />$ 3,820.00 <br />$ 56,334.15 <br />7.27 % <br />7.27 % <br />RECOMMENDED FOR APPROVAL <br />CONST TION MANAGER <br />CITY OF SOUTH BEND <br />BOARD OF PUBLIC WORKS <br />Approved Date: IICg'l w <br />Q <br />Therese J. Dora emiber <br />James A. Mueller, Member <br />