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TlIIP.NYiA1RN <br />Date: <br />521 W. 84th Drive Suite A, N <br />Engineer: Greeley and Hansen <br />spray <br />SUMMARY OF DETAILED BREAKDOWN <br />for both tanks <br />Contractor's / Subcontractor's <br />Change Order Request Summary <br />COR: 5 R1 <br />10, 219-947-4700 phone/ 219-947-4711 fax <br />Owner: City of South Bend <br />Project: South Bend Grit and Screenings <br />Improvements <br />TO Job# 1511 <br />Additions Deletions Net Total <br />LABOR <br />$ 539.00 $ <br />- $ <br />539.00 <br />MATERIAL <br />$ 220.00 $ <br />- $ <br />220.00 <br />EQUIPMENT <br />$ - <br />$ <br />- <br />OTHER COSTS <br />1. SAFETY <br />(1%of LABOR)-Deletion-0- <br />$ <br />5-39 <br />2. EXPENDABLE TOOLS <br />(3.0%of LABOR)-Deletion-0- <br />$ <br />16.17 <br />NETTOTAL <br />(A+B+C+Dl+D2) <br />$ <br />780.56 <br />OVERHEAD AND PROFIT <br />(Ex15%) - Deletion -0- <br />$ <br />117.08 <br />TOTAL WORK PERFORMED BY CONTRACTOR <br />(Lines E+F) <br />$ <br />897.64 <br />CONTRACTOR'S MARK-UP ON WORK OF SUBCONTRACTORS <br />Detailed Breakdowns and summaries from each contractor must be attached. <br />SUBCONTRACTOR: Firm Name <br />CONTRACT WORK: Description <br />PROPOSAL <br />1. <br />2. <br />3. <br />4 <br />SUBTOTAL of all work performed by contractor's subcontractors <br />MARK-UP on work of subcontractors (Min. $.00) <br />PROPOSAL <br />BONDS <br />BUILDER'S RISK INSURANCE <br />TOTAL PROPOSAL <br />$0.00 <br />(Line H x 5%)- Deletion-0- <br />$0.00 <br />(Lines G+H+I) <br />$897.64 <br />(1.5%of PROPOSAL)-Deletion-0- <br />$13.46 <br />(0.0% of PROPOAAL) - Deletion -0- <br />$911.11 <br />TOTAL PROPOSAL for subject COR Increase (decrease) in contract amount $921.11 <br />An extension time of day to extend the Contract dates for Completion will be required commencing on <br />the date when we are notified a Change Order will be issued for the price quoted herein. Approval needed in 5 days. <br />If the work has to be performed to continue construction with no response on pricing or if we are issued a Work <br />Change Directive (WCD) to proceed with this work and agreement on the price has not been reached within 30 <br />calendar days, then this proposal shall be considered a Claim, in accordance with Article 10.5 of the <br />Contract General Conditions. <br />CONTRACTOR <br />Signature Awt ✓14ceory Title: PM Date: 9/19/2016 <br />