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CITY OF SOUTH BEND <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 />All items completed substantially as <br />See attached Comparison of Fstim, <br />etyou rhB�� <br />b <br />U O <br />Y <br />1865 <br />11-22-2016 <br />116-021 <br />Marriott Hotel Site Development at the Hall of Fame Phase I <br />6-28-2016 <br />:5 <br />Cost of additional work See attached explanation of work <br />The original contract sum <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 />and <br />® Increased <br />❑ Decreased <br />$ 731,348.93 <br />$ 87,580.45 <br />$ 818,929.38 <br />$ 1,267.49 <br />$ 820,196.87 <br />0.17 % <br />12.15 % <br />Original contracted completion date/time 10-1-2016 <br />Extension of date/time by previous change orders 27 days <br />Date/time extension by this change order 0 days <br />New completion date/time 10-28-2016 <br />RECOMMENDED FOR APPROVAL <br />CONTRACTOR <br />Contractor Signature <br />Printed Name and Title <br />Majority Builders, Inc. <br />Company name <br />62900 US 31 South 46614 <br />Address <br />South Bend Indiana <br />City, State, Zip <br />Project Manager <br />CITY OF SOUTH BEND <br />BOARD OF PUBLIC WORKS <br />Approved Date: <br />Gary A. Gilo , President <br />Elizabeth A. Maradik, Member <br />Therese J. Dorau,Vembet <br />James A. Mueller, Member <br />Suzanna IfFritzberg, M(Onber <br />