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Contractor's / Subcontractor's <br />T111A1V VVV Change Order Request Summary <br />Date: 12/7/2016 COR: 6 R2 <br />General Contractor 521 W. 84th Drive Suite A, Merrillville, IN 46410, 219-947-4700 phone/ 219-947-4711 fax <br />Engineer: Greeley and Hansen <br />Owner: City of South Bend <br />Project: South Bend Grit and Screenings <br />Improvements <br />TCI Job #__.___.�� 1511 <br />and install an Allen Bradley Panel View Plus touch screen, color, 12" (2711P-T12W22A9P) monitor to the existing SCADA <br />s material, installation, progamming, training, and one (1) year warranty. <br />SUMMARY OF DETAILED BREAKDOWN <br />LABOR <br />MATERIAL <br />EQUIPMENT <br />OTHER COSTS <br />1. SAFETY <br />2. EXPENDABLE TOOLS <br />NETTOTAL <br />OVERHEAD AND PROFIT <br />TOTAL WORK PERFORMED BY CONTRACTOR <br />Additions Deletions Net Total <br />(1%of LABOR)-Deletion-0- $ - <br />(3.0%of LABOR)-Deletion-0- $ - <br />(A+B+C+D1+D2) $ - <br />(Ex15%)- Deletion -0- $ - <br />(Lines E+F) $ - <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 />1. BL Anderson (with Toric) <br />2. <br />3. <br />4. <br />CONTRACT WORK: Description PROPOSAL <br />Add Touch Screen $15,644.29 <br />SUBTOTAL of all work performed by contractor's subcontractors $15,644.29 <br />MARK-UP on work of subcontractors (Min. $ .00) (Line H x 5%)- Deletion -0- $782.21 <br />PROPOSAL (Lines G+H+I) $16,426.50 <br />BONDS (1.5%of PROPOSAL)-Deletion-0- $246.40 <br />BUILDER'S RISK INSURANCE (0.0% of PROPOASQ - Deletion -0- <br />$16,672.90 <br />TOTALPROPOSAL <br />TOTAL PROPOSALfor subject COR increase (decrease) in contract amount $16,672.90 <br />An extension time of 50 days 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 Atatt Akear*. Title: PM Date: 12/7/2016 <br />