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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 Estime <br />01/12/2017 <br />116-051 <br />WWTP - Belt Filter Press #3 Rehabilitation <br />06/28/2016 Contract Award; Notice to Proceed 07/11/2016 <br />001 <br />Credit of $5,000 for Unused Project Allowance <br />The original contract sum <br />$ <br />192,665.00 <br />Net change by previously authorized change orders <br />$ <br />0.00 <br />The contract sum prior to this change order <br />$ <br />192,665.00 <br />By this Change Order, the project amount is <br />❑ Increased <br />® Decreased <br />$ <br />5,000.00 <br />The new contract sum including this change order <br />$ <br />187,665.00 <br />This Change Order represents a total change of <br />-2.60 % <br />Total change for entire project <br />-2.60 % <br />Original contracted completion date/time <br />11/30/2017 <br />Extension of date/time by previous change orders <br />0 days <br />Date/time extension by this change order <br />0 days <br />New completion date/time <br />Work is complete. <br />RECOMMENDED FOR APPROVAL <br />CONTRACTOR <br />"j, <br />Contractor Signature 0 <br />Ken Medlin / Market Unit Manager -Environmental <br />Printed Name and Title <br />Alfa Laval Inc. <br />Company name <br />10470 Deer Trail Drive <br />Address <br />Houston, Texas 77038 <br />City, State, Zip <br />90-t' G/ /, Of-3/-2017 <br />(/Construction Manager <br />CITY OF SOUTH BEND <br />BOARD OF PUBLIC VVORKS <br />Approved Date: / cb <br />On 4bie(- <br />Gary A. Gilot, President <br />L �1 <br />Jam A. Mueller, Member <br />Suzanna M. Fritzberg, Member <br />Elizabeth AElizabeth A. Maradik, Member <br />Therese J. Dora embe- r <br />