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Project No, 116-001 Change Order No. 41 — 12/2116 <br />Coo) <br />CITY OF SOUTH BEND 01 <br />PROJECT NAME: One-Wav to Two-Wav Street Conversion — Division B iID <br />PROJECT NUMBER: 116-001 <br />Division A: <br />Item <br />No. <br />Description <br />Quantity <br />Unit <br />Unit Price <br />Total Amount <br />482 <br />HMA for Patching Type B (Saigon Parking Lot) <br />39.76 <br />Ton <br />$125.00 <br />$4,970.00 <br />$4,970.00_ <br />OWNER: City of South Bend CONTRACTOR: Rieth-Riley <br />Construction <br />C_ <br />Signature Signature <br />Aik <br />Date Date <br />Sheet 2 of 2 <br />