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CITY OF SOUTH BEND, INDIANA <br />WWTP SECONDARY TREATMENT IMPROVEMENTS <br />CITY PROJECT NO. 114-053 <br />CHANGE ORDER PROPOSAL <br />Change Order Proposal No.: 114-053-073 Date: 4/13/17 <br />Submitted in Response to Proposal Request No.: <br />Contract Name and No.: 114-053 South Bend WWTP Secondhr Treatment Improvements <br />Contractor: Thieneman Construction Inc. <br />Subject: Repair existing 60" RCP joint between FC7 drop box and junction box. <br />The following changes to the Contract are proposed: <br />SCOPE OF WORK: (attach and list supporting information as required) <br />1. Item: TO — See attached cost breakdown - $1,512.00 <br />JUSTIFICATION: <br />1. Item: Owner Request <br />CHANGES IN CONTRACT PRICE AND CONTRACT TIMES: <br />We propose that the Contract Price and Contract Times be changed as follows: <br />For Contract Price, when requested by Engineer, attach detailed cost breakdowns for Contractor and <br />Subcontractors, Supplier quotations, and other information required. <br />For the Contract Times, state increase, decrease, or no change to Contract Times for Substantial Completion, <br />readiness forfinal payment, and Milestones, ffany. Ifincrease or decrease, state specific number ofdays forchanges <br />to the Contract Times. <br />Description <br />Amount <br />Contract Times (days) <br />Substantial <br />Final <br />1. Item — TCI <br />$1, 512.00 <br />0 <br />0 <br />2, Item — TC1— Markup: 5% Subs / 15% TO <br />$227.00 <br />0 <br />0 <br />Total This Chan e Order Proposal <br />$1,739.00 <br />0 <br />0 <br />Changes to Milestones if any: N/A <br />The adjustment proposed is the entire adjustment to the Contract to which the proposer believes it <br />is entitled as a result of the proposed change. <br />Change Order Proposal By: Crai Steel <br />Signature of Proposer: !�11 <br />