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CITY OF SOUTH BEND, INDIANA <br />WWTP SECONDARY TREATMENT IMPROVEMENTS <br />CITY PROJECT NO, 1�14-053 <br />CHANGE ORDER PROPOSAL <br />Change Order Proposal No.: 114-053-075 Date: 5/4/17 <br />Submitted in Response to Proposal Request No.: <br />Contract Name and No.: 114-05.3South Bend WWTP Secondary Treatment Improvements <br />Contractor: Thieneman Construction Inc. <br />Subject: Assist City with the closure of existing Clarifier #5 gate as requested, as the existing gate <br />was not operational. <br />The following changes to the Contract are proposed: <br />SCOPE OF WORK: (allach and list supporting inforuration as required) <br />1. Rena: TCI — See attached cost breakdown - $662.00 <br />JUSTIFICATION: <br />1. Rein: 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 Iry Engineer, atlach detailed cost breakdowns for Contractor and <br />Subcontractors, Supplier quotations, and other infbrrrration required. <br />For the Contract Times, state increase, decrease, or no change to Contract Threes for Substantial Completion, <br />readiness for final payment, and illrlesiones, Marry. Ifincr•ease or decrease, state specrflc number ofdays for changes <br />to the Contract Times. <br />Description <br />Amount <br />Contract Tim s days <br />Substantial <br />Final <br />1. Item — TCI <br />$662.00 <br />0 <br />0 <br />2. Item — TCI — Markup: 5% Subs 1 15% TCI <br />$99.00 <br />0 <br />0 <br />Total This Change Order Proposal <br />$761.00 <br />0 <br />0 <br />Changes to Milestones if any: NIA <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: CraigSteele <br />teele <br />Signature of Proposer: <br />