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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.: 114-053-076 Date: 5/4/17 <br />Submitted in Response to Proposal Request No.: <br />Contract Name and No.: 114-053 South Bend WWTP Secondary TreatmejitImproyemenis <br />Contractor: Thieneman Construction, Inc. <br />Subject: Additional concrete forming to create a P strip of stone between the walkways to 1~C 6 <br />& 7 bridges due to an elevation conflict with the side mounted tank handrails. <br />The following changes to the Contract are proposed: <br />SCOPE OF WORK: (attach and list supporting informalion as required) <br />1. Item: TCl — See attached cost breakdown - $748.00 <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, altach detailed cost breakdowns for Contractor and <br />Subcontractors, Supplier quotations, and other in foruration required <br />For the Corvract Times, stale increase, decrease, or no change to Contract Times for Substanlial Completion, <br />readiness,f o,frnalpayurent, and Milestones, ifany. Ifincrease or decrease, slate specific number ofdays for changes <br />to the Conlract Pines, <br />Description <br />Amount <br />Contract Times (days) <br />Substantial <br />I Final <br />1. Item — TCI <br />$748.00 <br />0 <br />0 <br />2. Item — TCI — Markup: 5% Subs / 15% TCI <br />$1 12.00 <br />0 <br />0 <br />Total This Change Order Proposal <br />$860,00 <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: Craig Steele <br />Signature of Proposer: <br />