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CITY OF SOUTH BEND, INDIANA <br />WWJ`7 <br />CITY PROJECT NO. 114-053 <br />CHANGE ORDER PROPOSAL <br />Change Order Proposal No.: 114-053-108 Date: 1/5/18 <br />Submitted in Response to Proposal Request No.,. <br />Contract Name and No.: 114-053 South Bend WWTP Second;1ryLrqp1ment 111) ts <br />Contractor: Thieneman Construction, hic, <br />Subject: Extend sidewalk at South end of Aeration Deck per the City's request. Pre-negotiateda <br />lump sum value of $2,000 with City (Jacob) prior to performing the work. <br />The following changes to the Contract are proposed: <br />SCOPE OF WORK: (attach and list supporting information as required) <br />1. Item: TCl — See attached cost breakdown - $2,000.00 <br />2. Item: — See attached cost breakdown - $0 <br />JUSTIFICATION: <br />1. Item: Owner request <br />r d 9, ti rol W.'"L 71XIKIIOI <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 Conti -act Times for Substantial Completion; <br />readiness for finalpayment, and Milestones, ifany. Ifincrease or decrease, state specific number ofdays for changes <br />to the Contract Times, <br />Contract Tim S-(qk Xq). - _ - <br />Deser <br />Amount <br />Substantial <br />Final <br />1 :it—em --ffir—ectCosts <br />$2,000 <br />0 <br />0 <br />2. Item_...,._. <br />tem — Mark. py . �: 5% Subs�mm <br />$0 <br />10 <br />0 <br />Total This Change Order <br />$2,000 <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: Craig Steel <br />Signature of Proposer: . .. . .. . .. .. <br />