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D DATE: <br />ATE' <br />PROJECT NO: <br />PROJECT NAME: <br />CONTRACT LDATE: <br />CHANGE ORDER NO: <br />AM <br />aag"AW <br />1111111111111111U <br />3/13/2018 <br />117-116 <br />2017 Engineering Remodel <br />11/28/2017 <br />PCR #1-Add Countertop <br />The original contract sum <br />Net change by previously authorized change orders <br />The contract sum prior to this change order <br />By this Change Order, the project amount is <br />The new contract sum including this change order <br />This Change Order represents a total change of <br />Total change for entire project <br />Original contracted completion date/time <br />Extension of date/time by previous change orders <br />Date/time extension by this change order <br />New completion date/time <br />Contractor Signature <br />Printed Name and Title <br />Ziolkowski Construction Inc. <br />Company Name <br />4050 Ralph Jones Drive <br />Address <br />South Bend, IN, 46628 <br />City, State, Zip <br />Increased <br />Decreased $ <br />3/1512018 <br />0 days <br />0 days <br />3/15/2018 <br />11,567.00 <br />0.010 <br />11,567.00 <br />1,825.00 <br />13,392.00 <br />15.78 % <br />15.78 % <br />"'TION MANAGER <br />--7ill t, President <br />'AAA <br />anna lFnwTier -66er <br />Elizabeth A. Maradik, Member <br />Therese J. Dordu, Member <br />Jam ll A. Mueller, Member <br />