Change Order No 4 - Charles Black Center Renovation Project No 116-073 - Gibson Lewis LLC

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Document G701 Change Order PROJECT: (Name and Address) Charles Black Center 3419 W. Washington SoutBend, IN 46619 TO CONTRACTOR: (Name and Address) Gibson Lewis 1001 W 11 th St Mishawaka, IN 46544 CHANGE ORDER NUMBER: C04 OWNER ❑ DATE: 12118118 ARCHITECT ARCHITECT'S PROJECT NO: 2015-0200 CONTRACTOR FIELD CONTRACT DATE: 26-Sep-17 OTHER ❑ CONTRACT FOR: CBC The Contract is changed as follows: (Include, where applicable, any undisputed amount attributable to previously executed Construction Change Directives) Various items- see attached explanation The original Contract Sum was $ $3,796,000.00 The net change by previously authorized Change Orders $ $125,637.00 The Contract Sum prior to this Change Order was $ $3,921,637.00 The Contract Sum will be increased by this Change Order in the amount of $ $51,823.00 The new Contract Sum including this Change Order will be $ $3,973,460.00 The Contract Time will be unchanged by <enter days in words> ( Zero ) days The date of Substantial Completion as of the date of this Change Order therefore is (Note: This Change Order does not include changes in the Contract Sum, Contract Time or Guaranteed Maximum Price which have been authorized by Construction Change Directive until the cost and time have been agreed upon by both the Owner and Contractor, in which case a Change Order is executed to supersede the Construction Change Directive) NOT VALID UNTIL SIGNED BY THE ARCHITECT, CONTRACTOR AND OWNER. Jones Petrie Rafinski ARCHITECT (Firm name) 325 S. Lafayette Blvd. South Bend, IN 46601 ADDRESS BY ( tQnah r,9) Edward J. Kowalqyk Typed name Dec.19 2018 DATE Gibson Lewis CONTRACTOR(Firm name) 1001 W 11 th St Mishawaka, IN 46544 Typed name 2 i DATE South Bend Parks and Venues OWNER (Firm name) 321 E Walter St South Bend, IN 46614 AI.YDR $� a " t r attrrrr Typed name i ira sd c� a !t�I 1111'�I r"�P'�III amuuaw,�a„�+y�wawraa� aa�wa�*wraww�...��u.+urwmxwrmwwarwNw+ayrmvs