Change Order No 4 - Fire Station No 9 Project No 116-012 - Ziolkowski Construction

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AIA Document G701 TM -2017 Change Order PROJECT: (Name and address) CONTRACT INFORMATION: CHANGE ORDER INFORMATION: 17398 - Fire Station Number 9 Contract For: General Construction Change Order Number: 004 2108 Mishawaka Avenue Date: March 13, 2018 Date: February 8. 2019 South Bend, IN 46615 OWNER: (Name and address) City of South Bend Board of Public Works 227 West Jefferson Blvd South Bend, IN 46614 ARCHITECT: (Name and address) EPOCH Architecture + Planning 300 West Jefferson Blvd South Bend, IN 46601 CONTRACTOR: (Name and address) Ziolkowski Construction, Inc. 4050 Ralph Jones Drive South Bend, IN 46628 THE CONTRACT IS CHANGED AS FOLLOWS: (Insert a detailed description of the change and, if applicable, attach or reference specific exhibits. Also include agreed upon adjustments attributable to executed Construction Change Directives) RCO #011 - Change to provide masonry sealer and anti -graffiti coating = Add $8,825.00 RCO #012 - Change to provide base cabinet, TV wall box, dry erase board relocation and removal of dishwasher and furnishings = Deduct $9,994.00 RCO #013 - Change to remove the wardrobes and nightstands = Deduct $21,588.00 The original Contract Sum was $ _052,,500.00 The net change by previously authorized Change Orders $ 15,359.00 The Contract Sum prior to this Change Order was $ 3,667,859.00 The Contract Sum will be decreased by this Change Order in the amount of $ 22 757.00 The new Contract Sum including this Change Order will be $ 3,645,102.00 The Contract Time will be increased by Zero (0) days. — 0. 4 L % -TNi& C. 0 , The new date of Substantial Completion will be t , psq */a Ta-rw� NOTE: This Change Order does not include adjustments to the Contract Sum or Guaranteed Maximum Price, or the Contract Time, that 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. EPOCH Architectur ;, ARCHITE el°rra r) SIGNAT (PRINTED NAME AND TITLE ,. / 9 DATE Ziolkowski Construction, Inc. City of South Bend Board of Public Works CONTRACTOR ('Firin name) S GNATURE OWNER (Firm name) SIGNATURE ea-rd of Pula.Pulaic varkS Bill Favors, President & CFO PRINTED NAME AND TITLE PRINTED NAME February 8, 2019 DATE DATE AIA Document G701 TM — 2017. Copyright © 1979, 1987, 2000 , 2001 and 2017 by The American Institute of Architects. All rights reserved. Y�kttAll IIQNGw "'II'lill nr AINA'' It9auw.nnimr.irrf iinw Ipirawtau;P:eat Ilfy N Pf. Cm IpYmutptnt IL.anns awirwaa Ilirnt:anarn�aurnawnnat "'Iflrrnafiiaa. Numsmmur,tunirIPxaat nellu nraan,urmtmmr>�� rcair wtu„,t:miin.uft'w�sirn r�wf fl:hlis AIIA""'' t:'tw�na,:uuirmu*irrt:, arir° any Ipointion of lit:,, may iresuit mrn severe cilvill ;aimed a.m°ni ydi nail Ileum lltigs, and wiillll be prosecuted to the maxiNn iiuirn extent Ilpos ilbIle a nateir the (law. This document was produced by AIA software at 15:21:29 ET on 02/08/2019 under Order No. 1093394963 which expires on 07/05/2019, and is not for resale, User Notes: (3B9ADA5A)