Change Order No 5 - Fire Station No 9 Project No 116-012 - Ziolkowski Construction Inc

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Islam *A1A Change Order PROJECT: (Name and address) 17398 - Fire Station Number 9 2108 Mishawaka Avenue South Bend, IN 46615 OWNER: (Name and address) City of South Bend Board of Public Works 227 West Jefferson Boulevard South Bend, IN 4614 0c men 7 ........1 TM Document 2017 CONTRACT INFORMATION: Contract For: General Construction Date: March 13, 2018 ARCHITECT: (Name and address) EPOCH Architecture + Planning 300 West Jefferson Boulevard South Bend, IN 46601 CHANGE ORDER INFORMATION: Change Order Number: 005 Date: May 3, 2019 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 #014 - Change to provide additional ductwork for rerouting of main trunk line of duct in Residence and removal of tunk fill line pipes and fittings due to relocation. = Deduct $553.00 Ziolkowski Construction, Inc. letter dated the 14th day of April, 2019: Request for Contract Time Extension. Substantial completion on May 17, 2019 and Final Completion on June 14, 2019 The original Contract Sum was 3,652,500.00 The net change by previously authorized Change Orders $-7,398.00 The Contract Sum prior to this Change Order was $ 36a4.5,102.00 The Contract Sum will be decreased by this Change Order in the amount of $ 553.00 The new Contract Sum including this Change Order will be $ 3,444, 549.00 The Contract Time will be increased by Fifteen (15) days. The new date of Substantial Completion will be May 17, 2019 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 Architecture ARCHIIT („tu SIGNAT Andrew Avara, PM PRINTED NAME AND TITLE a D Ziolkowski Construction, Inc. CONTRACTOR (Firm name) µ SIGNATURE Bill Favors, President & CFO PRINTED NAME AND TITLE May 3, 2019 DATE City of South Bend Board of Public Works OWNER (Firm name) & SIGNATURE y Y4 201 PRINTED N l DATE �. AIA Document G701 TM — 2017. Copyright © 1979, 1987, 2000 , 2001 and 2017 by The American Institute of Architects. All rights reserved. VVAV''tINIMGW "W hIls AIIA""" Document Ifs protected by U.S. ColpyrVglht ILaw aired Ilint:eirivatlionall "rreatlies. U naautlhorlized reproduction oir rNVstirdlbutllcan of tVnlls AVIA""` Document,, or ainsy Ipa:au°tlia:aau of Vt„ may result iiirn severe cWill and criinnilirnaall paeriallt'ua.s, and wHII be Iprosacuute d to tllm maxilrywir n extent Ipos,„iibli a under tlPue paw. This document was produced by AIA software at 12:42:45 ET on 05/03/2019 under Order No. 1093394963 which expires on 07/05/2019, and is not for resale. User Notes: (3139ADA56)