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CITY OF SOUTH BEND, INDIANA <br />DEPARTMENT OF PUBLIC WORKS <br />PROJECT CHANGE ORDER <br />DATE: <br />PROJECT NO: <br />PROJECT NAME: <br />CONTRACT DATE: <br />CHANGE ORDER NO: <br />SUBJECT OF CHANGE ORDER: <br />5/30/2019 <br />118-305A <br />East Bank Sinkhole Re airs Base + Alt2 <br />4/23/2019 <br />1 <br />PCR #1-Remove Line Item #22 (-$4,615.00). Decrease Line Item <br />#23 Quantity to 50 CYS (-$2,200.00). Increase Line Item #21 <br />Quantity by 102 CYS ($18,360). Add Line Item #25 - Remove Roof <br />Slab of Existing Raceway for Access (LSUM @ $1,970.00 = <br />$1,970.00). Add Line Item #26 - 3/4" PVC Conduit; 35 LF @ $6.75 <br />/LF ($236.25). Add Line Item #27 - Rebar to Tie Curb into Sidewalk; <br />38 EA a $19.25/EA $731.50 . <br />The original contract sum <br />Net change by previously authorized change orders <br />The contract sum prior to this change order <br />By this Change Order, the project amount is <br />The new contract sum including this change order <br />This Change Order represents a total change of <br />Total change for entire project <br />Original contracted completion date/time <br />Extension of date/time by previous change orders <br />Date/time extension by this change order <br />New completion date/time <br />e <br />—Contractor ;Si ure <br />ked Name and Title <br />Northern Indiana Construction Company, <br />Inc. <br />Company Name <br />P. 0. Box 1333 <br />Address <br />Mishawaka, IN 46545 <br />City, State, Zip <br />$ <br />68,728.00 <br />$ <br />0.00 <br />$ <br />68,728.00 <br />X <br />�Increased <br />Decreased <br />$ <br />14,482.75 <br />$ <br />83,210.75 <br />21.07 % <br />21.07 % <br />6/30/2019 <br />0 days <br />0 days <br />6/30/2019 <br />r _T <br />m <br />CONSTI�T IN MANAGER <br />CITY OF • <br />BOARD OF PUBLIC WOR S <br />Approved Date: <br />//6 <br />Gary A. Gilot, President <br />Genevie 'e E. Miller, Vember <br />Elizabeth A. Maraidik„ Member <br />Therese I D u, Member <br />Laura O'Sullivan, Member <br />