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ENVIRONMENTAL <br />GLASS, INC. <br />12675 Marlin Drive a Redford, MI 48239 • Voice: 734.261.1930 • Fax. 734.261.5590 <br />CHANGE ORDER REQUEST <br />Liberty Tower Exterior Renovations - l l8 086R � � . ........ „ Change „ � � „ Project Name order request. #04 <br />213 W. Washington St. Date: 8/19/2019 <br />South Bend, IN 46601 E.G.I. Project #: 19001 <br />Contracting Authority: City of South Bend - Board of Public Works <br />1316 County -City Building <br />227 W. Jefferson Boulvevard <br />South Bend, IN 46601 <br />Ph: 574-235-9251 <br />Workscope: Cost associated with providing (3) power supplies & electrician to install power supplies, & auto operators <br />Material: JLM (2) 4 amp Power Supplies, (1) 2 amp Power Supply per EGI's HW Consultant S 1,315,92 <br />$ 1,315.92 <br />Labor: Martell Electric Labor & Material to install (3) power supplies, (2) auto operators, and run low voltage to EPT's $ 1,750.00 <br />Environmental Glass Truck & Driver 2 hr min charge forjobsite delivery (2 hr x $125/hr) $ 250.00 <br />$ 2,000.00 . <br />Material & Labor Sub -Total $ 3,315.92 <br />15% OH&P $ 497.39 <br />Lump sum Change order„ ADD „ $ 3,813.31 <br />schedule Imptacl. None <br />wG4 t�'/d";� tr��,i�rtmr:�^,unJ vwril�w�asrl � grill t„j•�trrdtM (( tsr�rlpm <br />'lease submit a change corder as direction to proceed per the above noted work scope changes. <br />l.tuvtr ttpucruttl(ila�A l <br />D"%6vt Flatpl"user <br />8/19/2019 <br />City of South Bend - Board of Public Works <br />Accepted by : <br />(Authorized signature) <br />Dated <br />