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o� urH vE4o <br />CITY OF SOUTH BEND, INDIANA <br />DEPARTMENT OF PUBLIC WORKS' <br />PROJECT CHANGE ORDER 1865 # <br />DATE: 10/30/2024 <br />PROJECT NO: 124-048 <br />PROJECT NAME: Jefferson Alley Repair <br />CONTRACT DATE: 8/16/2024 <br />CHANGE ORDER NO: 1 (Final) <br />SUBJECT OF CHANGE ORDER: PCR #1-swapping 1800gal drywells for 900gal drywells <br />All items completed substantially as planned. <br />See attached Comparison of Estimate for overruns and underruns. <br />The oriqinal contract sum <br />Net chanqe by previously authorized chanqe 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 chanqe order <br />This Change Order represents a total change of <br />Total change for entire project <br />Oriqinal contracted completion date/time <br />Extension of date/time by previous change orders <br />Date/time extension by this chanqe order <br />New completion date/time <br />C NTRA TOR <br />C <br />ontractor S nag&e j< <br />Bee�,Lu 1. Yeabe nesrL�� <br />Printed N me and Title <br />Premium Concrete Services <br />Company Name <br />712 Richmond St <br />Address <br />❑ Increased <br />X❑ Decreased <br />11 /15/2024 <br />$ 36,405.00 <br />$ 0.00 <br />$ 36,405.00 <br />$ 9,161.48 <br />$ 27,243.52 <br />-25.17 % <br />-25.17 % <br />0 days <br />11 /15/2024 <br />RECOMMENDED FOR APPROVAL <br />CON RUCTION MANAGER <br />CITY OF SOUTH BEND, INDIANA <br />BOARD OF PUBLIC WORKS <br />V'aa <br />Elizabeth A. Maradik, President <br />Gary A. Gilot, Member <br />",I-zil t <br />Joseph R. Molnar, Vice President <br />Briana Micou, Member <br />Elkhart, IN 46516 Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk <br />City, State, Zip Date: November 26, 2024 <br />