HomeMy WebLinkAboutChange Order No 1 - 2017 Engineering Remodel Proj No 117-116 - Ziolkowski Construction1316 C'OJ NTY-C;ErY 1 mi, agar.,
227 W. JEriFERSON BOULEVARD
Sour ti 13E"ND. INDI,ANA 46601-11330
CITY OF SOUTH BEND PETE BUTTIGIEG, MAY
BOARD OF PUBLIC WO I
April 10, 2018
Adana Bradley
Ziolkowski Construction, Inc.
4050 Ralph Jones Drive
South Bend, IN 46628
PHONE 574/235-9251
FAX 574f 235-9171
RE: Change Order No. 1 - 2017 Engineering Remodel — Project No. 117-1.16
Dear Mr. Bradley:
The Board of Public Works, at its meeting held on April 10, 2018, approved the above
referenced Change Order for an increase of $1,825, bringing the current contract amount to
$13,392.
Enclosed is a copy of the Change Order for your records.
If you have any further questions regarding this matter, please call this office at (574) 235-
9251.
Sincerely,
Linda M. Martin, Clerk
Enclosure
c: Toy Villa, Engineering
GARY A. Crno'r sUZAN]* A M. FRITZBERc, ELIZAB M A. MA1' ADIK JA MEs A. MUELLER THERESE J. DORALJ
D DATE:
ATE'
PROJECT NO:
PROJECT NAME:
CONTRACT LDATE:
CHANGE ORDER NO:
AM
aag"AW
1111111111111111U
3/13/2018
117-116
2017 Engineering Remodel
11/28/2017
PCR #1-Add Countertop
The original contract sum
Net change by previously authorized change orders
The contract sum prior to this change order
By this Change Order, the project amount is
The new contract sum including this change order
This Change Order represents a total change of
Total change for entire project
Original contracted completion date/time
Extension of date/time by previous change orders
Date/time extension by this change order
New completion date/time
Contractor Signature
Printed Name and Title
Ziolkowski Construction Inc.
Company Name
4050 Ralph Jones Drive
Address
South Bend, IN, 46628
City, State, Zip
Increased
Decreased $
3/1512018
0 days
0 days
3/15/2018
11,567.00
0.010
11,567.00
1,825.00
13,392.00
15.78 %
15.78 %
"'TION MANAGER
--7ill t, President
'AAA
anna lFnwTier -66er
Elizabeth A. Maradik, Member
Therese J. Dordu, Member
Jam ll A. Mueller, Member
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
late 03/29/2018
Name Joy Vi I I a Department Engineeni
BPW Date 04/10/2018 Phone Extension 5920
Required Prior to Submittal to Board
Legal E] Attorney Name
Controller EJ Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
NEEM �
F] Agreement r] Contract Ll Proposal ❑ Addendum
F-1 Professional Services E] Resolution
F-1 Bid Opening El Bid Award ❑ Req. to Advertise E] Title Sheet
❑ Quote Opening F] Quote Award
Change Order No. 1 C/O & PCA No. PCA
Ease/Encroach. ❑ Traffic Control
Other:
Company or Vendor Name
New Vendor
MBE/WBE Contractor
MBE/WBE Contractor
Requested
Project Name
Project Number
Funding Source
Account No.
Amount
Terms of Contract
Purpose/Description
Ziolkowski Construction, Inc.
I l Yes IN No I I If Yes. Ar)r)roved by Purchasina
I iTI 1 0.1 a 0I ITITI 1.11
0 No E] Yes Name of Comipany
2017 Engineerin Remodel
117-116
Building & Street Maintenance
101.0602.431.36.01
Approval of C.O. #1
F-1 Required Contractor's Certification Form Attached (Non -
Collusion, Non -Discrimination, Non-Debarm�ent, E-Verify, Iran, etc.
Amount of M Increase $ 1,825.00
El Decrease $
Previous Amount $ 11,567.00
Current Percent of Change: 15,78%
New Amount $ 13,392.00
Total Percent of Change:
Copy
Original
1-1
El
El
F
n
F
15.78%
Dispersal After Approval