HomeMy WebLinkAboutChange Order No 1 - Engineering Office Improvements Project No 118-107 - Ziolkowski Construction Inc1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND- INDIANA 46601-1930
December 20, 2018
Adam Bradley
Ziolkowski Construction, Inc.
4050 Ralph Jones Drive
South Bend, IN 46628
PHONE 574/ 235-9251
FAx 574/ 235-9171
RE: Change Order No. I - Engineering Office Improvements — Project No. 118-107
Dear Mr. Bradley:
The Board of Public Works, at its meeting held on December 20, 2018, approved the above
referenced Change Order for an increase of $1,433, bringing the current contract amount to
$9,233.
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
GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J. DoRAu
CITY OF SOUTH BEND, INDIANA
DEPARTMENT OF PUBLIC WORKS
PROJECT CHANGE ORDER
DATE:
PROJECT NO:
PROJECT NAME:
CONTRACT DATE:
CHANGE ORDER NO:
SUBJECT OF CHANGE ORDER:
NwYO «
12/20/2018
118-107
Engineering Office Im rovements
11 /27/2018
1
PCR #1-Delete Door PCR #2-New Vault Door PCR #3-Add Power
Outlets PCR #4-Add Ethernet Ports
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
Contractor Signature
Printed Name and Title
Ziolkowski Construction Inc.
Company Name
4050 Ral h Jones Drive
Address
South Bend„ IN, 46628
City, State, Zip
$
7,800.00
$
0.00
$
7,800.00
X Increased
Decreased $
1,433.00
$
9,233.00
18.37 %
18.37 %
12/31 /2018
0 days
0 days
12/31 /2018
•TION MANAGER
CITY OF SOUTH BEND
BOARD OF PUBLIC WO KS
Approved Date:
Gary A. ilot, President
Suzanna M. Fr tzberg, M `mber
Elizabeth A. Maradik, Member
Therese orau, Member
i
Jarde A . lue , Member
f�v>� � Su111ufAv�
BOARD OF PUBLIC WORKS
AGENDA ITEM REVIEW REQUEST FORM
Date 12/18/2018 Department Public Works
Name Toy Villa Division/Bureau Engineering
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BPW Date 12/20/2018 Phone Extension 5920
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Required Prior to Submittal to Board
Legal E] Attorney Name:
Controller Controller review is required for all Contracts $5,000.00 or more and
greater than one year in length per the City Purchasing Policy
Purchasing ❑
Check the .
H Agreement Amendment
Professional Services
( Bid Opening
Quote Opening
® Change Order No. 1
[� Ease/Encroach.
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❑] Bid Award ❑ Req. to Advertise
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El Traffic Control:
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
Required Information
Ziolkowski Construction„ Inc.
Enaineerina Office Improvements
118-107
Professional Servic
es
. 101.0602.431.31.06
........... . ....................
Addendum
❑ Title Sheet
Purpose/Description _
....E] Required
...Contractor's Certification Forms Attached (Non -
Collusion, Non -Discrimination, Non -Debarment, E-Verify, Iran, etc.)
.. ........ _..... _ ... ........ _
w Required For Chan e�Orders Only _
Amount of ® Increase $ 1, 00
❑ Decrease $
Previous Amount
Current Percent of Change:
New Amount
Total Percent of Chanute:
$ 7,800.00
18.37%
9,233.00
18.37%
Dispersal After A
Copy Original
® ❑ Kara Boyles
® [❑ Toy Villa
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