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•1�i Contractor's / Subcontractor's <br />THIFTIAN Change Order Request Summary <br />Date: 8/18/2016 CO R: 2 <br />General Contractor 521 W. 84th Drive Suite A, Merrillville, IN 46410, 219-947-4700 phone/ 219-947-4711 fax <br />Engineer: Greeley and Hansen Owner: City of South Bend <br />Project: South Bend Grit and Screenings <br />Improvements <br />_ _ __ _ _ TO Job M i511 <br />DESCRIPTION OF CHAN6E�-----���------���--�����������— <br />In accordance with the agreement at progress meeting 44 on July 5, 2016, TO offers the following <br />will install three (3) valves, necessary piping, and insulation in the basement pump room to isolate sections of the spray loop. <br />work will be performed at no additional cost in exchange for deletion of the crane testing and inspection requirements in tht <br />cifcations. In particular, All references to load testing and certification of the plant's existing overhead cranes as required in <br />c section 02 4100 are now void. <br />SUMMARY OF DETAILED BREAKDOWN <br />LABOR <br />MATERIAL <br />EQUIPMENT <br />OTHER COSTS <br />1. SAFETY <br />2. EXPENDABLETOOLS <br />NET TOTAL <br />OVERHEAD AND PROFIT <br />TOTAL WORK PERFORMED BY CONTRACTOR <br />Additions Deletions Net Total <br />(1% of LABOR)- Deletion -0- <br />(3.0% of LABOR)- Deletion -0- <br />(A+B+C+D1+D2) <br />(Ex15%) - Deletion -0- <br />(Lines E+F) <br />CONTRACTOR'S MARK-UP ON WORK OF SUBCONTRACTORS <br />Detailed Breakdowns and summaries from each contractor must be attached. <br />SUBCONTRACTOR: Firm Name <br />1. <br />2. <br />3. <br />4. <br />CONTRACT WORK: Description <br />PROPOSAL <br />SUBTOTAL of all work performed by contractor's subcontractors $0D0 <br />MARK-UP on work of subcontractors (Min.$ .00) (Line Hx 5%)-Deletion-0- $0.00 <br />PROPOSAL (Lines G+H+I) $0.00 <br />BONDS (1.5%of PROPOSAL)-Deletion-0- $0.00 <br />BUILDER'S RISK INSURANCE (0.0%of PROPOASQ- Deletion-0- <br />$0.00 <br />TOTAL PROPOSAL <br />TOTAL PROPOSAL for subject CDR increase (decrease) in contract amount $0.00 <br />An extension time of 0 day to extend the Contract dates for Completion will be required commencing on <br />the date when we are notified a Change Order will be issued for the price quoted herein. Approval needed in 5 days. <br />If the work has to be performed to continue construction with no response on pricing or if we are issued a Work <br />Change Directive (WCD) to proceed with this work and agreement on the price has not been reached within 30 <br />calendar days, then this proposal shall be considered a Claim, in accordance with Article 10.5 of the <br />Contract General Conditions. <br />CONTRACTOR <br />Signature Malt able ay, Title: PM Date: 8/18/2016 <br />