Change Order No 1 - Wastewater Treatment Plant Grit Screenings & Improvements Proj No. 114-075 - Thieneman Construction Inc

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�p Contractor's / Subcontractor's THTF. IAN Change Order Request Summary Date: 9/19/2016 COR: 3 R1 521 W. 84th Drive Engineer: Greeley and Hansen of building Owner: Project: TCI lob q in house opposed to onsite. Five days of labor and SUMMARY OF DETAILED BREAKDOWN LABOR MATERIAL EQUIPMENT OTHER COSTS 1. SAFETY 2. EXPENDABLE TOOLS NETTOTAL OVERHEAD AND PROFIT TOTAL WORK PERFORMED BY CONTRACTOR City of South Send South Bend Grit and Screenings Improvements Additions Deletions Net Total (1%of LABOR)- Deletion -0- $ - (3.0%of LABOR)-Deletion-0- $ - (A+B+C+D1+D2) $ - (Exl$%) - Deletion -0- $ - (Lines E+F) $ - CONTRACTOR'S MARK-UP ON WORK OF SUBCONTRACTORS Detailed Breakdowns and summaries from each contractor must be attached. SUBCONTRACTOR: Firm Name CONTRACT WORK: Description PROPOSAL 1. Toric Credit-$3,684.00 2. 3. _ 4. SUBTOTAL of all work performed by contractor's subcontractors -$3,684.00 MARK-UP on work of subcontractors (Min. $ 00) (Line H x 5%) -$184.20 PROPOSAL (Lines GA H) -$3,868.20 BONDS (1.516 of PROPOSAL)-Deletion-0- -$58.02 BUILDER'S RISK INSURANCE (0.0% of PROPOAAL) - Deletion -0- -$3,926.22 TOTAL PROPOSAL TOTAL PROPOSAL for subject COR increase decrease in contract amount-$3,926.22 An extension time of 0 day to extend the Contract dates for Completion will be required commencing on the date when we are notified a Change Order will be issued for the price quoted herein. Approval needed in 5 days. If the work has to be performed to continue construction with no response on pricing or if we are issued a Work Change Directive (WCD) to proceed with this work and agreement on the price has not been reached within 30 calendar days, then this proposal shall be considered a Claim, In accordance with Article 10.5 of the Contract General Conditions. CONTRACTOR Signature Atatt.AdeeWj. Title: PM Date: 9/19/2016