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CITY OF SOUTH BEND, INDIANA <br />WWTP SECONDARY TREATMENT IMPROVEMENTS <br />CITY PROJECT NO.114-053 <br />CHANGE Olt -DER PROPOSAL <br />Change Order Proposal No.: 114-053-071 Date: 4/4/17 <br />Submitted in Response to Proposal Request No. <br />Contract Name and No.:. 114-053 South Bend WWTP Secondary Treatment Improvements <br />Contractor: Thieneman Construction, Inc. <br />Subject: During the March 2017 Progress Meeting the Owner requested TCI to furnish and install <br />an isolation valve in the Re -Use water line. Related to COP #64. <br />The following changes to the Contract are proposed: <br />SCOPE OF WORK: (attach and list supporting information as required) <br />1. Item: TCI — See attached cost breakdown - $800.00 <br />JUSTIFICATION: <br />1. Item: Owner Request <br />CHANGES IN CONTRACT PRICE ANl) CONTRACT TIMES: <br />We propose that the Contract Price and Contract 'rimes be changed as follows: <br />For Contract Price, when requested by Engineer, attach detailed cost breakdowns for Contractor and <br />Subcontractors, Supplier quotations, and other information required. <br />For the Contract Times, state increase, decrease, or no change to Contract Times for Substantial Completion <br />readiness for f nal payment, and Milestones, ifany. If increase or decrease, state specific number ofdays for changes <br />to the Contract Times. <br />Description <br />Amount <br />Contract Times days <br />Substantial <br />Final <br />1. Item — TCI <br />$800,00 <br />0 <br />0 <br />2. Item — TCI - Markup: 5% Subs / 15% TCI <br />$120.00 <br />0 <br />0 <br />Total This Change Order Proposal <br />$920.00 <br />0 <br />0 <br />Changes to Milestones, if any: <br />The adjustment proposed is the entire adjustment to the Contract to which the proposer believes it <br />is entitled as a result of the proposed change. <br />Change Order Proposal By: Craig Steele <br />Signature of Proposer: <br />