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CITY OF SOUTH BEND, INDIANA <br />WWTP SECONDARY TREATMENT IMPROVEMENTS <br />CITY PROJECT NO. 114-053 <br />CHANGE ORDER PROPOSAL <br />Change Order Proposal No.: 114-053-079 Date: 5/4/17 <br />Submitted in Response to Proposal Request. No.: <br />Contract Name and No.: 1.14-053 South Bend WWTP Secondary Treatment Improvements <br />Contractor: Thieneman Construction, Inc. <br />Subject: Furnish and install 2 additional bollards (6" x 7'0" primed) bollards on the Bast side as <br />requested, locations to be determined. <br />The following changes to the Contract are proposed: <br />SCOPE OF WORK: (attach arrd list supporting information cis required) <br />1. Item: TC] —See attached cost breakdown- $1,461.00 <br />JUSTIFICATION: <br />1, Item: Owner request <br />CHANGES IN CONTRACT PRICE AND CONTRACT TIMES: <br />We propose that the Contract Price and Contract Times be changed as follows: <br />For Contract Price, when requested by Engineer, attach detailed cost breakdowns for Contractor and <br />Subcontractors, Supplier quolations, and other information required. <br />For the Contract Titres, stale increase, decrease, or no change to Contract Titres for Substantial Completion, <br />i-eaclirtess for,firictlperynreint, and rllilestones, ifagy. If increase or decrease, state specific number nfdgys for changes <br />to the Contract Times. <br />Description <br />Amount <br />Contract Tim clays <br />Substantial <br />Final <br />1. Item — TC1 <br />$1,461.00 <br />0 <br />0 <br />2. Item — TCI — Markup: 5% Subs / 15% TCI <br />$219.00 <br />0 <br />0 <br />Total This Change Order Proposal <br />SI,6K00 <br />0 <br />f 0 <br />Changes to Milestones if any: N/A <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 />