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CITY OF SOUTH BEND, INDIANA <br />CITY PROJECT NO. 114-0,53 <br />CHANGE ORDER PROPOSAL <br />�- 11 <br />Change Order Proposal No.: 114-053-100.1 Date: 12/12/17 <br />Submitted in Response to Proposal Request No.: <br />Contract Name and No.: 114-053 South Bend WWTP Secondary I I I reatnient lin venients <br />Contractor: Thienen <br />Subject; Incorporate 3 additional bridge decks (FC 1/2/3) into RFP #3. Revised/Negotiated per <br />John Huston's email dated 12/8/17, see pricing sheet for a summary of the revisions. <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 - $4,254.59 <br />2. Item: <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 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 finalpayment, and Milestones, if any. Ifincrease or decrease, state specific number ofdays for changes <br />to the Contract Times. <br />Contract Times da s <br />Description Amount Substantial Final <br />1. Item — Direct Costs $4,255 0 0 <br />2. Item — Markups: 5% Subs / 15% TO $228 0 0 <br />$4,4? 0 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 S cle <br />Signature of Proposer: <br />a.. <br />