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CITY OF SOUTH BEND, INDIANA <br />UVM*E W11 11fL <br />CITY PROJECT NO. 114-053 <br />CHANGE ORDER PROPOSAL <br />Change Order Proposal No.: 114-053-111 Date: 1/15/18 <br />Submitted in Response to Proposal Request No.: <br />Contract Name and No.: 114-053 South Bend WW'11Secondar <br />Contractor: Thicneinan Construction, hic. <br />Subject: Additional l6sf of surface spall repair per contract unit costs. <br />The following changes, to the Contract are proposed: <br />SCOPE OF W01RK: (attach and list supporting information as required) <br />1, Item: TC1 - See attached cost breakdown - $3,296.00 <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 />readinessforfinalpayment, and Milestones, ifany. If increase or decrease, state specific number ofdays for changes <br />to the Contract Times, <br />Contract Tim s (days) <br />Description Amount. Substantial Final <br />—Item"-- Direct Costs $3,296 0 0 <br />2. Item .::24!!1Lupjs: 51 Subs / 151;o TCI n $0 0 0 <br />-Total This Char? e Order ELqposal $3,296 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 Stee <br />Signature of Proposer: ........ . ....... <br />