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CITY OF SOUTH BEND, INDIANA <br />15WyJ ivvylff-Jo <br />CITY PROJECT NO. 114-053 <br />CHANGE ORDER PROPOSAL <br />Change Order Proposal No.: 114-053-110 Date: 1/15/18 <br />Submitted in Response to Proposal Request No.: <br />Contract Name and No.: 114-053 South Bend WWTPSecoRdar Treatment_Im ro vementws <br />Contractor: Thieneman Construction, Inc.. <br />Subject: Install 24" blind flange at Gallery I floor opening of existing 24" ATE as requested. <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 - $1,160 <br />2. Item: — See attached cost breakdown - $0 <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 formal payment, and Milestones, if any. ffincrease at, decrease, state specific number ofdays for changes <br />to the Contract Times. <br />Contract Tim s (days) <br />Description Amount Substantial Final <br />I, Item— D irect Costs 1,160 <br />1 ItM�rku s5 p.::'% Subs / 15% TO $165 0 0 <br />ToZiThis changi�nqiEqp 0 0 <br />— <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 than e, <br />W <br />Change Order Proposal By: C <br />Signature of Proposer: <br />