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'm <br />M-AIA <br />Change Order <br />PROJECT: (Name and address) <br />17043 - Erskine Clubhouse Renovation <br />City Project #236563 <br />OWNER: (Name and address) <br />Board of Public Works <br />City of South Bend, IN <br />1316 County City Building <br />227 W Jefferson Boulevard <br />South Bend, IN 466011830 <br />CONTRACT INFORMATION: <br />Contract For: General Construction <br />Date: 8/28/2018 <br />ARCHITECT: (Name and address) <br />Gregory A. Kil & Associates, Inc. <br />(d/b/a) Kil Architecture / Planning <br />1126 Lincolnway East <br />South Bend, IN 46601 <br />CHANGE ORDER INFORMATION: <br />Change Order Number: 07 <br />Date: 01/15/2019 <br />CONTRACTOR: (Name and address) <br />Ziolkowski Construction Co., Inc. <br />4050 Ralph Jones Drive <br />South Bend, IN 46628 <br />THE CONTRACT IS CHANGED AS FOLLOWS: <br />(Insert a detailed description of the change and, if applicable, attach or reference specific exhibits. Also include agreed upon adjustments <br />attributable to executed Construction Change Directives.) <br />Per the attached RCO #019 Rev.1, Add $2,984.00 to provide labor, material and equipment to remove loose concrete on existing porch. <br />Place (MG KRETE) in damaged areas. Repair damaged wood base at the existing columns per RFI #012. <br />The original Contract Sum was $ 907,000.00 <br />The net change by previously authorized Change Orders $ 80,142.00 <br />The Contract Sum prior to this Change Order was $ 987„142.00 <br />The Contract Sum will be increased by this Change Order in the amount of $ 2,984.00 <br />The new Contract Sum including this Change Order will be $ 990,126.00 <br />The Contract Time will be increased by Zero (0) days. <br />The new date of Substantial Completion will be March 22, 2019 <br />NOTE: This Change Order does not include adjustments to the Contract Sum or Guaranteed Maximum Price, or the Contract <br />Time, that have been authorized by Construction Change Directive until the cost and time have been agreed upon by both the <br />Owner and Contractor, in which case a Change Order is executed to supersede the Construction Change Directive. <br />NOT VALID UNTIL SIGNED BY THE ARCHITECT, CONTRACTOR AND OWNER. <br />Gregory A. Kil & Associates, Inc. <br />Sl ' <br />Grea;orw . KiINCARB. AIA Architect <br />PRINT7 NAME AND TITLE <br />DATE <br />Ziolkowski Construction, Inc <br />CONTRACTOR (Firm name) <br />SIGNATURE <br />tat <br />PRINTE <br />D NAME ANO TITLE <br />1- I1• L1 <br />DATE <br />Board of Public Works, City of South <br />Bend, IN <br />OWNER (Firm name) <br />SIGNATURE , .(:AJ?1` V <br />Board of PuhU,. <br />PRINTED NAME AND TITLE <br />4 <br />DATE_: 'N <br />AIA Document G701 TM — 2017. Copyright© 1979, 1987, 2000 , 2001 and 2017 by The American Institute of Architects. All rights reserved dd'dDA�wII'tlIN "Ii'lMs <br />t is protected IbyCopyright. " � � t, actia " om distirullmuutl: oin of thlia AIIA", Document, oir <br />ADA'�' litaaa°mnmmnoir� � U.D.„„"ro. Il.aaaar rnmual Untaam��icnawtUaa>irwall 1'1ru.at�ua�aa tDirnouutlPnaair�Ux�a�aaD iro mma�ua�tu <br />aairuy pcm°fiori of mt, i niamy m° suullt in severe clivil and cirumrnin all ponaaUtios, and MCI I e pnosecuutred to tlhe mrrnaazuiii w uunm eMent paassilbIle under, the haw, This <br />document was produced by AIA software at 16:49:48 ET on 01/15/2019 under Order No. 1887572679 which expires on 01/15/2020, and is not for resale, <br />User Notes: (3139ADA70) <br />