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:iA <br />Change Order <br />PROJECT: (Name and address) <br />Venues, Parks and Arts Maintenance <br />Storage Building <br />1020 High Street <br />South Bend, IN 46601 <br />OWNER: (Name and address) <br />South Bend Board of Public Works <br />227 West Jefferson Blvd <br />South Bend, IN 46601 <br />CONTRACT INFORMATION: <br />Contract For: Owner and Contractor <br />Date: September 11, 2018 <br />ARCHITECT: (Name and address) <br />Gregory A Kil & Associates, Inc. (d/b/a) <br />Kil Architecture/Planning <br />1126 Lincolnway East <br />South Bend, IN 46601 <br />CHANGE ORDER INFORMATION: <br />Change Order Number: 05 <br />Date: May 28, 2019 <br />CONTRACTOR: (Name and address) <br />Robert Henry Corporation <br />404 South Frances St. <br />South Bend, IN 46624 <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 />Deduct $396.00 for deletion of the Pavement Striping. <br />The original Contract Sum was $ 330 174.00 <br />The net change by previously authorized Change Orders $ 59,206.00 <br />The Contract Sum prior to this Change Order was $ 389,380.00 <br />The Contract Sum will be decreased by this Change Order in the amount of $ 396.00 <br />The new Contract Sum including this Change Order will be $ 38&98,L00 <br />The Contract Time will be unchanged by Zero (0) days. <br />The new date of Substantial Completion will be 3/25/19 <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 />Gregiory A Kil & Associates, Inc <br />ARCHIT%T""r <br />in name) <br />SIG A�"U <br />Gregor A Il N A'RB, AIA <br />Architect <br />PRINTED NAME AND TITLE <br />DATE <br />action Ci of South Bend Venues Parks & Arts <br />name) OWNER (Firm name) <br />0IRVA&MAMAA'' <br />PRINTED NAME AND TITLE PRINTED NA E, <br />DATE DATE <br />J <br />AIA Document G701 TM — 2017. Copyright © 1979. 1987. 2000 , 2001 and 2017 by The American Institute of Architects. All rights reserved. WARMING!: 'q"'tn s <br />MA'a'' Document is by US Copyright t.aw and Ilrntairrnaatiornal Timatllea, i,trnauuwtlnoidZed ra 1piroduuction or fflsG:riltmuu9loin of tffls AM',, Ilaoc urmuont:, or, <br />any 14por°tmanrn of it, rnamy it°o' nullt fin „rev ue (:Ilvil and ciHonkiam pe nallt es, and wullll I e piroa, ecuuted to the rmnaxilimmaurmm extent Ipaassiliulle under Uiie Ilaw. This <br />document was produced by AIA software at 12:17:14 ET on 05/28/2019 under Order No 0201792401 which expires on 05/27/2020, and is not for resale, <br />User Notes: (3139ADA46) <br />