K-2 - Change Order 4 - Rathje Construction - Original Town Phase 3

CHANGE ORDER REQUEST DATE: 6/10/2025 CONTRACT # 0 CHANGE ORDER REQUEST NO. 5 PROJECT: Tiffin Phase 3 Reconstruction Project CONTRACTOR: Rathje Construction CONTRACTOR PROJECT MANAGER: Dan Scofield CITY OF TIFFIN CONSTRUCTION PROJECT MANAGER: Ben Carhoff DESCRIPTION OF REQUEST: 1. While installing storm pipe run P-59 (18" RCP) it was discovered that the 8" watermain would need to be lowered to keep positive drainage in the storm sewer. Plans call out 8" watermain, when exposed we found it to be 8". Price below reflects the additional costs of materials and labor between 8" & 8". Work completed 6/5/2025. This will take place of item # 31 at this location. Roughly 7+cc, 10L. 2. Water service disconnects were requested to 301 Main Street (Old Slims Bar). There were 2 lines that got disconnected. 1-2" line & 1-1" line. Corporations were shut off and capped at the main. Work completed 6/3/2025. 3. It was requested to abandon the sewer service that went to an old apartment building on the SW corner of Third and Main (fire station parking lot). The service was capped at the storm sewer ditch and also at the sanitary Sewer Main. 4. It was requested to add an additional SW-501 Modified, to accomodate storm sewer to the proposed bar/restaurant on the NW corner of Third & Main Street. We had to custom make an intake to fit the alignment of the storm sewer to the new curb line. SUDAS SPECIFICATION SECTION TO SUPPORT REQUEST, DIVISION 1: JUSTIFICATION FOR THE REQUEST, WORKING DIVISION: <table> <tr> <th>Line No.</th> <th>Spec. #</th> <th>Item No.</th> <th>Item Description</th> <th>Quantity</th> <th>Unit</th> <th>Unit Price</th> <th>Mark up</th> <th>Unit Price w/ Markup</th> <th>Working Days Requested</th> <th>Proposed Increase (Decrease) In Contract Price</th> </tr> <tr> <td>1</td> <td>IDOT 2553</td> <td>8011</td> <td>Water Main Conflicts 8"</td> <td>1.00</td> <td>EA</td> <td>$6,930.32</td> <td>0.00%</td> <td>$6,930.32</td> <td>0</td> <td>$6,930.32</td> </tr> <tr> <td>2</td> <td>5010</td> <td>8012</td> <td>Water service Abandonment, 1"</td> <td>1.00</td> <td>EA</td> <td>$2,100.00</td> <td>0.00%</td> <td>$2,100.00</td> <td>1</td> <td>$2,100.00</td> </tr> <tr> <td>2</td> <td>5010</td> <td>8013</td> <td>Water service Abandonment, 2"</td> <td>1.00</td> <td>EA</td> <td>$2,100.00</td> <td>0.00%</td> <td>$2,100.00</td> <td>1</td> <td>$2,100.00</td> </tr> <tr> <td>3</td> <td>4010-K</td> <td>8014</td> <td>Sanitary Sewer Abandonment, Plug 4"</td> <td>1.00</td> <td>EA</td> <td>$1,200.00</td> <td>0.00%</td> <td>$1,200.00</td> <td>1</td> <td>$1,200.00</td> </tr> <tr> <td>4</td> <td>6016-108-B-0</td> <td>8015</td> <td>SW-501 Modified (additional)</td> <td>1.00</td> <td>EA</td> <td>$6,743.40</td> <td>0.00%</td> <td>$6,743.40</td> <td>1</td> <td>$6,743.40</td> </tr> <tr> <td colspan="9">Net Increase (Decrease)</td> <td>4</td> <td>$19,073.72</td> </tr> </table> SUPPORT DOCUMENTS INCLUDED: CONTRACT TIME IMPACT: (N/A) REVISED SCHEDULE PROVIDED? YES or NO STANDARD SUDAS BID ITEMS MUST BE USED IF POSSIBLE, OTHERWISE PROVIDE COST BREAKDOWN: INVOICES (REQUIRED): MATERIAL SUBMITTALS (REQUIRED): ADDITIONAL SUPPORT DOCUMENTS INCLUDED: This document does not change the Contract Price or Contract Time but is evidence that the parties expect that the subject changes will be incorporated into a subsequent Contract Change Order following negotiation by the parties as to effect, if any, upon Contract Price or Contract Time. Work shall not be deemed acknowledged per Division 1, General Provisions and Covenants until all signatures are received. Payment related to this document will only be made after execution of Contract Change Order through City Council.