Approval of Change Order #11 – Rathje Construction Co. – Original Town Urbanization – Phase 3 — E-5

CHANGE ORDER REQUEST DATE: 11/12/2025 CONTRACT # 0 CHANGE ORDER REQUEST NO. 10 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: After installing the water main on HWY 6 it was discovered that two of the water services, 320 Main Street (Car Wash) and 107 W Marango Rd (Bryant's Restaurant) were actually 2" corporation instead of 1" as per plan. The price below reflects the material costs and additional labor time, as the larger the size the more time it takes to get it installed and assembled. Work was completed on 11/11/2025 to get the new water main in service. 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>5010-108-D-2</td> <td>8020</td> <td>Water Service Corporation 2"</td> <td>2.00</td> <td>EA</td> <td>$1,350.00</td> <td>0.00%</td> <td>$1,350.00</td> <td>0</td> <td>$2,700.00</td> </tr> <tr> <td>2</td> <td>5010-108-D-2</td> <td>24</td> <td>Water Service Corporation1"</td> <td>2.00</td> <td>EA</td> <td>-$450.00</td> <td></td> <td>-$450.00</td> <td></td> <td>($900.00)</td> </tr> </table> Net Increase (Decrease): 0 $1,800.00 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.