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

CHANGE ORDER REQUEST DATE: 12/26/2024 CONTRACT # 0 CHANGE ORDER REQUEST NO. 4R 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: During class 10 excavation to meet the proposed grade for the combo sidewalk/wall at 331 Summerhayes it was discovered that the existing waterline would not have frost protection with the new grades. The waterline had to be exposed from the storm sewer to the stop box, disconnected to get it lowered under the existing gas main. 10' of 3/4" copper was added to the service to get it lowered 4' to ensure frost protection. Price below reflects equipment, parts and labor for a 4 man crew for 1/2 a day. After backfilling was completed we were out of the Type 1 Seeding Window (August 10 - September 30) to place permanent Seeding. Per DOT, Any disturbed area is to be stabilized after 14 days. The Mulching is without seed and for stabilization for the winter season only. SUDAS SPECIFICATION SECTION TO SUPPORT REQUEST, DIVISION 1: JUSTIFICATION FOR THE REQUEST, WORKING DIVISION: <table> <tr> <th>Line No.</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></td> <td>Lower Existing 3/4" Waterline</td> <td>1.00</td> <td>LS</td> <td>$3,200.00</td> <td>0.00%</td> <td>$3,200.00</td> <td>0</td> <td>$3,200.00</td> </tr> <tr> <td>2</td> <td></td> <td>Mulching, Wood Cellulous Fiber</td> <td>1.00</td> <td>LS</td> <td>$1,000.00</td> <td>10.00%</td> <td>$1,100.00</td> <td>0</td> <td>$1,100.00</td> </tr> <tr> <td colspan="8">Net Increase (Decrease)</td> <td>0</td> <td>$4,300.00</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.