K-3 - Change Order #17 – Rathje Construction, Original Town Urbanization Phase Two

Date: July 14, 2022 To: Ben Carhoff Project: Tiffin Original Town Urbanization Phase II Re: COR #19 Rathje # 7187 Ben, I am hereby submitting the following change order request for: 1. Relocation of the firehydrant on the NW corner of Second and Grant due new sidewalk conflicts. 2. Install new mailboxes Summerhayes as requested. 3. Lower and insulate water service line to 210 W. Second Street due to less than 4' of cover. 4. Additional concrete sawing at driveways and intersections that were additional to plan quantity. 5. Relocate, lower and replace handhole on SE corner of E Second and Main Street due to conflict with sidewalk ramp. 6. This is for crew time, equipment and dumptruck to go back remove and regrade more driveway than planned quantity due to changes or home owner request. This does not include item # 51 removal of driveway or any concrete replacement item. (Sidewalk or Driveway). <table> <tr> <th>Item</th> <th>Description</th> <th>Qty</th> <th>Unit</th> <th>Unit Price</th> <th>MU</th> <th>Unit w/ MU</th> <th>Total</th> </tr> <tr> <td>1</td> <td>Fire Hydrant Relocation</td> <td>1.00</td> <td>EA</td> <td>$4,100.00</td> <td>0.00%</td> <td>$4,100.00</td> <td>$4,100.00</td> </tr> <tr> <td>2</td> <td>Install New Mailboxes</td> <td>6.00</td> <td>EA</td> <td>$450.00</td> <td>0.00%</td> <td>$450.00</td> <td>$2,700.00</td> </tr> <tr> <td>3</td> <td>Lower & Insulate water service</td> <td>1.00</td> <td>EA</td> <td>$700.00</td> <td>0.00%</td> <td>$700.00</td> <td>$700.00</td> </tr> <tr> <td>4</td> <td>Additional Concrete Sawing</td> <td>230.00</td> <td>LF</td> <td>$4.00</td> <td>10.00%</td> <td>$4.40</td> <td>$1,012.00</td> </tr> <tr> <td>5</td> <td>Replace @ Relocate Street Light Handhole</td> <td>1.00</td> <td>LS</td> <td>$2,065.00</td> <td>10.00%</td> <td>$2,271.50</td> <td>$2,271.50</td> </tr> <tr> <td>6</td> <td>Removals and grading for 2nd time</td> <td>12.00</td> <td>Ea</td> <td>$500.00</td> <td>0.00%</td> <td>$500.00</td> <td>$6,000.00</td> </tr> <tr> <td colspan="7">Total</td> <td>$16,783.50</td> </tr> </table> Additional Days Requested 6 1/2 day @ each location of rework 1 fire hydrant relocation TOTAL 7 Please call if you have any questions.