K-5 - Change Order #12 - Rathje Construction - Original Town Phase Two

CHANGE ORDER DATE: 19 November, 2021 Change Order No: 12 (twelve) Agreement Date: 5 May, 2020 PROJECT: Original Town Urbanization Project: Phase Two HFC#12218.13123 OWNER: City of Tiffin, IA CONTRACTOR: Rathje Construction DESCRIPTION OF CHANGES TO CONTRACT DOCUMENTS: The approved bricks for the decorative inlay in the intersection of Main and Second Streets are no longer available this year. See attached COR #13 for additional information. CONTRACT PRICE CHANGES: Original CONTRACT PRICE: $ 1,824,618.96 CONTRACT with LAST CHANGE ORDER: $ 1,873,245.54 THIS CHANGE ORDER AMOUNT: $ 2,499.00 NEW CONTRACT PRICE: $ 1,875,745.44 CONTRACT TIME CHANGES CONTRACT TIME (increased)(decreased): ____________________________ NEW Completion Date: _________________________________________ APPROVALS REQUIRED: To be effective this Order must be approved by the OWNER. OWNER: ______________________________________________________ CONTRACTOR: See Attached COR#13 ENGINEER: __________________________________________________