K-4 - Change Order #11 - Rathje Construction - Original Town Phase Two

Date: November 18, 2021 To: Ben Carhoff Project: Tiffin Original Town Urbanization Phase II Re: COR #12 Rathje # 7187 Ben, I am hereby submitting the following change order request for the concrete throat removal and replacement on the existing intake at the NE corner of E. Second and Brown Street. The existing throat had to be removed to meet the new grades due to moving the removal limits further to the east. <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>Throat replacement</td> <td></td> <td>1.00</td> <td>EA</td> <td>$2,800.00</td> <td>0.00%</td> <td>$2,800.00</td> <td>$2,800.00</td> </tr> <tr> <td colspan="6">Total</td> <td>$2,800.00</td> </tr> <tr> <td>Additional Days Requested</td> <td></td> <td>0</td> <td>EA</td> <td></td> <td></td> <td>Total</td> <td>0.0</td> </tr> </table> Please call if you have any questions. Respectfully, Dan Scofield