K-5 - Change Order 10 - Rathje Construction, Original Town Phase Two

Date: November 5, 2021 To: Ben Carhoff Project: Tiffin Original Town Urbanization Phase II Re: COR #11 Rathje # 7187 Ben, I am hereby submitting the following change order request for the last minute down spout installation at the fire station. Two downspouts went to the North with an intake box connection and one downspout we took to the South with an intake connection. We used 6" solid double wall HDPE for the main line and 4" HDPE to tie onto the gutters and backfilled with porous backfill. <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>Firestation Downspouts</td> <td></td> <td>1.00</td> <td>LS</td> <td>$4,250.00</td> <td>0.00%</td> <td>$4,250.00</td> <td>$4,250.00</td> </tr> <tr> <td colspan="7">Total</td> <td>$4,250.00</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