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Exhibit C <br /> °` City of Decatur, Illinois <br /> A C <br /> " #1 Gary K. Anderson Plaza <br /> Decatur, IL 62523-1196 Change Order <br /> Date: <br /> Request No. ❑ Final <br /> Consulting <br /> Engineer: <br /> Address: <br /> I recommend that an ❑addition of $ be made to the above contract. <br /> ❑ deduction <br /> I recommend that an extension of days be made to the above contract completion date. <br /> The revised completion date is now <br /> Amount of original contract $ <br /> Amount of previous change orders $ <br /> Amount of current change order $ <br /> Amount of adjusted/final contract $ <br /> ❑ addition <br /> ( Total net ❑ deduction to date $ which is %of Contract Price <br /> I State fully the nature and reason for the change order <br /> t <br /> j When the net increase or decrease in the cost of the contract is$10,000 or more or the time of completion is increased or <br /> decreased by 30 days or more,one of the following statements shall be checked. <br /> i <br /> The undersigned determine that the change is germane to the original contract as signed,because: <br /> ❑ Provision for this work is induckd in the original contract. <br /> ❑ Work of this type was included in the original contract,and the additional efforts of this work are within the intent of <br /> the contract. <br /> ❑ The chane re resents an adjustment required by the contract, based on unpredictable developments in the work. <br /> The change in design is neipessary to fulfill the original intent of the Contract. <br /> ❑ Other: (Explain) <br /> Recommended <br /> Public Works Director Date <br /> Approved Attested <br /> Mayor City Clerk <br /> Date Date <br /> C-1 <br />