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'' ' ' • ' Exhibit D <br /> �` °f` City of Decatur, Illinois <br /> s <br /> �r_ <br /> i i�,�� .e <br /> �, #1 Gary K. Anderson Plaza Change Order <br /> '�"�� Decatur, IL 62523-1196 <br /> «���o,�. <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 /> State fuily the nature and reason for the change <br /> 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 /> The undersigned determine that the change is germane to the original contract as signed, because: <br /> ❑ Provision for this work in included 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 change represents an adjustment required by the contract, based on unpredictable developments in the work. <br /> ❑ The change in design is necessary 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 /> D-1 <br />