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i <br />s Elk River Youth Athletic Bldg Request for Change - <br />9850165th Ave NW <br />Elk River, MN 55330 <br />To: Ebert Construction, Inc. RFC Number: RTL #005 <br />Original Contract : <br />$11,959.00 <br />Other Approved Change Orders: <br />$3,993.53 <br />Total Contract to Date: <br />$15,952.63 <br />Other Pending Requests: <br />$0.00 <br />This Request: <br />$613.80 <br />RTL Job # 21-181 <br />Date:12/1/2021 <br />Draft sto <br />labor <br />Material <br />Total Cost <br />Overhead and Profit $ <br />Self -Performed Total <br />Subcontractors $ <br />Overhead and Profit on Subs $ <br />Subcontractor Total <br />Total Change in Contract <br />$ 450.00 <br />$ 108_.00 <br />$ 558.00 <br />55.80 <br />$613.80 <br />0.00 <br />0.00 <br />$0.00 <br />$613.80 <br />10% 1 <br />Labor Hours Bate Total <br />Insulation 5 $96.56 __._ $450.00 <br />Labor Total 5 $450.00 <br />`Material-. `' _ Total <br />Material Total y $108.00 <br />The above work is subject to the same conditions as specified in the original contract unless otherwise stipulated. <br />Upon approval the sum of $613.80 will be added to the contract price. <br />Authorized Signature: Date:. <br />Ebert Construction, Inc. <br />