00 63 49 - Work Change Directive Form.pdf
PDF 477 KB Posted
- Attached to
- West Pump Station Replacement Project
- Solicitation number
- Not on record
- Issued by
- Chester County, Pennsylvania
About this file
This is a Work Change Directive Form template developed by Herbert, Rowland & Grubic, Inc. for use in the West Pump Station Replacement Project administered by the Northwestern Chester County Municipal Authority in Pennsylvania. The form serves as a mechanism for directing contractors to proceed with work modifications prior to final agreement on contract price and time adjustments. The directive accommodates changes necessitated by either non-agreement on pricing of proposed modifications or the need to proceed for schedule-related or other project reasons. The form allows for preliminary, non-binding estimates of changes to contract price (identified as increase, decrease, or not yet estimated) and contract time (measured in days with similar flexibility regarding direction of change). Supporting documentation for the change must be attached and the purpose for the modification clearly described.
The Work Change Directive Form requires authorization and approval signatures from the Engineer, Owner, and Funding Agency, with corresponding dates for each approval stage. The basis for determining changes in contract price may be established through lump sum arrangements, unit prices, cost of work, or other defined methods. This template is fundamental to contract administration and change management processes on the West Pump Station Replacement Project, which encompasses General Construction (Contract WPS-1), Electrical Construction (Contract WPS-2), and Mechanical Construction (Contract WPS-3) on a lump sum bid basis. Bids for the project were scheduled to close on May 20, 2026, at 10:00 AM local time through the PennBid platform.
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Text version
Herbert, Rowland & Grubic, Inc. 00 63 49 - 1 000483.0450
WORK CHANGE DIRECTIVE NO. [X]
Date of Issuance: Effective Date: [DATE EXECUTED BY OWNER]
Owner: Contract No.:
Contractor: Contract Name:
Engineer: HRG Project No.:
Project:
Contractor is directed to proceed promptly with the following change(s):
Description: [Description of the change to the Work]
Attachments: [List documents supporting change]
Purpose for Work Change Directive: [Describe the purpose for the change to the Work]
Directive to proceed promptly with the Work described herein, prior to agreeing to changes on Contract Price and Contract Time, is issued due to: NOTE - check one or both of the following
Non-agreement on pricing of proposed change Necessity to proceed for schedule or other Project reasons.
Estimated Change in Contract Price and Contract Times (non-binding, preliminary):
Contract Price: $ [increase] [decrease] [not yet estimated].
Contract Time: days [increase] [decrease] [not yet estimated].
Basis of determining change in Contract Price:
Lump Sum Unit Prices Cost of the Work Other
RECOMMENDED: AUTHORIZED BY: APPROVED (if applicable):
By: By: By:
Engineer (Authorized Signature) Owner (Authorized Signature) Funding Agency
Title: Title: Title:
Date: Date: Date:
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