00 63 49 - Work Change Directive Form.pdf
PDF 227 KB Posted
- Attached to
- WCTA Meter Replacement Project
- Solicitation number
- US.257570
- Issued by
- Lancaster County, Pennsylvania
About this file
This is a Work Change Directive Form template created by Herbert, Rowland & Grubic, Inc. for the WCTA Meter Replacement Project (Contract No. 011364.0448) involving West Cocalico Township Authority as the Owner. The form serves as the official document used to direct the contractor to proceed with changes to the Work prior to final agreement on contract price and time modifications. The directive includes provisions for documenting the description of changes, supporting attachments, and the purpose for the Work change, along with preliminary estimates of impacts to both contract price and schedule. The form requires authorization signatures from the Engineer, Owner, and applicable Funding Agency, establishing a formal change management process for the project.
The Work Change Directive includes non-binding, preliminary cost and schedule impact assessments with options to document changes as lump sum, unit prices, cost of work, or other bases for determining adjustments. The form allows for issuance of directives when non-agreement exists on pricing of proposed changes or when necessity to proceed is driven by schedule or other project requirements. Multiple signature lines accommodate different approval authorities, ensuring proper authorization hierarchy within the project management structure. The document provides a standardized mechanism for managing scope changes while maintaining project continuity and accountability among all parties.
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Text version
Herbert, Rowland & Grubic, Inc. 00 63 49 - 1 011364.0448
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:
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:
File details come from the government source that posted it. Updated .