00 63 63 - Change Order Form.pdf
PDF 276 KB Posted
- Attached to
- Contract 2026-01: Maintenance & Emergency Contract (Excavation) – Project No. 7297. 0444
- Solicitation number
- Not on record
- Issued by
- York County, Pennsylvania
About this file
This is a Change Order Form for Contract 2026-01, a Maintenance & Emergency Contract (Excavation) issued by West Manchester Township in Pennsylvania, with Herbert, Rowland & Grubic, Inc. serving as the engineer. The contract encompasses emergency and maintenance work for West Manchester Township-owned utilities, including repair and maintenance of existing sanitary sewer and storm sewer collection and conveyance systems, to be performed upon issuance of Work Orders by the Owner. The original contract bid opening occurred on May 20, 2026, with sealed bids received online until 10:00 AM local time, and bids were publicly opened through PennBID. The bidding documents were made available through the designated website https://pennbid.bonfirehub.com/, with prospective bidders required to register as plan holders. No pre-bid conference was scheduled for this project. Bid security was required in the form of a Certified Check or Bid Bond in an amount not less than 10% of the bid.
The Change Order Form presented is a blank template (EJCDC C-941, modified version) used to document modifications to the contract price and contract times, including provisions for changes in Substantial Completion dates and Ready for Final Payment dates. The form requires authorization signatures from the Engineer, Owner, and Contractor, with an additional approval line for the Funding Agency if applicable. The document does not contain filled-in pricing or schedule information, indicating this is a template for future use should change orders become necessary during project execution.
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Text version
Herbert, Rowland & Grubic, Inc. 00 63 63 - 1 007297.0444
CHANGE ORDER NO. X
Date of Issuance: Effective Date:
Owner: West Manchester Township Contract No.: 2026-01 Contractor: Contract Name:
Engineer: Herber, Rowland & Grubic, Inc. HRG Project No.: 007297.0444
Project: Maintenance & Emergency Contract (Excavation)
The Contract is modified as follows upon execution of this Change Order:
Description:
Attachments:
CHANGE IN CONTRACT PRICE CHANGE IN CONTRACT TIMES
[note changes in Milestones if applicable]
Original Contract Price: Original Contract Times:
Substantial Completion: _______________________ $ Ready for Final Payment: _______________________ days or dates
[Increase] [Decrease] from previously approved Change Orders No. to No. :
[Increase] [Decrease] from previously approved Change Orders No. to No. :
Substantial Completion:
$ Ready for Final Payment:
days
Contract Price prior to this Change Order: Contract Times prior to this Change Order:
Substantial Completion:
$ Ready for Final Payment:
days or dates
[Increase] [Decrease] of this Change Order: [Increase] [Decrease] of this Change Order:
Substantial Completion:
$ Ready for Final Payment:
days or dates
Contract Price incorporating this Change Order: Contract Times with all approved Change Orders:
Substantial Completion:
$ Ready for Final Payment:
days or dates
RECOMMENDED: AUTHORIZED BY: RECEIVED:
By: By: By:
Engineer (Authorized Signature) Owner (Authorized Signature) Contractor (Authorized Signature)
Title: Title: Title:
Date: Date: Date:
Approved by Funding Agency (if applicable)
By: Date:
Title:
Modified EJCDC® C-941, Change Order. Prepared and published 2018 by the Engineers Joint Contract Documents Committee.
File details come from the government source that posted it. Updated .