11-F. Master Change Order Form.pdf

PDF 17 KB Posted

Attached to
Heritage Hills PID New Improvement Project
Solicitation number
BVB 416-26 KD
Issued by
Orange County, Texas

About this file

This is a Master Change Order Form template used by the City of Amarillo Development Services Department for managing contract modifications on public works projects. The form is designed to track changes to original contract estimates, quantities, unit prices, and contract timelines for construction and improvement projects within the city's jurisdiction.

The form provides fields for documenting the change order number, original and revised estimates, changes in quantities and unit pricing, and the net dollar impact of the modification. It requires approval signatures from the contractor, engineer, development services coordinator, and city manager, with distribution to departmental accounting, contractor representatives, and public works project coordinators. The template allows for documentation of revised contract time measured in working days and includes space for a detailed description of the change. The form itself contains no specific project values, quantities, or dates, serving as a blank template for future use on city improvement projects such as the Heritage Hills Public Improvement District infrastructure initiative.

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Text version

DATE:

CHANGE ORDER NO.

ORIGINAL REVISED NET NET

ITEM ESTIMATE ESTIMATE CHANGE UNIT UNIT CHANGE

NO. DESCRIPTION QUAN. QUAN. IN QUAN. MEASURE PRICE IN DOLLARS

NET THIS CHANGE ORDER $ 0.00

PREVIOUS CHANGE ORDERS $ 0

TOTAL OF CHANGE ORDERS $ 0.00

ORIGINAL CONTRACT TOTAL $

REVISED CONTRACT TOTAL $ 0.00

APPROVED: RECOMMENDED:

Contractor Engineer

By DEVELOPMENT CUSTOMER SERVICE COORDINATOR

City Manager cc: Departmental

Accounting

Contractor

Project Representative

Public Works Project Coord.

REVISED CONTRACT TIME IN WORKING DAYS- 0

DESCRIPTION OF CHANGE

CHANGE ORDER

CITY OF AMARILLO

DEVELOPMENT SERVICES DEPARTMENT

CONTRACTOR:

JOB NO.

File details come from the government source that posted it. Updated .