25-25-728 Attachment 12 ChangeOrderProposalForm.pdf
PDF 530 KB Posted
- Solicitation number
- 2025-728
- Issued by
- King County, Washington
About this file
This is a Contract Change Order Proposal (COP) form (DES-EA-099, Revised 03-03-2025) issued by the Washington State Department of Enterprise Services for use on Professional Facilities Services (FPS) contracts. The form provides a standardized process for contractors to submit proposals for changes to existing contract work. The contractor must describe the change work in detail or reference attached Cost Estimate Detail Sheets, specify whether the change impacts contract sum (increase, decrease, or no change) and contract time (increase, decrease, or no change), identify the reason for the change through categories including latent conditions, code requirements, design errors, design omissions, value engineering, or alternative public works, and indicate the calendar days required to complete the change work. The proposal must be submitted within 14 days of the request date unless an alternative date is agreed upon, and all provisions of the original contract remain in full force and effect pending incorporation of the COP into a formal Change Order by the Department of Enterprise Services.
The form requires cost documentation through attached detail sheets and includes signature blocks for verification and approval by the contractor, Architect/Engineer (A/E), FPS Project Manager, FPS Management (required for changes exceeding $50,000), and the authorizing signatory from the client agency. The A/E must certify that the cost is reasonable and recommend acceptance. The contractor acknowledges that submission of the COP does not authorize proceeding with the specified changes until the Department of Enterprise Services formally incorporates the proposal into a Change Order. The form applies to the Bellevue College Parking Garage Update project, a General Contractor/Construction Manager (GC/CM) delivery method contract at Bellevue College in Washington State.
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Text version
COP No.
PROJECT TITLE
TO: (CONTRACTOR) PROPOSAL REQUEST DATE:
TO: (A/E) TO:
WE AGREE TO PERFORM ALL CHANGE IN THE WORK DESCRIBED IN THE PROPOSAL REQUEST FOR:
CONTRACT SUM:
OF
(WASHINGTON STATE SALES TAX NOT INCLUDED)
OF CALENDAR DAYS
BY
DATE
DATEFPS PROJECT MANAGER
FORM DES-EA-099 (Revised 03-03-2025)
DATE
A/E
CLIENT AGENCY
TO: The Department of Enterprise Services' Authorizing Signator We have carefully examined this proposal and find the cost to be reasonable. Therefore, we recommend acceptance.
SIGNATURE CONTRACTOR
FPS COST VERIFICATION (PM < $50k > CE)
DATE
R E
C O
M M
E N
D A
T
IO
N C
O N
T R
A C
T O
R P
R O
P O
S A
L
P
R O
P O
S A
L R
E Q
U E
S T
In accordance with the General Conditions, Cost Estimate Detail Sheet(s) are attached hereto.
CONTRACT TIME:
You are directed to prepare a cost proposal for the work described below and/or detailed on the attachments referred to:
DATE
The foregoing amount covers everything required in connection with the change. All other provisions of the contract remain in full force and effect.
(14 days from Request Date, unless other date agreed to)
REASON FOR CHANGE:
EXPLANATION:
DATE PROPOSAL REQUIRED:
CHANGE ORIGINATED BY:
PROPOSAL REQUESTED BY:
PM (FPS)
AGENCYFACILITY PROFESSIONAL SERVICES (FPS)
CONTRACT CHANGE ORDER
PROPOSAL (COP)
CONTRACT
NO.
AGENCY LATENT CONDITIONS
CODE REQUIREMENTS VALUE ENGINEERING
DESIGN ERRORS DESIGN OMMISSIONS
INCREASE
NO CHANGE
DECREASE
NO CHANGE
INCREASE
DECREASE
ALTERNATIVE PUBLIC WORKS CONSTRUCTION PHASE (W)
FPS Management Initials required for Changes to Contract Time
INITIALS DATE
FPS MANAGEMENT (> $50k) DATE
We understand that this proposal does not constitute authorization to proceed with the specified changes in the work until incorporation of this COP into a Change Order by the Department of Enterprise Services.
| COP No: |
| CALENDAR DAYS: |
| CONTRACTOR: |
| DATE_2: |
| DATE_3: |
| DATE_4: |
| DATE_5: |
| Text3: |
| Date4_af_date: |
| AE: |
| Dollars: |
| Amout: |
| Scope of work: |
| Explanation: |
| Date Required: |
| Change Originated by: |
| Proposal requested by: |
| Reason For Change: Latent Conditions |
| Contract NO: |
| Date: |
| NoChangeContractSum: Off |
| IncreaseContractSum: Off |
| DecreaseContractSumm: Off |
| NoChangeContractTime: Off |
| IncreaseContractTime: Off |
| DecraeseContractTime: Off |
| E&AS project manager: |
| Contractor signature: |
| AE Signature: |
| Agency Signature: |
| Cost Verification Signature: |
| PM Signature: |
| Project Title: |
| Agency: |
| APM INITIALS: |
| APM Date: |
| Text7: |
| FPS Managment Signature (>$50k): |
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