4-Consent of Surety-Change Order.pdf.pdf

PDF 648 KB Posted

Attached to
Sidewalk Replacement and Repair - South (WORCS 2)
Solicitation number
IFB-26-00297
Issued by
Hillsborough County, Florida

About this file

This is a Consent of Surety to Change Order form used by Hillsborough County, Florida for construction contracts. The form serves as formal acknowledgment by a surety company that it consents to modifications of an existing contract with the county. The document requires the surety to acknowledge and agree to a specific change order number, which may increase or decrease the contract amount by a specified dollar figure and/or extend the completion date by a designated number of calendar days. The surety further confirms that both the performance bond and payment bond furnished under the original contract are adjusted accordingly to reflect the changes in contract amount and/or timeline specified in the change order.

The form requires execution by an authorized representative of the surety company, either as an officer with company seal or as an attorney-in-fact with attached power of attorney documentation. The document must be notarized in Hillsborough County, Florida, with the notary public certifying the identity and authority of the signing party. The form was last revised on March 9, 2020, and is applicable to the Sidewalk Replacement and Repair - South project (WORCS 2), a Hillsborough County Engineering and Operations Department initiative with an estimated contract value of $10,000,000.00 that includes sidewalk replacement, repairs, ADA compliance upgrades, and site restoration work, with a 9% Small Business Enterprise subcontractor participation goal.

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Text version

CONSENT OF SURETY TO CHANGE ORDER

CONTRACT TITLE:

CONTRACTOR (PRINCIPAL):

SURETY:

AGENT:

The SURETY does hereby acknowledge and agree to Change Order No. to the above referenced contract with Hillsborough County, the contract amount

(increasing/decreasing) by $ , and/or extending the completion date by ( ) calendar days. The SURETY further acknowledges that the performance bond and/or payment bond furnished under the aforementioned contract is accordingly changed to reflect the change in contract amount, and/or time included in Change Order No. .

This Consent is dated this day of , 20 .

SURETY:

BY: (SEAL)

Authorized Signature

-OR-

BY: (SEAL)

As Attorney in Fact (Attach Power of Attorney)

Printed Name

STATE OF FLORIDA

COUNTY OF HILLSBOROUGH

The foregoing instrument was acknowledged before me by means of physical presence or online notarization this ___ day of ____________, 20___, __________________________ by (Name of person)

________________________ for _________________________________________________.

(ie. Officer, attorney in fact) (Name of party on behalf of whom instrument was executed.)

(Signature of Notary Public)

(Print, Type, or Stamp Name of Notary Public)

Personally Know OR Produced Identification

Type of Identification Produced __________________

Revised 03.09.2020

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