5-16. Attachment O - Sample Master Change Order Form.pdf

This is a Sample Master Change Order Form attachment provided by the City of Amarillo for the Osage Water Treatment Plant (WTP) Settling Basin Repairs Phase 02 - West Basin project in Texas. The form serves as a template for documenting and processing change orders throughout the contract execution period, establishing a standardized procedure for contractors to request modifications to the original contract scope of work, schedule, or cost. The document outlines the administrative framework for tracking changes, including fields for change order identification, description of work modifications, and authorization signatures from both the contractor and city representatives, ensuring clear communication and documentation of any deviations from the bid specifications.

The Master Change Order Form establishes pricing protocols for requested changes, requiring detailed cost breakdowns that include labor, materials, equipment, and overhead allocations. The form includes provisions for schedule impact analysis, contract amount adjustments, and approval workflows that necessitate signatures from appropriate city officials before implementation. This standardized approach protects both the City of Amarillo and the contractor by creating a transparent mechanism for managing scope changes, preventing disputes over unapproved modifications, and maintaining clear records of all contract amendments throughout the project duration for the settling basin repair work at the West Basin facility.