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

PDF 648 KB Posted

Attached to
Roadway Resurfacing Repair and Preservation Districts 3&4 WORCS
Solicitation number
IFB-26-00363
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 document serves as formal acknowledgment from a surety company that it consents to modifications made to an existing contract between the county and a contractor. The form requires identification of the contract title, the contractor (principal), the surety company, and the surety's agent. The surety must acknowledge and agree to a specific change order number, which may increase or decrease the contract amount by a stated dollar figure and/or extend the completion date by a specified number of calendar days. The document confirms that the performance bond and payment bond originally furnished under the contract will be adjusted accordingly to reflect the changes in contract amount and timeline.

The form requires authorization by an authorized representative of the surety company or an attorney in fact, along with a notarized signature. The notarization must occur in the State of Florida, Hillsborough County, and can be executed through either physical presence or online notarization. The document includes standard fields for the notary public's signature, printed name, and identification of the person being notarized, along with the date of notarization. This form is applicable to the Roadway Resurfacing Repair and Preservation Districts 3 and 4 project, a $16,000,000 contract for roadway resurfacing and preservation work throughout Hillsborough County involving milling, resurfacing, preservation treatments, and full-depth reclamation methods, with a 5% Small Business Enterprise (SBE) 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 .