CONTRACT_CHANGE_ORDER.pdf

CITY OF CARMEL

TO: CONTRACT CHANGE ORDER NO.:

DATE:

PROJECT NAME:

CITY REQ. NO.:

CITY PO NO.:

CITY PO DATE: _

I. You are directed to make the following changes in this Contract:

(Brief Description)

SCHEDULED ADJUSTMENT

ITEM AMOUNT (+) OR (-) DAYS

II. The following referenced Documents further describe the changes outlined in Paragraph I, and are to be considered a part of this Change Order: R.F.P.: ________ W.D.C. No.: _______ Other:_____________________________________________________________________

The changes result in the following adjustment of Contract Price and Contract Time:

Contract Price prior to this Change Order $_______________________ Contract Price will be increased/decreased by this Change Order $_______________________ New Contract Price including this Change Order $_______________________ Contract Time Prior to this Change Order ______ Days _______ Completion Date Net increased/decreased resulting from this Change Order_____ Days Current Contract Time including this Change Order_____ Days _______ Completion Date This Change Order is for full and final settlement of all direct, indirect, impact costs and time extensions incurred at any time resulting from the performance of the changed work.

The Above Changes Are Recommended

The Above Changes Are Accepted:

Approved:

ENGINEER CONTRACTOR Laura Campbell, Presiding Officer

Address Address James Barlow, Member

Alan Potasnik, Member

City/State/Zip City/State/Zip Brad Pease, PE, City Engineer

By:

By:

ATTEST:

Phone:__________________ Phone:__________________ Jacob Quinn, Clerk

Date:___________________ Date:___________________ Date: _________________

Version 2024-09-23