CONTRACT_CHANGE_ORDER.pdf
PDF 51 KB Posted
- Solicitation number
- 24-ENG-07b1
- Issued by
- Hamilton County, Indiana
About this file
This is a contract change order form issued by the City of Carmel, Indiana, designed to document modifications to construction contracts. The form provides a standardized template for recording changes to contract scope, pricing, and timeline. Key sections include a description of the scheduled adjustment items and associated costs or time extensions, reference documentation (such as RFP or Work Direction Change numbers), and calculation fields for revised contract price and completion dates. The form requires signatures and approval from the City Engineer (Brad Pease, PE), the contractor, and city officials including the Presiding Officer (Laura Campbell), City Clerk (Jacob Quinn), and Board Members (James Barlow and Alan Potasnik). The document version is dated September 23, 2024.
The contract change order form establishes that any modifications constitute full and final settlement of all direct, indirect, and impact costs associated with the changed work, as well as any approved time extensions. The form requires documentation of the original contract price and timeline, the adjustment amount, and the resulting new contract values before approval. Approval authority rests with the City Engineer, contractor authorization, and the Presiding Officer, with attestation by the City Clerk. This template is applicable to the City of Carmel's Raised Crosswalk Improvements project at Gray Road and Hazel Dell Roundabouts, which involves construction work at six intersections with a substantial completion date of August 10, 2026.
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Text version
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
File details come from the government source that posted it. Updated .