CONTRACT_CHANGE_ORDER.pdf
PDF 51 KB Posted
- Attached to
- 106th and Westfield Water Main Extension
- Solicitation number
- IFB-2026-006
- Issued by
- Hamilton County, Indiana
About this file
This is a Contract Change Order form issued by the City of Carmel, Indiana. The document serves as a template for documenting modifications to existing contracts within the city's procurement process. The form provides structured sections for describing changes to contract scope of work, specifying adjusted line items with corresponding cost amounts and schedule impacts measured in days. The change order references supporting documentation including Requests for Proposal (RFP), Work Distribution Code (WDC) numbers, and other relevant contract exhibits. The form tracks contract price adjustments by displaying the original contract price, the increase or decrease amount resulting from the change order, and the new total contract price. Similarly, it documents contract time modifications by noting the original contract completion date, any net adjustment in days, and the revised completion date.
The change order explicitly states that it constitutes full and final settlement of all direct, indirect, and impact costs and time extensions resulting from the changed work. Approval authority is distributed among multiple city officials, including the City Engineer (Brad Pease, PE), the Presiding Officer (Laura Campbell), and board members (James Barlow and Alan Potasnik), along with the City Clerk (Jacob Quinn) for attestation. The contractor must also execute the change order by authorized representative. Signature lines and date fields are provided for all parties to evidence their acceptance of the modifications and associated adjustments to contract price and timeline.
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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 .