CONTRACT_CHANGE_REQUEST.pdf

PDF 32 KB Posted

Attached to
99th Street Path Construction Between Westfield Blvd and Haverstick Rd
Solicitation number
22-ENG-05
Issued by
Hamilton County, Indiana

About this file

This document is a Contract Change Request form issued by the City of Carmel for the 99th Street Path Construction project between Westfield Boulevard and Haverstick Road. The form is a standardized template designed to document and request modifications to an existing contract, with sections for describing the scope of work changes, reasons for the change, cost implications, potential timeline extensions, and personnel requirements. The form provides space for detailing the proposed contract modification, including approximate cost changes, additional contract time needed, and any impacts on project personnel.

The form does not contain specific details about the current contract modification, as all fields are blank. It serves as a structured mechanism for the City of Carmel to formally propose and track changes to the 99th Street Path Construction project contract. The document includes sections for identification of attachments, dates, preparer and reviewer signatures, and a space for comments and recommendations from the reviewing engineer. The blank form indicates that no specific contract change has been implemented at this time, but the template is ready to be used when modifications to the original contract become necessary.

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Text version

CITY OF CARMEL

TO: CONTRACT CHANGE REQUEST NO.:

DATE:

PROJECT NAME:

FROM:

IT IS REQUESTED THAT A CONTRACT CHANGE BE MADE TO THE ABOVE

REFERENCED CONTRACT.

1. SCOPE OF WORK (USE ADDITIONAL PAGES IF REQUIRED. ALSO LIST OTHER

CONTRACTS INVOLVED.)

2. REASON FOR CHANGE:

3. APPROXIMATE COST CHANGE TO CONTRACT PRICE: _____________________

4. WILL THE CONTRACT NEED ADDITIONAL CONTRACT TIME TO COMPLETE

THE CHANGE IN WORK SCOPE? _____ -YES _____ -NO _____ -(CALENDAR

DAYS)

5. WILL THE CONTRACTOR NEED ADDITIONAL PERSONNEL TO COMPLETE

THE CHANGE IN WORK SCOPE? _____ -YES _____ -NO

IF NO, TRADE(S): _____________________________________

NO. OF PERSONNEL: _________________________________

DURATION: ______________________________________

6. IDENTIFICATION OF ATTACHMENTS:

DATE: _______________________ DATE: ________________________

PREPARED

REVIEWED BY:____________ REVIEWED BY:____________________________

ENGINEER

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File details come from the government source that posted it. Updated .