Exhibit_I_-_Change_Order_Form.pdf
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- Solicitation number
- 2025-25
- Issued by
- Miami-Dade County, Florida
About this file
This is a Change Order Form template used by the City of Doral, Florida for modifications to construction contracts. The form is designed to document authorized changes to existing contracts and includes provisions for contract extensions, scope of work modifications, and adjustments to contract amounts and timelines. The form requires detailed documentation of the proposed changes, including identification of the Field Work Order number, proposal number, and change request details, along with comprehensive justification for the requested modifications. Signatures from the contractor, the Capital Improvements Division Chief or Parks & Recreation Director, and the City Manager are required for authorization and execution of the change order.
The Change Order Form categorizes requested modifications by source, including Authority Having Jurisdiction (AHJ) requirements, errors and omissions, owner requests, contractor errors, vis major events, unforeseen conditions, and owner direct purchases. The form accommodates adjustments to both contract dollar amounts and contract time (measured in calendar days), with explicit designations for increases, decreases, or no change to the original contract terms. All material, equipment, and labor associated with the proposed scope of work modifications are included within the stated change order amount, and the form establishes clear financial tracking by documenting the original contract amount, previous authorized change orders, the current contract amount prior to the change order, and the new total contract amount following execution.
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Text version
Project Name:
Project Number:
, dated:
This change order includes all material, equipment and labor for the following scope of work:
Contract extension request: (Calendar Days) Justification Checked by:
Contract expiration date:
Total additional dollar amount requested:
Total Amount of this Change Order:
The City and Contractor agee to modify the original Contract by the following CHANGE ORDER amount:
Original Contract Amount……………………………………………………………………………………………………………….
Net change by Previous authorized Change Orders…………………………………………………………….………..
Contract Amount prior to this Change Order………………………………………………………………………………….
Contract Amount will be (increased)(decrease)(unchanged) in the amount of…………………………..
Contract Deduction for Owner Direct Purchase…
New Contract Amount including this Change Order………………………………………………………….…………..
Contract Time will be (increased)(decreased)(unchanged) by………………………………….….….…………..
Contractor Signature: Date:
Title: President
Authorized CITY Signature: Date:
Title: Capital Improvements Division Chief/Parks & Recs Director
Authorized CITY Signature: Date:
Title: City Manager
"For all the right reasons!"
SM
CHANGE ORDER FORM
To Contractor:
Contractor Address:
0 Days
The City and Contractor hereby agree to perform the changes to the work as shown on the Field Work Order No. , dated: N/A and/or the additional work as described on Proposal Number and/or Change Request:
PROPOSAL DESCRIPTION:
N/A
ACCEPTANCE: The above prices and specifications of the Change Order Proposal are satisfactory and are hereby accepted.
N/A
AHJ Requirement
Errors & Omissions
Owner Request
Contractor Error
Vis Major
Unforseen
Owner Direct Purchase
File details come from the government source that posted it. Updated .