Exhibit_L_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 document used by the City of Doral, Florida for modifying existing contracts. The form provides a standardized template for authorized city officials and contractors to document modifications to original contract terms, including changes to scope of work, contract amounts, and contract duration. The form accommodates various types of changes including contract extensions, cost adjustments, and time modifications, with designated signature lines for both contractor authorization (President) and city authorization (Capital Improvements Division Chief/Parks & Recreation Director and City Manager). The change order references field work orders, proposals, and change requests as supporting documentation, with provision for categorizing the nature of changes such as authority jurisdiction (AHJ) requirements, errors and omissions, owner requests, contractor errors, force majeure events, or owner direct purchases.
The form structure requires documentation of the original contract amount, accumulated previous change order amounts, the current proposed change order amount, and the resulting new total contract amount and timeline. While specific pricing terms and contract amounts are not populated in this template version, the document establishes the procedural framework for cost increases, decreases, or no change scenarios, as well as for contract time adjustments. The form does not specify set-asides, incumbents, or funding sources, as it serves as a blank template for future use across city projects rather than a document tied to a specific solicitation or active contract.
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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 .