Sample_Change_Order.pdf

This document is a Sample Change Order template from the Pinellas County Purchasing Department in Clearwater, Florida, designed to formally document modifications to an existing contract. The template provides a standardized format for recording changes to a contract's total agreement amount, including potential additions or deletions, with designated spaces for fiscal number, change order number, and account number. The form includes signature lines for various county officials, including the Director of Purchasing, County Attorney, Board of County Commissioners Chairman, and the Clerk, as well as for the contractor.

The change order template includes a critical clause stating that the contractor's execution of the change order constitutes a waiver of all claims for additional time or compensation for activities prior to the order's execution. It also acknowledges that the authorized payment represents full compensation for labor, materials, incidental expenses, overhead, profit, impact costs, and associated work time. This particular sample change order is related to the ARPA Paving and Local Roads project (PID 005651A), which involves milling and resurfacing five local subdivision roadways in the Ridgecrest, Lealman, and Highpoint communities, funded partially or fully by Coronavirus Local Fiscal Recovery Funds from the American Rescue Plan Act (ARPA).