Sample_Change_Order.pdf

This document is a Sample Change Order form from the Pinellas County Purchasing Department located in Clearwater, Florida. The form provides a template for documenting modifications to an existing contract, with spaces to record fiscal numbers, account numbers, total agreement amounts, additions, deletions, and new total agreement values. The change order includes provisions that require the contractor to waive any claims for additional time or compensation related to the changes, and acknowledges that the authorized payment represents full compensation for labor, materials, incidental expenses, overhead, profit, impact costs, and associated work.

The change order form includes signature lines for various official parties, including an Investigator, Director of Purchasing, County Attorney, County Commissioners, County Clerk, and the contractor. The document emphasizes that only authorized signatures should be used and that claim procedures are outlined in the separate contract documents. While this is a sample template, it is specifically tied to the Pinellas County Drawbridge Services contract for preventative maintenance and emergency repair services for three bascule bridges, as indicated in the related contract opportunity description.