Sample_Change_Order.pdf
PDF 73 KB Posted
- Attached to
- SCB Replacement of Generator Controls and Switchgear (PID 004906DE) State and local contract opportunity
- Solicitation number
- 25-0073-ITB-C
- Issued by
- Pinellas County, Clewiston City, Florida
About this file
This document is a Sample Change Order template from the Pinellas County Purchasing Department in Clearwater, Florida, designed for documenting modifications to an existing contract. The template provides a standardized format for recording changes to contract terms, including additions, deletions, and adjustments to the total agreement amount. It is specifically related to the SCB Replacement of Generator Controls and Switchgear project (PID 004906DE) at the Pinellas County South Cross Bayou Advanced Waste Reclamation Facility, which involves removing and replacing two switchboard line-ups, including utility circuit breakers, generator circuit breakers, feeder circuit breakers, and automatic failover systems.
The change order template includes provisions that require the contractor to waive any claims for additional time or compensation for activities prior to the change order's execution. It stipulates that the authorized payment represents full compensation for labor, materials, incidental expenses, overhead profit, impact costs, and associated work. The document requires signatures from multiple parties, including an Investigator, Director of Purchasing, County Attorney, Board of County Commissioners Chairman, County Clerk, and the contracting company representative, ensuring a comprehensive review and approval process for any contract modifications.
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Text version
APPENDIX 2 – SAMPLE CHANGE ORDER
APPENDIX 2 – SAMPLE CHANGE ORDER
SAMPLE CHANGE ORDER
PINELLAS COUNTY PURCHASING DEPARTMENT
CLEARWATER, FLORIDA
FISCAL NO. CHANGE ORDER NO.
ACCOUNT NO.
TO Total Agreement $
FOR Addition $
IN CONNECTION WITH New Total $
Deletion $
New Total Agreement $
Execution by the contractor of this Change Order shall be considered a waiver of all claims or request for additional time or compensation for any activities prior to time of execution related to items included in the Change Order. The contractor also acknowledges that payment authorized by this Change Order represents full and complete compensation for labor, materials, incidental expenses, overhead profit, impact cost, and time associated with this Work. Claim procedures are outlined in the Contract documents.
Investigator
Director of Purchasing APPROVED AS TO FORM: Accepted this day of
OFFICE OF COUNTY ATTORNEY 20
By PINELLAS COUNTY Attorney BOARD OF COUNTY COMMISSIONERS
By Chairman
Attest: KEN BURKE, CLERK By
Deputy Clerk
Use Authorized Signatures Only Company
By Title
Witness
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