Sample_Change_Order.pdf

This is a sample change order form used by the Pinellas County Purchasing Department in Clearwater, Florida for construction projects. The form provides a standardized template for documenting modifications to existing contracts, including additions and deletions to the total agreement value. The change order requires authorization from the contractor, County Attorney's office, and the Board of County Commissioners, with execution requiring the contractor's signature and approval by designated county officials including the Director of Purchasing, County Attorney, Board Chairman, and County Clerk. The document establishes that execution of the change order constitutes a waiver of all claims or requests for additional time or compensation for activities prior to the change order execution date related to the included items.

The change order form specifies that payment authorized through the document represents full and complete compensation for all labor, materials, incidental expenses, overhead, profit, impact costs, and associated work. The form includes designated fields for fiscal number, change order number, account number, original total agreement amount, addition amounts, deletion amounts, and new total agreement value. Claim procedures for disputes or additional compensation requests are referenced as being outlined in the underlying contract documents, establishing a clear dispute resolution framework for contractors working on Pinellas County projects.