Sample_Change_Order.pdf
PDF 73 KB Posted
- Solicitation number
- 26-0144-ITB-C
- Issued by
- Pinellas County, Florida
About this file
This is a sample change order form from the Pinellas County Purchasing Department in Clearwater, Florida, applicable to the Light Electrical Commercial Repairs and Equipment contract. The document provides the standardized template and procedures for executing change orders to existing county contracts. The form accommodates both additions and deletions to the original agreement value, with designated fields for fiscal number, change order number, account number, and the resulting new total agreement amount. The change order requires execution by the contractor and must be approved by the county investigator, Director of Purchasing, Office of County Attorney, and the Board of County Commissioners, with final acceptance and authorization by company representatives and a witness.
The sample change order establishes important terms regarding contractor obligations and compensation limitations. Upon execution of a change order, the contractor waives all claims or requests for additional time or compensation for any activities prior to execution that relate to items included in the change order. The document explicitly states that payment authorized by the change order represents full and complete compensation for all labor, materials, incidental expenses, overhead, profit, impact costs, and time associated with the work. Claim procedures for any disputes are outlined in the primary contract documents, establishing a clear framework for managing scope modifications and cost adjustments within Pinellas County's procurement process.
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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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