Sample_Change_Order.pdf

This is a Sample Change Order form from the Pinellas County Purchasing Department in Clearwater, Florida, designed for use in conjunction with the South Cross Bayou Replacement of Generator Controls and Switchgear project. The change order document provides a structured template for documenting modifications to the original contract, including provisions for additions and deletions to the scope of work with corresponding adjustments to the total agreement value. The form requires signature authorization from the contractor, the Investigator, the Director of Purchasing, the Office of County Attorney, and the Board of County Commissioners, with attestation by the Clerk, establishing a formal approval process for any contract modifications.

The change order form explicitly states that execution by the contractor constitutes a waiver of all claims or requests for additional time or compensation for any activities prior to the change order's execution date related to included items. The contractor acknowledges that payment authorized by the change order represents full and complete compensation for labor, materials, incidental expenses, overhead, profit, impact costs, and time associated with the work, with claim procedures outlined in the contract documents. The template includes line items for Fiscal Number, Change Order Number, Account Number, addition amounts, deletion amounts, and new total agreement value, providing a comprehensive mechanism for formal contract modifications within Pinellas County's procurement framework.