Sample_Change_Order.pdf

This is a sample change order template document from the Pinellas County Purchasing Department in Clearwater, Florida, designed for use in construction and service contracts. The template provides a standardized format for documenting modifications to existing agreements, including provisions for additions and deletions to the contract scope. The change order requires authorization of additional compensation or time adjustments and must be executed by the contractor, the Pinellas County Attorney's Office (for legal approval), the Director of Purchasing, and the Board of County Commissioners through the Chairman and County Clerk. Key fields include fiscal number, change order number, account number, total agreement amount, addition amount, deletion amount, and the resulting new total agreement value. The document includes a critical waiver clause stating that contractor execution constitutes a waiver of all claims for additional time or compensation for activities prior to change order execution, and that authorized payment represents full and complete compensation for labor, materials, incidental expenses, overhead, profit, impact costs, and time.

The sample change order structure establishes that all compensation claims must follow procedures outlined in the underlying contract documents. The form requires execution by an authorized company representative with witness signature and incorporates multi-level approval authority including the County Attorney's Office review for legal sufficiency, the Director of Purchasing approval, and final authorization by the Board of County Commissioners. This template would be applicable to the STAR Center AHU Replacement project (ITB-C #26-0306) and similar Pinellas County construction contracts, ensuring consistent documentation and approval procedures for any modifications to the original contract terms, scope, or pricing.