Sample_Change_Order.pdf

This is a Sample Change Order form used by the Pinellas County Purchasing Department in Clearwater, Florida for modifying existing contracts. The document serves as a template for documenting contract modifications, including additions and deletions to the scope of work. The change order format includes fields for the fiscal number, change order number, account number, original total agreement amount, addition amounts, deletion amounts, and the resulting new total agreement value. The form requires execution by both the contractor and county officials, including approval by the Office of County Attorney, acceptance by the Pinellas County Attorney, and authorization by the Board of County Commissioners through the Chairman and Clerk signatures.

The change order establishes that execution by the contractor constitutes a waiver of all claims or requests for additional time or compensation for activities prior to the change order's execution that are related to the included items. The contractor acknowledges that payment authorized through the change order represents full and complete compensation for labor, materials, incidental expenses, overhead, profit, impact costs, and time associated with the work. All claim procedures are outlined in the underlying contract documents, and only authorized signatures are permitted on the form. This template is applicable to Pinellas County's Infrastructure Repair Work Order Contract, which covers reconstruction and repair projects including concrete repairs, site cleanup, milling and resurfacing, landscape work, fencing, sidewalk repairs, ADA ramps, sheet pile installation, and related incidental items throughout Pinellas County, Florida.