Sample_Change_Order.pdf

This is a Sample Change Order document from the Pinellas County Purchasing Department in Clearwater, Florida, designed for use in connection with the Ridgemoor Boulevard and Brooker Creek Bridge #154153 Bridge Replacement Project. The change order template provides a standardized format for documenting modifications to the original contract agreement, including additions and deletions to the scope of work. The form requires specification of the fiscal number, change order number, account number, original total agreement amount, addition amounts, deletion amounts, and the resulting new total agreement value. The document establishes that execution of the change order 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 date that are related to the included items.

The change order requires approval and signature authorization from multiple parties, including the Investigator, Director of Purchasing, Office of County Attorney, Board of County Commissioners Chairman, County Clerk, and the contractor. 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, with claim procedures outlined in the original contract documents. This template is applicable to the federally funded Local Agency Program (LAP) project administered through the Florida Department of Transportation (FDOT) for the bridge replacement work along Ridgemoor Boulevard.