Sample_Change_Order.pdf

This is a Sample Change Order form from the Pinellas County Purchasing Department in Clearwater, Florida, designed to document modifications to existing contracts. The form is structured to capture essential change order information including the fiscal number, change order number, account number, and the original total agreement amount. It accommodates both additions and deletions to the contract scope, with fields to calculate the new total agreement value. The form requires execution by the contractor, which constitutes acknowledgment that the change order represents full and complete compensation for all labor, materials, incidental expenses, overhead, profit, impact costs, and time associated with the work being modified.

The change order requires approval signatures from multiple parties including an Investigator, the Director of Purchasing, the Office of County Attorney, and the Board of County Commissioners, with attestation by the County Clerk or Deputy Clerk. Execution of the change order by the contractor serves as a waiver of all claims or requests for additional time or compensation for any activities prior to the execution date that are related to items included in the change order. The document establishes that claim procedures are outlined in the underlying contract documents, ensuring clear delineation of contractor rights and county obligations regarding modifications to the original agreement scope and compensation.