Sample_Change_Order.pdf

This is a sample change order template from the Pinellas County Purchasing Department in Clearwater, Florida, designed for use with state and local contracts. The document provides a standardized format for documenting modifications to existing agreements, including provisions for additions and deletions to the original contract scope. The change order requires execution by both the contractor and county representatives, including approval by the Office of County Attorney and authorization by the Board of County Commissioners, with documentation by the County Clerk.

The change order template 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 date. The document specifies 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 performed. The form includes fields for fiscal number, change order number, account number, total agreement amount, addition and deletion amounts, and new total agreement amount. Claim procedures related to change orders are outlined in the underlying contract documents and must be followed for any disputes or additional requests.