Sample_Change_Order.pdf

The document is a Sample Change Order template from the Pinellas County Purchasing Department in Clearwater, Florida, designed to formally document modifications to an existing contract. The template provides a standardized format for recording changes to the total agreement value, including additions or deletions, with designated spaces for fiscal number, change order number, and account number. The form requires signatures from multiple parties, including the contractor, county attorney, Board of County Commissioners, and a clerk, to validate the change order.

The change order template includes a critical clause stipulating that the contractor's execution of the document constitutes a waiver of any additional time or compensation claims related to the activities covered in the change order. The document confirms that the authorized payment represents full compensation for labor, materials, incidental expenses, overhead, profit, impact costs, and associated work time. While this is a sample document and not tied to a specific contract, it is likely intended for use with Pinellas County's contracts, such as the referenced FY 2026 Pavement Preservation Package 3 project, which involves milling and resurfacing approximately 47.12 lane miles of roadway across five local neighborhood locations.