Sample_Change_Order.pdf

This document is a Sample Change Order template from the Pinellas County Purchasing Department located in Clearwater, Florida. The form is designed to document modifications to an existing contract, with designated spaces for recording fiscal numbers, account numbers, total agreement amounts, additions, deletions, and new total agreement values. The change order includes provisions that require the contractor to waive any claims for additional time or compensation for activities prior to the change order's execution.

The template requires signatures from multiple parties, including an Investigator, Director of Purchasing, County Attorney, County Commissioners (specifically the Chairman), County Clerk, and the contractor. The document explicitly states that any payment authorized by the change order represents full compensation for labor, materials, incidental expenses, overhead profit, impact costs, and time associated with the work. The form is structured to ensure formal documentation and approval of contract modifications, with a clear emphasis on using only authorized signatures and maintaining a comprehensive record of contractual adjustments.