Sample_Change_Order.pdf

This 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 amount, including potential additions or deletions, with designated spaces for fiscal number, change order number, and account number. The form includes provisions that require the contractor to acknowledge that executing the change order constitutes a waiver of additional time or compensation claims related to the documented changes.

The change order template is structured to capture comprehensive financial adjustments, with sections for recording the original total agreement amount, any additions or deletions, and the resulting new total agreement value. The document emphasizes that any payment authorized through the change order represents full compensation for labor, materials, incidental expenses, overhead, profit, impact costs, and associated time. The form requires signatures from multiple parties, including an investigator, Director of Purchasing, County Attorney, Board of County Commissioners Chairman, County Clerk, and the contractor, ensuring a multi-level review and approval process for contract modifications.