Sample_Change_Order.pdf

This document is a Sample Change Order template from the Pinellas County Purchasing Department in Clearwater, Florida, designed for modifying existing contract agreements. The form provides a standardized framework for documenting changes to contract terms, including additions or deletions to the total agreement amount, with designated spaces for fiscal number, change order number, and account number. The change order includes provisions that require the contractor to waive all claims for additional time or compensation related to the changes, and acknowledges that the authorized payment represents full compensation for labor, materials, expenses, overhead, profit, and associated work.

The template is structured to capture financial adjustments and require multiple levels of approval, including signatures from the County Attorney's Office, the Board of County Commissioners (with a specific line for the Chairman), and the County Clerk. It also includes a section for the contractor's company representative to accept and sign the change order. While this is a generic sample form, it is specifically related to the Annual Sanitary Sewer Repair and Extension FY24-FY26 project, which involves repair, rehabilitation, and replacement of sanitary sewer infrastructure throughout Pinellas County, Florida.