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 or project agreement. The template provides a structured format for recording changes in total agreement amount, including potential additions or deletions, with designated spaces for fiscal number, change order number, and account number. The form includes signature lines for various county officials, including the Director of Purchasing, County Attorney, Board of County Commissioners Chairman, and the contractor.

The change order template includes a critical disclaimer that execution of the change order constitutes a waiver of any additional claims or requests for compensation related to activities prior to the change order's execution. The document emphasizes 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 a specific contract, it is likely connected to the FY 2024 Pavement Preservation Package 2 project in Pinellas County, which involves milling and resurfacing approximately 31.2 miles of roadway across four paving locations, including one arterial and three neighborhood projects.