Sample_Change_Order.pdf

This document is a Sample Change Order template from the Pinellas County Purchasing Department located in Clearwater, Florida. The form provides a standardized framework for documenting changes to an existing contract, with designated spaces to record fiscal numbers, account numbers, total agreement amounts, additions, deletions, and new total agreement values. The template includes signature lines for various county officials, including the Director of Purchasing, County Attorney, Board of County Commissioners Chairman, County Clerk, and the contracted company representative.

The change order form includes critical legal language indicating that the contractor's execution of the change order serves as a waiver of additional time or compensation claims for activities prior to the change order's execution. The document stipulates that the authorized payment represents full compensation for labor, materials, incidental expenses, overhead profit, impact costs, and associated work time. The form is designed to formally document and approve modifications to an existing contract, with provisions for comprehensive financial and operational adjustments while protecting the interests of Pinellas County.