Work_Directive_Change_Form.pdf

PDF 119 KB Posted

Attached to
Rob Sullivan Park Maintenance Barn State and local contract opportunity
Solicitation number
05-15
Issued by
Volusia County, Florida

About this file

This is a Work Directive Change Form template used by the City of DeBary, Florida, for the Rob Sullivan Park Maintenance Barn project (Bid #05-15). The form provides a standardized mechanism for documenting and authorizing changes to the contract scope, with fields for identifying the work directive number, project name, effective date, owner, and contractor. The form requires a detailed description of the change and the reason for the change, establishing a clear record of project modifications and their justifications.

The form offers multiple methods for determining the financial and temporal impacts of changes. For contract price adjustments, the form accommodates Time and Materials, Unit Prices, Cost Plus Fixed Fee, or other determination methods, with provisions for documenting estimated increases or decreases in contract price and establishing authorization thresholds. Similarly, for contract time adjustments, the form allows for determination based on Contractor's Records, Engineer's Records, or other specified methods, with estimated increases or decreases measured in days. The form requires signatures from the City of DeBary's authorized representative, the contractor's authorized representative, and recommendation by the City, ensuring proper authorization and documentation of all contractual modifications before implementation.

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Text version

City of Debary – Rob Sullivan Park Maintenance Barn (Bid # 05-15)

SECTION 00945

WORK DIRECTIVE CHANGE FORM

Work Directive No.:

Name of Project:

Effective Date:

Owner:

Contractor:

Description of Change:

Reason for Change:

If a claim is made that the above change(s) have affected Contract Price or Contract Time, any claim for a Change Order based thereon will involve one of the following methods of determining the effect of the change(s).

Method of Determining the Change in Contract Price

Time and Materials Unit Prices Cost Plus Fixed Fee Other

Estimated increase (decrease) in Contract Price = $ . If the change involves an additional increase, estimated amount is not to be exceeded without further authorization.

Method of Determining the Change in Contract Time

Contractor’s Records Engineer’s Records As Specified Below Other

Estimated increase (decrease) in Contract Time = days. If the change involves an additional increase, estimated time is not to be exceeded without further authorization.

Recommended By:

City of DeBary Date

City of Debary – Rob Sullivan Park Maintenance Barn (Bid # 05-15)

Executed By:

Owner’s Authorized Representative Date

Contractor’s Authorized Representative Date

END OF SECTION

File details come from the government source that posted it. Updated .