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SECTION 00942 - Change Order Form <br /> No , <br /> DATE OF ISSUANCE : EFFECTIVE DATE : <br /> OWNER : Indian River County <br /> CONTRACTOR <br /> Bid No . 2012033 <br /> Project : 6th enue S . W . Culvert Replacement North of 23rd Street S W <br /> OWNER 's Project No . 1136 <br /> ENGINEER Indian River County <br /> You are directed to make the following changes in the Contract Documents : <br /> Description : <br /> Reason for Change Order : <br /> Attachments : ( List documents supporting change ) <br /> CHANGE IN CONTRACT PRICE : CHANGE IN CONTRACT TIMES <br /> Description Amount Description Time <br /> Original Contract Price $ Original Contract Time : ( days or dates ) <br /> Substantial Completion : <br /> Final Com letion : <br /> Net Increase ( Decrease ) from $ Net change from previous Change <br /> previous Change Orders No , Orders No . to ( days ) <br /> to Substantial Completion : <br /> Final Completion : <br /> Contract Price prior to this $ Contract Time prior to this Change <br /> Change Order : Order : ( days or dates ) <br /> Substantial Completion : <br /> Final Completion : <br /> Net increase ( decrease ) of this $ Net increase ( decrease ) this <br /> Change Order : Change Order : ( days or dates ) <br /> Substantial Completion : <br /> Final Completion : <br /> Contract Price with all approved $ Contract Time with all approved <br /> Change Orders : Change Orders : ( days or dates ) <br /> Substantial Completion : <br /> Final Completion : <br /> ACCEPTED : RECOMMENDED : APPROVED : <br /> By : By : By : <br /> CONTRACTOR ( Signature ) ENGINEER ( Signature ) OWNER ( Signature ) <br /> Date : Date : Date : <br /> 00942 - Change Order Form REV 04-07 . doc <br /> 00942 - 1 <br /> F :\Public Works\ENGINEERING DIVISION PROJECTS\ 1136-6th Ave SW_ Culvert Replacement N of 23rd St SW\Admim\Contract Documents\00942 - Change Order <br />Form <br /> REV 04 -07 .doc Rev . 05101 <br />