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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 />B id No. 2014009 <br />P roject. Indian River Boulevard Resurfacing (US 1 to 17th Street) <br />OWNER's Project No. 1302 <br />Engineer: Indian River County <br />You are directed to make the following changes in the Contract Documents: <br />D escription: <br />Reason for Change Order: <br />Attachments: (List documents supporting change) <br />00942 - 1 <br />F:\Public Works\ ENGINEERING DIVISION PROJECTS\1302-IR Blvd Resurfacing (SCOP) USI to 17th St\Admim\bid documents\00942 - Change Order Form REV 04-07.doc <br />Rev 05/01 <br />CHANGE IN CONTRACT PRICE: <br />CONTRACTOR (Signature) <br />Date: <br />CHANGE IN CONTRACT TIMES <br />Description <br />Amount <br />Original Contract Price <br />$ <br />(days or dates) <br />Net Increase <br />previous <br />(Decrease) from <br />Change Orders No. <br />to . <br />$ <br />(days) <br />Contract Price prior to this <br />Change Order: <br />$ <br />Contract Time prior to this Change <br />Order: <br />Substantial Completion: <br />Final Completion: <br />Net increase(decrease) this ease) of <br />Change Order: <br />$ <br />Net increase (decrease) this <br />Change Order: <br />Substantial Completion: <br />Final Completion: <br />Contract Price with all approved <br />Change Orders: <br />$ <br />Contract Time with all approved <br />Change Orders: <br />Substantial Completion: <br />Final Completion: <br />00942 - 1 <br />F:\Public Works\ ENGINEERING DIVISION PROJECTS\1302-IR Blvd Resurfacing (SCOP) USI to 17th St\Admim\bid documents\00942 - Change Order Form REV 04-07.doc <br />Rev 05/01 <br />ACCEPTED <br />By: <br />CONTRACTOR (Signature) <br />Date: <br />CHANGE IN CONTRACT TIMES <br />00942 - 1 <br />F:\Public Works\ ENGINEERING DIVISION PROJECTS\1302-IR Blvd Resurfacing (SCOP) USI to 17th St\Admim\bid documents\00942 - Change Order Form REV 04-07.doc <br />Rev 05/01 <br />RECOMMENDED: <br />By: <br />CHANGE IN CONTRACT TIMES <br />Description <br />Time <br />Original Contract Time. <br />Substantial Completion: <br />Final Completion: <br />(days or dates) <br />Net change from previous Change <br />Orders No. to : <br />(days) <br />Substantial Completion: <br />Final Completion: <br />Contract Time prior to this Change <br />Order: <br />Substantial Completion: <br />Final Completion: <br />(days or dates) <br />Net increase (decrease) this <br />Change Order: <br />Substantial Completion: <br />Final Completion: <br />(days or dates) <br />Contract Time with all approved <br />Change Orders: <br />Substantial Completion: <br />Final Completion: <br />(days or dates) <br />00942 - 1 <br />F:\Public Works\ ENGINEERING DIVISION PROJECTS\1302-IR Blvd Resurfacing (SCOP) USI to 17th St\Admim\bid documents\00942 - Change Order Form REV 04-07.doc <br />Rev 05/01 <br />RECOMMENDED: <br />By: <br />ENGINEER (Signature) <br />Date: <br />00942 - 1 <br />F:\Public Works\ ENGINEERING DIVISION PROJECTS\1302-IR Blvd Resurfacing (SCOP) USI to 17th St\Admim\bid documents\00942 - Change Order Form REV 04-07.doc <br />Rev 05/01 <br />00942 - Change Order Form REV 04-07.doc <br />APPROVED* <br />By: <br />OWNER (Signature) <br />Date: <br />00942 - Change Order Form REV 04-07.doc <br />