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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 />Project: CR512 Resurfacing from 125th Avenue to 1-95 <br />OWNER's Project No. 1304 OWNER'S Bid No. 2016003 <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: <br />Description <br />Amount <br />Original Contract Price <br />$ <br />Net Increase (Decrease) from <br />previous Change Orders No. <br />to : <br />$ <br />Substantial Completion: <br />Final Completion. <br />Contract Price prior to this <br />Change Order <br />$ <br />Net increase (decrease) of this <br />Change Order. <br />$ <br />Contract Price with all approved <br />Change Orders: <br />$ <br />ACCEPTED. <br />By: <br />CONTRACTOR (Signature) <br />Date: • <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 />RECOMMENDED: <br />By: <br />ENGINEER (Signature) <br />Date: <br />APPROVED: <br />By: <br />OWNER (Signature) <br />Date: <br />00942 - Change Order Form REV 04-07 <br />00942 - 1 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1304-CR 512 Resurf (SCOP)_125th Ave to I-95/Admim\bid documents\Master Contract Documents\00942 - Change <br />Order Form REV 04-07.doc Rev 05/01 <br />