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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: Old Dixie Highway Sidewalk Improvements, 38" Lane to 45`h Street <br /> OWNER's Project No. 0845B ENGINEER's Bid No. 2014032 <br /> FM No. 423186-2-58-01 <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 Completion: <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 /> FAPublic Works\ENGINEERING DIVISION PROJECTS\08458-Old Dixie Hwy Sidewalk(38th Ln-45th St)Vadmim\bid documents\Master Contract Documents\00942- <br /> Change Order Form REV 04-07.doc Rev.05/01 <br />