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SECTION 00942 - Change Order Form No. DATE OF ISSUANCE: EFFECTIVE DATE: OWNER: Indian River County CONTRACTOR Project: Vero Lake Estates Asphalt Millings Project (Phase I) Project No. 1314 Bid No. 2015010 You are directed to make the following changes in the Contract Documents: Description: Reason for Change Order: Attachments: (List documents supporting change) CHANGE IN CONTRACT PRICE: OWNER (Signature) Date: Description Amount Original Contract Price $ Net Increase (Decrease) from previous Change Orders No. to . $ Substantial Completion: Final Completion: Contract Price prior to this Change Order: $ Net increase (decrease) of this Change Order: $ Contract Price with all approved Change Orders: $ ACCEPTED: By: CONTRACTOR (Signature) Date: CHANGE IN CONTRACT TIMES OWNER (Signature) Date: Description Time Original Contract Time: Substantial Completion: Final Completion: (days or dates) Net change from previous Change Orders No. to: (days) Substantial Completion: Final Completion: Contract Time prior to this Change Order: Substantial Completion: Final Completion: (days or dates) Net increase (decrease) this Change Order: Substantial Completion: Final Completion: (days or dates) Contract Time with all approved Change Orders: Substantial Completion: Final Completion: (days or dates) RECOMMENDED: By: ENGINEER (Signature) Date: 00942 - 1 F:\Public Works\ENGINEERING DIVISION PROJECTS\1314-107th Ave Milling_90th St to 94th St\Admin\bid documentsWaster Contract Documents\00942 - hange Order Form REV 04-07.doc Rev. 05/01 APPROVED: By: OWNER (Signature) Date: 00942 - Change Order Form R V 04-07.doc