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i <br /> SECTION 00942 - Change Order Form <br /> No. <br /> DATE OF ISSUANCE: EFFECTIVE DATE: <br /> OWNER: Indian River County <br /> CONTRACTOR <br /> Project: ROUND ISLAND RIVERSIDE PARK PAVEMENT RESURFACING <br /> OWNER's Project No. 1619 OWNER'S Bid No. 2017017 <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 <br /> ompletion•-------- <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 <br /> 00942-1 <br /> F\Public Works\ENGINEERING DIVISION PROJECTS\1619 Round Island Facility Paving\t-Admin\bid documents\tvlaster Contract Documents\00942-Change Order Form <br /> REV 04-07.doc Rev 05/01 <br />