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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: IRC HEALTH DEPARTMENT ROOF REPLACEMENT AND EXTERIOR REPAIR <br />PROJECT <br />OWNER's Project No. IRC -1736 OWNER'S Bid No. 2018013 <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 />$ <br />previous Change Orders No. <br />to <br />Contract Price prior to this <br />$ <br />Change Order. <br />Net increase (decrease) of this <br />$ <br />Change Order: <br />Contract Price with all approved <br />$ <br />Change Orders: <br />ACCEPTED: <br />By: <br />CONTRACTOR (Signature) <br />Date: <br />CHANGE IN CONTRACT TIMES <br />Description <br />Time <br />Original Contract Time: <br />(days or dates) <br />Substantial Completion: <br />Final Completion: <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 />(days or dates) <br />Substantial Completion: <br />Final Completion: <br />Net increase (decrease) this <br />Change Order. <br />(days or dates) <br />Substantial Completion: <br />Final Completion: <br />Contract Time. with all approved. <br />Change Orders: <br />(days or dates) <br />Substantial Completion: <br />Final Completion: <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.%Publlo WWWENGINEERINO DIVISION PROJECTS11730IRC'Healln Department Roof Replacement Projecl\1,f+dminMld DoamentslWaster Contract Dooumenlst00942 - <br />Change Ordet,F4rtn REV 04-07.doe Rev. 05/01 <br />