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SECTION 00942 - Change Order Form <br />No. 1 <br />DATE OF ISSUANCE: May 10, 2018 EFFECTIVE DATE: May 10, 2018 <br />OWNER: Indian River County <br />CONTRACTOR Blue Goose Construction. <br />Project: Forest Park Water Main Ext. <br />OWNER'S Bid No. WA 2017-008 <br />You are directed to make the following changes in the Contract Documents: <br />Description: Add/Deduct line items/quantities from contract. <br />Reason for Change Order: Final Pay Application: Adjust contract amount to reflect actual <br />constructed material and quantities, and delete contingency. <br />Attachments: See itemized schedule <br />CHANGE IN CONTRACT <br />y�OhtiMISS/p.. <br />PRICE: <br />Time <br />Description <br />Amount <br />Original Contract Price <br />$74,920.78 <br />Net Increase (Decrease) <br />$0.00 <br />from previous Change <br />.oQi <br />Orders No. <br />(days) <br />Contract Price prior to this <br />$74,920.78 <br />Change Order: <br />Net increase (decrease) of <br />($14,532.38) <br />this Change Order: <br />(days or dates) <br />Contract Price with all <br />$60,388.40 <br />approved Change Orders: <br />ACCEPTED: <br />By: <br />CONTRACTOR (Signature) <br />Date: �� f <br />CHANGE IN CONTRACT TIMES <br />y�OhtiMISS/p.. <br />Description <br />Time <br />Original Contract Time: <br />(days or dates) <br />Substantial Completion: <br />s* <br />Final Completion: <br />Net change from previous Change <br />.oQi <br />Orders No.: <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 />,a, J, / /7: ?? , <br />?16 [NEER (Signat e) <br />Date: 4/�/ 20/ <br />APPROVED: <br />OWNER (Signature) <br />Bob Solari, Vice Chairmar <br />Date: June 5, 2018 <br />APPROVED AS TO FORM <br />y�OhtiMISS/p.. <br />AND LEGAL SUFFICIENCY <br />,���'�' • �F�'� <br />- <br />BY <br />s* <br />DNrL. AN RE1NG0L0 <br />COUNTY ATTORNEY <br />.oQi <br />C:\Users\tgormanlAppData\Local\Microsoft\Windows\INetCache\Content.Outlook\7DX40179\CO-1 WA2017-008.docx <br />00942-1 <br />o= <br />y ->.w 8•'�: <br />•'•._ R/lir : �e1� .•' <br />0 <br />P <br />U <br />b <br />0 <br />U <br />-H <br />E <br />