Laserfiche WebLink
DATE OF ISSUANCE: <br />SECTION 00942 - Change Order Form <br />M <br />EFFECTIVE DATE: <br />OWNER: Indian River County <br />CONTRACTOR <br />Project: CR 512 RESURFACING& SHOULDER WIDENING FROM MYRTLE STREET <br />TO 125th AVENUE <br />OWNER's Project No. IRC -1305 <br />OWNER'S Bid No. 2018009 <br />FM No: 433068-1-54-01 <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: <br />Description <br />Amount <br />Original Contract Price <br />(days or dates) <br />Net Increase (Decrease) from <br />previous Change Orders No. <br />to <br />Contract Price prior to this <br />(days) <br />Change Order: <br />Net increase (decrease) of this <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 />9,X9377AMM: �► <br />By: <br />ENGINEER (Signature) <br />Date: <br />By: <br />OWNER (Signature) <br />Date: <br />00942 - Change Order Form REV 04-07 <br />00942-1 <br />F:Tublic WorkSTNGINEERING DIVISION PROJECTS11305-CR 512 Resurf (SCOP) Myrtle St to 125th ShAdmimkbid documentsWaster Contract Docurnants=942 - Change <br />Order Form REV G"Tdoc Rev. 05101 <br />