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2022-132A
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2022-132A
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Last modified
9/13/2022 12:03:35 PM
Creation date
9/13/2022 11:36:01 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
07/12/2022
Control Number
2022-132A
Agenda Item Number
12.G.1.
Entity Name
C.W. Roberts Contracting, Inc
Subject
Indian River Blvd Resurfacing from 53rd Street to the Merrill Barber Bridge
FDOT FM 441919-1-54-01
Project Number
IRC-1707
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IRC -1707 <br />SECTION 00942 - Change Order Form <br />No. <br />DATE OF ISSUANCE: EFFECTIVE DATE: <br />OWNER: Indian River County <br />CONTRACTOR <br />Project: INDIAN RIVER BOULEVARD RESURFACING FROM 53rd STREET TO THE MERRILL <br />BARBER BRIDGE <br />OWNER's Project No. IRC -1707 OWNER'S Bid No. 2022046 <br />FM No.: 441919-1-54-01 <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 />$ <br />Net Increase (Decrease) from <br />$ <br />previous Change Orders No. <br />to <br />Contract Price prior to this Change <br />$ <br />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 CONTRACTTIMES <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 Change <br />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 />APP <br />By: <br />OWNER (Signature) <br />Date: <br />Change Order Form — 00942 <br />F:\Public Works\ENGINEERING DIVISION PROJECTS\1707 Indian River Blvd Merrill Barber Bridge to 53rd St Resurfacing (SCOP)\1-Admin\Bid Documents\Bid <br />Documents\DIV 0 4 Forms IRC-1707.docx <br />
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