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DATE OF ISSUANCE: <br />OWNER: Indian River County <br />CONTRACTOR: <br />Project: <br />Change Order Form <br />fe7fa23e-3f6d-42ce-gd52-86d8a5lead21 <br />LM <br />EFFECTIVE DATE: <br />OWNER's Bid/RFP No. <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 <br />PRICE: <br />Time <br />Description <br />Amount <br />Original Contract Price <br />$ <br />Net Increase (Decrease) from <br />$ <br />previous Change Orders No. <br />to <br />(days) <br />Contract Price prior to this <br />$ <br />Change Order: <br />Net increase (decrease) of <br />$ <br />this Change Order: <br />(days or dates) <br />Contract Price with all <br />$ <br />approved Change Orders: <br />ACCEPTED: <br />By: <br />CONTRACTOR (Signature) <br />Date: <br />RECOMMENDED: <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 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 />By: <br />ENGINEER (Signature) <br />Date: <br />APPROVED: <br />By: <br />OWNER (Signature) <br />Date: <br />184 <br />