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SECTION 00942 - Change Order Form DATE OF ISSUANCE: 06/19/2025 No. 04 EFFECTIVE DATE:07/15/2025 OWNER: Indian River County CONTRACTOR Halley Engineering Contractors, Inc. Project: 66th Avenue Roadway Widening (49th Street to 69th Street) OWNER's Project No. IRC -1505 FM NO: 436379-1-54-01 8,436379-1-54-02 OWNER'S Bid No. 2021018 You are directed to make the following changes in the Contract Documents: Reason for Change Order: The project is complete. This change order is intended to make final adjustments to bid line items and time to finalize the contract. Attachments: Description of Itemized Changes CHANGE IN CONTRACT PRICE: Description Amount Original Contract Price $32,728.137.85 Net Increase from previous Change Orders No. 01 to 03: $1.601,094.49 Contract Price prior to this Change Order: $34,329,232.34 Net decrease of this Change Order: ($1,322,311.29) Contract Price with all approved Change Orders: $33,006,921.05 ACCEPTED: pgilelN N�etl by RI[Itle L Rickie L �„�„ Shepherd By: CONTRACTOR (Signature) Date: CHANGE IN CONTRACT TIMES Description Time Original Contract Time: (days or dates) Substantial Completion: 720 Final Completion: 750 Net change from previous Change Orders No. 01 to 03: (days) Substantial Completion: 60 Final Completion: 60 Contract Time prior to this Change Order: (days or dates) Substantial Completion: 780 Final Completion: 810 Net increase (decrease) this Change Order: (days or dates) Substantial Completion: 657 Final Completion: 657 Contract Time with all approved Change Orders: (days or dates) Substantial Completion: 1.437 Final Completion: 1.467 RECOMMENDED: (I 4:. By: Kelly CowgK E ENGINEER (Signature) Date: APPROVED: Addie Javed. By: OWNER (Signature) Date: 00942 - Change Order Form REV 04-07 00942-1 F:Tublic WorksNENGINEERING DIVISION PROJECTS11505-66th Ave Widening 49th St to 69th St\1-AdminlAgenda ItemsTrojecl Closeout100942 - Change Order Form REV 04-07.doc Rev. 05/01