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2015-095A
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2015-095A
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Last modified
3/30/2017 10:34:14 AM
Creation date
7/24/2015 10:06:55 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
05/12/2015
Control Number
2015-095A
Agenda Item Number
8.J.
Entity Name
Timothy Rose Contracting
Subject
Intersection Improvements
Area
20th Ave. & 16th Street
Project Number
0225
Bid Number
2015037
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SECTION 00942 - Change Order Form <br />No. <br />DATE OF ISSUANCE: <br />EFFECTIVE DATE: <br />OWNER: Indian River County <br />CONTRACTOR <br />Project: 20th Avenue & 16th Street Intersection Improvements <br />OWNER's Project No. 0225 ENGINEER's Bid No. 2015037 <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 />Net Increase (Decrease) from <br />previous Change Orders No. <br />to <br />Contract Price prior to this <br />Change Order: <br />Net increase (decrease) of this <br />Change Order: <br />Contract Price with all approved <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 />Substantial Completion: <br />Final Completion: <br />(days or dates) <br />Net change from previous Change <br />Orders No. to <br />Substantial Completion: <br />Final Completion: <br />Contract Time prior to this Change <br />Order: <br />Substantial Completion: <br />Final Completion: <br />(days) <br />(days or dates) <br />Net increase (decrease) this <br />Change Order: <br />Substantial Completion: <br />Final Completion: <br />(days or dates) <br />Contract Time with all approved <br />Change Orders: <br />Substantial Completion: <br />Final Completion: <br />(days or dates) <br />RECOMMENDED: <br />By: <br />ENGINEER (Signature) <br />Date: <br />F:APublic Works\ENGINEERING DIVISION PROJECTSv0225 20th A ,:. <br />Change Order Form RFV 04-C,7 doc Rev 05/01 <br />APPROVED: <br />By: <br />OWNER (Signature) <br />Date: <br />00942 - Change Order Form REV 04-07 <br />00942 - 1 <br />of Intersection Diode,em_r. .. P.m?. r: docamenheaMorder Condo-, Documents <br />
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