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DATE OF ISSUANCE: <br />SECTION 00942 - Change Order Form <br />No. <br />EFFECTIVE DATE: <br />OWNER: Indian River County <br />CONTRACTOR <br />Bid No:2008xxxxxx <br />Project: Powerline Road North of C R 510 to the Sebastian City Limits <br />OWNER's Contract No. <br />ENGINEER Indian River County <br />ENGINEER's Contract No. N/A <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 <br />$ <br />Change 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 CONTRACT TIMES <br />Description -Time <br />Original Contract Time: (days or dates) <br />Substantial Completion: <br />Final Completion: <br />Net change from previous Change <br />Orders No. to (days) <br />Substantial Completion: <br />Final Completion: <br />Contract Time prior to this Change <br />Order: (days or dates) <br />Substantial Completion: <br />Final Completion: <br />Net increase (decrease) this <br />Change Order: (days or dates) <br />Substantial Completion: <br />Final Completion: <br />Contract Time with all approved <br />Change Orders: (days or dates) <br />Substantial Completion: <br />Final Com letion: <br />RECOMMENDED: <br />By: <br />INEER (Signature) <br />Date: <br />00942-1 <br />FAEngineering\Capital Projects\0217-Powerline Road\Bid Documents\00942 - Change Order Form.doc Rev. 05/01 <br />APPROVED: <br />By: <br />OWNER (Signature) <br />Date: <br />00942 - Change Order Form <br />