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SECTION 00942 - Change Order Form <br /> No . <br /> DATE OF ISSUANCE : 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 . ENGINEER' s Contract No . N/A <br /> ENGINEER Indian River County <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 : CHANGE IN CONTRACT TIMES <br /> Description Amount Description Time <br /> Original Contract Price $ Original Contract Time : (days or dates) <br /> Substantial Completion : <br /> Final Completion : <br /> Net Increase ( Decrease) from $ Net change from previous Change <br /> previous Change Orders No . Orders No . to (days) <br /> to Substantial Completion : <br /> Final Completion : <br /> Contract Price prior to this $ Contract Time prior to this Change <br /> Change Order: Order: (days or dates) <br /> Substantial Completion : <br /> Final Completion, <br /> Net increase (decrease) of this $ Net increase (decrease) this <br /> Change Order: Change Order: (days or dates) <br /> Substantial Completion : <br /> Final Completion : <br /> Contract Price with all approved $ Contract Time with all approved <br /> Change Orders: Change Orders: (days or dates) <br /> Substantial Completion : <br /> Final Com letion : <br /> ACCEPTED : RECOMMENDED : APPROVED : <br /> By : By: By: <br /> CONTRACTOR (Signature) ENGINEER (Signature) OWNER ( Signature) <br /> Date : Date : Date : <br /> 00942 - Change Order Form <br /> 00942 - 1 <br /> FAEngineering\Capital Projects\0217-Powerline Road\Bid Documents\00942 - Change Order Form.doc Rev. 05/01 <br />