Specifications - City of Montpelier, Vermont

CHANGE ORDER # _________CHANGE ORDER FORMProject No. ___________________Contract No. __________________CONTRACT TITLE: ______________________________________OWNER: _______________________________________________CONTRACTOR: _________________________________________Date: _______________________Agreement Date:________________ORIGINAL PRICE: $________________Original Completion Date: ___________The following changes are hereby made to the CONTRACT DOCUMENTS:DESCRIPTION:JUSTIFICATION:PRICE: This C.O. (1) will (not change/increase/decrease)the Contract Price By:Current Contract Price per most recent C.O.:The new Contract Price including this C.O. is:$____________$____________$____________TIME: Current Contract Calendar Days as per most recent C.O.:DAYS _____This C.O. will (not change/increase/decrease)the Contract Calendar Days by:The new Contract Calendar Days including this C.O. is:The new Contract Completion Date is, therefore:DAYS _____DAYS _________________________The attached Contractor's Revised Project Schedule reflects increases or decreases in Contract Time as authorized bythis C.O.Stipulated price and time adjustment includes all costs and time associated with the above described change.Contractor waives all rights for additional compensation or time extension for said change. Contractor and Owneragree that the price(s) and time adjustment(s) stated above are equitable and acceptable to both parties.REQUESTED BY: __SIGNATURES/APPROVALS:Montpelier District Heat SystemPage 14