CHANGE ORDER TO CONTRACT

PAGE

1

OF

2

PROJECT NAME/LOCATION:

COUNTY CONTRACT NO.:

CHANGE ORDER NO.:

OWNER:

CONTRACT DATE:

County of Beaver

DATE OF CHANGE:

TO (CONTRACTOR):

PREPARED BY:

TITLE:

You are directed to make the following changes in this Contract:

Description of Change:

LINE ITEM CONTRACT CHANGES

Original Contract

$

Change Orders to Date (+,-)

$

Revised Contract

$

0.00

This Change Order (+,-)

$

Adjusted Contract

$

0.00

CHANGE ORDER TO CONTRACT

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2

OF

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Contractor agrees that the amount of this Change Order constitutes full and final satisfaction of all costs,

damages, delays, accelerations, disruptions, overhead and profits directly or indirectly attributable to this

Change Order.  All other terms and conditions of the Contract Aggreement and Contract Documents shall

remain unchanged and in effect.

REVIEWED:

By

Date

APPROVED:

By

Date

AGREED TO:

By

Date

APPROVED:

COUNTY OF BEAVER, BOARD OF COMMISSIONERS

Commissioner Tony Amadio, Chairman

Date

Commissioner Joe Spanik

Date

Commissioner Charles A. Camp

Date