CHANGE ORDER
No.
PROJECT NAME: Siphon Rehabilitation Project DATE OF ISSUANCE:
OWNER: City of Nashua, NH OWNER PROJECT NO. IFBO779-071422
ADDRESS: 229 Main Street Nashua, NH 03060
Street Name City/Town State ZIP
CONTRACTOR:
CONTRACT FOR:
ENGINEER:
ENGINEER: Hazen and Sawyer ENGINEER PROJ NO. 90006-034
ADDRESS: 1750 Elm Street, Suite 402 Manchester, NH 03101
Street Name City/Town State ZIP
You are directed to make the following changes in the Contract Documents.
Description:
Purpose of Change Order:
Justification:
Attachments: (List documents supporting change)
CHANGE IN CONTRACT PRICE CHANGE IN CONTRACT TIME
Original Contract Price Original Contract Time
| days | | date
Previous Change Orders Net change from previous Change Orders
| days | | date
Contract Price prior to this Change Order Contract Time prior to this Change Order
| days | | date
Net Increase (Decrease) of this Change Order Net Increase (decrease) this Change Order
| days | | date
Contract Price with all approved Change Orders Contract Time with all Change Orders
| days | | date
This document will become a supplement to the CONTRACT and all provisions will apply hereto. The attached
Contractor’s Revised Project Schedule reflects increases or decreases in Contract Time as authorized by this Change
Order.
Stipulated price and time adjustment includes all costs and time associated with the above described change. Contractor
waives all rights for additional time extension for said change. Contractor and Owner agree that the price(s) and time
adjustment(s) stated above are equitable and acceptable to both parties.
RECOMMENDED BY: APPROVED BY: APPROVED BY: APPROVED BY:
Engineer Owner Contractor NHDES
Date Date Date Date
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