Work Change Directive No.

Transcription

1 Work Change Directive No. Date of Issuance: Owner: Contractor: Engineer: Effective Owner s Contract No.: Contractor s Project No.: Engineer's Project No.: Contract Name: Contractor is directed to proceed promptly with the following change(s): Description: Attachments: [List documents supporting change] Purpose for Work Change Directive: Directive to proceed promptly with the Work described herein, prior to agreeing to changes on Contract Price and Contract Time, is issued due to: [check one or both of the following] Non-agreement on pricing of proposed change. Necessity to proceed for schedule or other Project reasons. Estimated Change in Contract Price and Contract Times (non-binding, preliminary): Contract Price $ [increase] [decrease]. Contract Time days [increase] [decrease]. Basis of estimated change in Contract Price: Lump Sum Unit Price Cost of the Work Other RECOMMENDED: AUTHORIZED BY: RECEIVED: Engineer (Authorized Signature) Owner (Authorized Signature) Contractor (Authorized Signature) Approved by Funding Agency (if applicable) EJCDC C-940, Work Change Directive. Prepared and published 2013 by the Engineers Joint Contract Documents Committee. Page 1 of 1

2 Change Order No. Date of Issuance: Owner: Contractor: Engineer: Effective Owner's Contract No.: Contractor s Project No.: Engineer's Project No.: Contract Name: The Contract is modified as follows upon execution of this Change Order: Description: Attachments: [List documents supporting change] CHANGE IN CONTRACT PRICE CHANGE IN CONTRACT TIMES [note changes in Milestones if applicable] Original Contract Price: Original Contract Times: [Increase] [Decrease] from previously approved Change [Increase] [Decrease] from previously approved Change Orders No. to No. : Orders No. to No. : days Contract Price prior to this Change Order: Contract Times prior to this Change Order: [Increase] [Decrease] of this Change Order: [Increase] [Decrease] of this Change Order: Contract Price incorporating this Change Order: Contract Times with all approved Change Orders: RECOMMENDED: ACCEPTED: ACCEPTED: Engineer (if required) Owner (Authorized Signature) Contractor (Authorized Signature) Title Title Date Date Approved by Funding Agency (if applicable) EJCDC C-941, Change Order. Prepared and published 2013 by the Engineers Joint Contract Documents Committee. Page 1 of 1

3 Field Order No. Date of Issuance: Owner: Contractor: Engineer: Effective Owner s Contract No.: Contractor s Project No.: Engineer's Project No.: Contract Name: Contractor is hereby directed to promptly execute this Field Order, issued in accordance with General Conditions Paragraph 11.01, for minor changes in the Work without changes in Contract Price or Contract Times. If Contractor considers that a change in Contract Price or Contract Times is required, submit a Change Proposal before proceeding with this Work. Reference: Specification(s) Drawing(s) / Detail(s) Description: Attachments: ISSUED: RECEIVED: Engineer (Authorized Signature) Contractor (Authorized Signature) Copy to: Owner EJCDC C-942, Field Order. Prepared and published 2013 by the Engineers Joint Contract Documents Committee. Page 1 of 1

4 Contractor's Application for Payment No. Application Period: To From (Contractor): Via (Engineer): (Owner): Contract: Owner's Contract No.: Contractor's Project No.: Engineer's Project No.: Application For Payment Change Order Summary Approved Change Orders 1. ORIGINAL CONTRACT PRICE... $ Number Additions Deductions 2. Net change by Change Orders... $ 3. Current Contract Price (Line 1 ± 2)... $ 4. TOTAL COMPLETED AND STORED TO DATE (Column F total on Progress Estimates)... $ 5. RETAINAGE: a. X Work Completed... $ b. X Stored Material... $ c. Total Retainage (Line 5.a + Line 5.b)... $ 6. AMOUNT ELIGIBLE TO DATE (Line 4 - Line 5.c)... $ TOTALS 7. LESS PREVIOUS PAYMENTS (Line 6 from prior Application)... $ NET CHANGE BY 8. AMOUNT DUE THIS APPLICATION... $ CHANGE ORDERS 9. BALANCE TO FINISH, PLUS RETAINAGE (Column G total on Progress Estimates + Line 5.c above)... $ Contractor's Certification The undersigned Contractor certifies, to the best of its knowledge, the following: (1) All previous progress payments received from Owner on account of Work done under the Contract have been applied on account to discharge Contractor's legitimate obligations incurred in connection with the Work covered by prior Applications for Payment; (2) Title to all Work, materials and equipment incorporated in said Work, or otherwise listed in or covered by this Application for Payment, will pass to Owner at time of payment free and clear of all Liens, security interests, and encumbrances (except such as are covered by a bond acceptable to Owner indemnifying Owner against any such Liens, security interest, or encumbrances); and (3) All the Work covered by this Application for Payment is in accordance with the Contract Documents and is not defective. Payment of: $ is recommended by: Payment of: $ (Line 8 or other - attach explanation of the other amount) (Engineer) (Date) (Line 8 or other - attach explanation of the other amount) Contractor Signature is approved by: Approved by: (Owner) Funding or Financing Entity (if applicable) (Date) (Date) Page 1 of 4

5 Progress Estimate - Lump Sum Work Contractor's Application For (Contract): Application Period: Application Number: Work Completed E F G Specification Section No. A B C D Materials Presently Total Completed Balance to Finish % From Previous Application Stored (not in C or D) and Stored to Date (B - F) Description Scheduled Value ($) This Period (F / B) (C+D) (C + D + E) Totals Page 2 of 4

6 Progress Estimate - Unit Price Work Contractor's Application For (Contract): Application Number: Application Period: A B C D E F Bid Item No. Item Description Item Quantity Units Contract Information Unit Price Total Value of Item ($) Estimated Quantity Installed Value of Work Installed to Date Materials Presently Stored (not in C) Total Completed and Stored to Date (D + E) % (F / B) Balance to Finish (B - F) Totals Page 3 of 4

7 Stored Material Summary Contractor's Application For (Contract): Application Period: Application Number: Bid Item No. A Supplier Invoice No. B C D E F G Subtotal Amount Stored Previously Incorporated in Work Completed and Storage Date Placed Amount Stored Description of Materials or Equipment Stored Amount Stored to Date Date (Month/ Amount Location into Storage this Month ($) ($) (D + E) Year) ($) (Month/Year) Submittal No. (with Specification Section No.) Materials Remaining in Storage ($) (D + E - F) Totals Page 4 of 4