Amendment/Change Order/Renewal Request
What is the contract number that you would like to amend or renew?
Who is the current vendor?
What is the name of the current contract project?
What department are you from?
Council on Aging
Exec. Office of Enviro.
Traffic and Parking
Who is the project manager?
Summary of Change Order/Amndt/Renewal
Please provide a brief (1-2 sentence) description if this is for a change order/amdnt
Change Order/Amndt Type
Please select a change order/amdnt type.
Time Extension (only)
Increase $ (only)
Change in Scope (only)
Time and $
Time, $, and/or Scope
New Expiration Date
If this change order/amdnt will extend the contract, what is the new expiration date?
If this change order/amdnt will extend the contract, will it extend the contract over 3 years?
If this change order/amdnt increases the contract value, what is the revised contract value?
If the change order/amdnt increases the contract value, do you have sufficient budget to cover the increase?
Upload Any Applicable Files
Please attach any applicable documents (revised scope; additional price detail; etc..)
Send me a copy of my responses
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