The Alaska 25D 068 form is a crucial document used in the construction industry to formalize change orders related to projects managed by the Alaska Department of Transportation and Public Facilities. This form captures essential details such as project information, change order specifics, and approvals necessary for any modifications in the contract. To ensure compliance and clarity, it is important to fill out this form accurately.
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The Alaska 25D 068 form is a crucial document for contractors and project managers engaged in construction projects within the state. This form facilitates the change order process, allowing for necessary adjustments to project timelines and costs. Key elements of the form include the project number, contractor details, and a summary of the changes being proposed. It outlines the number of calendar days affected by the change, the new completion date, and the financial implications, including the amount of the change order. The form also requires signatures from both the contractor’s representative and the approving authority, ensuring that all parties acknowledge the changes. Importantly, it highlights the need for timely communication; if disputes arise, an Intent to Claim form must be submitted within specified timeframes. The document serves not only as a record of changes but also as an amendment to the existing contract, reinforcing the need for compliance with all contractual provisions. Understanding the 25D 068 form is essential for anyone involved in Alaska's construction industry, as it helps maintain clarity and accountability throughout the project lifecycle.
STATE OF ALASKA
DEPARTMENT OF TRANSPORTATION
AND PUBLIC FACILITIES
Select REGION
Change Order
Project No.:
Change Order No.
Project Name:
Contractor:
Address:
Change Order Summary:
Calendar Days (+ / -):
New Completion Date:
Amount of Change Order:
Recommended By:
Date:
Title:
Approved By:
This change order constitutes agreement to terms, conditions and prices stated below.
Accepted By:
Contractor’s Representative
Acknowledgement indicates only receipt of Change Order and not mutual agreement for basis of payment or time allowance. If a the matter cannot be resolved within 7 days from signature date, an Intent to Claim form must be submitted to the engineer within 14 days.
Acknowledged By:
Contractor's Representative
Permission for previously submitted subcontractor(s) to perform all or portions of the work described herein is as checked: Yes No N/A
Seal of Alaskan Professional Engineer
(if required)
The following change(s) in the above Contract are hereby made in accordance with the terms of the Contract and under the terms and conditions stated below. Price adjustments resulting from inaccurate cost and pricing data are subject to the provisions of AS 36.30.400(c). This document shall become an amendment to the Contract and all provisions of the Contract will be applicable.
DESCRIPTION OF CHANGE (Use Continuation Sheet 25D-065 as Required)
Form 25D-068 (Revised 04/12)
C.O. No.
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