State of Illinois
CAPITAL DEVELOPMENT BOARD
REQUEST FOR PROPOSAL
& CHANGE ORDER
Date: RFP Number:
! "Contra#tor$s Name% A&&ress% Tele'(one% Fa) * Attention+
" + , Fa) " + ,
Attn: e,mail:
CDB Pro-e#t .:
CDB Pro-e#t Name:
* Lo#ation:
CDB Contra#t .:
Contra#t /or0:
1! RE23EST for #(an4e b5:
CDB #ontem'lates ma0in4 #ertain #(an4es% a&&itions an& &eletions to t(e 6or0 to be 'erforme& un&er t(e sub-e#t Contra#t! 3nless ot(er6ise
in&i#ate& in t(e &es#ri'tion of #(an4e% a##om'an5in4 &ra6in4s an& s'e#ifi#ations% all 6or0 re7uire& s(all #onform to t(e #ontra#t &o#uments!
T(e Contra#tor is re7uire& to submit 6it(in 8 #alen&ar &a5s from t(e &ate (erein a 'ro'osal an& a &etaile& brea0&o6n for t(is #(an4e! T(e
'ro'osal s(all be submitte& in a##or&an#e 6it( CDB9s format an& t(e :eneral Con&itions!
;! REASON for #(an4e:
8! DESCRIPTION of #(an4e in#lu&in4 referen#e to &ra6in4s an& s'e#ifi#ations re<ise&% ne6 &ra6in4s an& s'e#ifi#ations issue&!
=! OT>ER CONTRACTS affe#te& b5 t(is #(an4e! List Contra#tor$s name% #ontra#t
6or0% RFP number an& amount!
IMPORTANT NOTICE
Disclosure of this ifor!"tio is !"#"tor$
i "ccor#"ce %ith the St"#"r# Docu!ets
for Costructio& F"ilure to co!'lete this %ill
're(et '"$!et for %or) co!'lete# "#*or
+e " !"teri"l +re"ch of cotr"ct&
?! CONSIDERATION:
/or0 to be a##om'lis(e& in Calen&ar Da5s from A''ro<al
of RFPCO!
T(e Contra#t Sum is INCREASED@DECREASED
b5 t(e total sum ofAAAAAAAB
NOTE, Uless s'ecific"ll$ i#ic"te# "+o(e- this #oes ot
e.te# the cotr"ct ti!e&
C! T(e #(an4e &es#ribe& abo<e an& on a##om'an5in4 &ra6in4s an& s'e#ifi#ations an& t(e Contra#tor$s 'ro'osal "if a''li#able+ are (ereb5
in#or'orate& b5 referen#e an& ma&e a 'art (ereof! >a<in4 re<ie6e& t(e abo<e an& &eterminin4 t(e amount to be fair an& 'ro'er t(e
un&ersi4ne&:
RECOMMEND issuan#e of a #(an4e or&er APPROVE as to form an& #ontent:
A@E Firm Name 3SIN: A:ENCD name
BD si4nature BD si4nature
COORDINATIN: CONTRACTOR or CONSTR3CT! MANA:ER CDB@PM APPROVE
BD si4nature si4nature
CONTRACTOR DATE CDB APPROVE #(an4e or&er DATE
BD 'rint name BD 'rint name
si4nature si4nature
title title
E!
FOR CDB
3SE ONLD
T5'e of C(an4e F Assess Pa#0a4e No! CO Date CO No! CO AMO3NT a&& "&e&u#t+
B
Revised August 2008