Form 700-010-80 "Work Order" - Florida

What Is Form 700-010-80?

This is a legal form that was released by the Florida Department of Transportation - a government authority operating within Florida. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2018;
  • The latest edition provided by the Florida Department of Transportation;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 700-010-80 by clicking the link below or browse more documents and templates provided by the Florida Department of Transportation.

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Download Form 700-010-80 "Work Order" - Florida

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STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-010-80
CONSTRUCTION
WORK ORDER
07/18
Page
of
Supplemental Agreement No.*
Work Order No.**
Fin Proj. ID
Contract No.
Date
F.A.P. No.
Road No.
Contractor
DESCRIPTION OF WORK:
REASON:
Revised Plan Sheet Nos.
Granted time due to delays to controlling items of work shown on approved work schedule:
days
1
TOTAL COST OF WORK:
Premium Cost
:
Amount to be paid from Lump Sum Contingency S.A. or Pay Item shown above:
Work described results from a Design Error or Omission:
Yes
No
*N/A when funding by contingency pay item
**Number Work Orders on a Contingency Pay item sequentially beginning with 01, 02, 03, etc.
For each subsequent Contingency Supplemental Agreement (CSA) restart the numbering of the Work Orders on that CSA
sequentially beginning with 01, 02, 03, etc.
Costs negotiated; work sheets documenting negotiated costs and basis for costs attached.
OR
Costs based on actual costs plus mark-ups as shown in above referenced Contingency Supplemental Agreement;
work sheets itemizing costs attached.
If, prior to execution of this Work Order, the Department has not issued a Notice to Proceed to the Contractor for the work
outlined herein, execution of this document by the Department shall serve as the Notice to Proceed.
The Department and the Contractor agree that the contract time adjustment and sum agreed to in this document
constitute a full and complete settlement of the matters set forth herein, including all direct and indirect costs for
equipment, manpower, materials, overhead, profit, and delay relating to the issues set forth in this document
________________________
Printed Name:
Contractor Signature
Title:
Date:
________________________
Printed Name:
FDOT or CCEI
Title:
Date:
Approved: ___________________________
2
FHWA
Date
FHWA Participation
Non-Participation
1
Premium Cost is defined as additional cost which would not have been incurred if the work described herein had been included in the original contract
2
Attach reasons justifying FHWA participation
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-010-80
CONSTRUCTION
WORK ORDER
07/18
Page
of
Supplemental Agreement No.*
Work Order No.**
Fin Proj. ID
Contract No.
Date
F.A.P. No.
Road No.
Contractor
DESCRIPTION OF WORK:
REASON:
Revised Plan Sheet Nos.
Granted time due to delays to controlling items of work shown on approved work schedule:
days
1
TOTAL COST OF WORK:
Premium Cost
:
Amount to be paid from Lump Sum Contingency S.A. or Pay Item shown above:
Work described results from a Design Error or Omission:
Yes
No
*N/A when funding by contingency pay item
**Number Work Orders on a Contingency Pay item sequentially beginning with 01, 02, 03, etc.
For each subsequent Contingency Supplemental Agreement (CSA) restart the numbering of the Work Orders on that CSA
sequentially beginning with 01, 02, 03, etc.
Costs negotiated; work sheets documenting negotiated costs and basis for costs attached.
OR
Costs based on actual costs plus mark-ups as shown in above referenced Contingency Supplemental Agreement;
work sheets itemizing costs attached.
If, prior to execution of this Work Order, the Department has not issued a Notice to Proceed to the Contractor for the work
outlined herein, execution of this document by the Department shall serve as the Notice to Proceed.
The Department and the Contractor agree that the contract time adjustment and sum agreed to in this document
constitute a full and complete settlement of the matters set forth herein, including all direct and indirect costs for
equipment, manpower, materials, overhead, profit, and delay relating to the issues set forth in this document
________________________
Printed Name:
Contractor Signature
Title:
Date:
________________________
Printed Name:
FDOT or CCEI
Title:
Date:
Approved: ___________________________
2
FHWA
Date
FHWA Participation
Non-Participation
1
Premium Cost is defined as additional cost which would not have been incurred if the work described herein had been included in the original contract
2
Attach reasons justifying FHWA participation
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-010-80
CONSTRUCTION
WORK ORDER
07/18
Page
of
Supplemental Agreement No.*
Work Order No.**
Fin Proj. ID
Contract No.
Date
F.A.P. No.
Road No.
Contractor
DESCRIPTION OF WORK (continued):
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
700-010-80
CONSTRUCTION
WORK ORDER
07/18
Page
of
Supplemental Agreement No.*
Work Order No.**
Fin Proj. ID
Contract No.
Date
F.A.P. No.
Road No.
Contractor
REASON (continued):
Page of 3