Saddleback College Change Order Form Date: Division: Requester: Extension: Supervisor: Requisition #: Purchase order Old Amount New Amount Change Account Number(s): $ - $ - $ - $ - Total: $ - $ - $ - Description: Important: E-mail Completed Form to Dean/Director with a copy to all approvers of the Requisition. The Dean/Director will forward the Change Order to District Purchasing. Irvine Valley College Change Order Form Date: 3/12/2007 Division: Division A Requester: John Smith Extension: 4566 Supervisor: Nancy Jackson PO #: P07-123456 Requisition #: (used for blanket or standard requisitions) (used for direct pay requisitions) Old Amount New Amount Change Account Number(s): 01-4600-0-000-4-036-000-6099 $ 12,222.00 $ 12,222.00 $ - 01-6410-0-000-4-036-000-6099 $ 222.00 $ 555.00 $ 333.00 01-6410-1-225-4-036-000-6099 $ 333.00 $ 444.00 $ 111.00 01-4600-1-074-4-036-000-6099 $ 666.00 $ 555.00 $ (111.00) Total: $ 13,443.00 $ 13,776.00 $ 333.00 Description: To provide additional coverage for event ABC, based on additional information received from XYZ. Important: Do not send the Form to District Purchasing. E-mail Completed Form to the IVC Director of Fiscal Services with a copy to all approvers of the PO. IVC Fiscal Office will forward the Change Order to District Purchasing.