Change Order Form -
This template document sets forth an agreement to change the terms or prices of an
underlying agreement. As drafted, this agreement is written by a sub-consultant or
subcontractor addressed to the consultant or general contractor whereby the sub is
requesting certain changes. This form provides standard clauses, such a listing
proposed changes, providing justifications for the change, and also listing any price or
schedule changes. This document can be modified to fit the needs of any party seeking
to modify an existing agreement.
CHANGE ORDER NO.
In accordance with the Agreement between [Insert Subconsultant Name] ("Subconsultant"), and [insert Consultant
Name] (“Consultant”), a [insert State] corporation dated [Insert date of Agreement, not of this Change Order] (for
Work Order/Addendum No. ) this Change Order describes the agreed upon changes to the Services,
Schedule, and Payment for the Services.
Project: Project No. Date:
REFERENCE: Drawing No. Specification No. Other
The Agreement is hereby changed as follows:
Justification for Change:
CHANGE TO ESTIMATED CONTRACT PRICE (See Attachment )
Original Work Order Amount: $
Current Work Order Amount, including previous change orders: $
The Work Order Amount due to this Change Order will be increased (or decreased) by: $
The revised Work Order Amount due to this Change Order will be: $
CHANGE TO THE ESTIMATED SCHEDULE (See Attachment )
The Schedule will be increased (or decreased) by calendar days after issuance of Notice to Proceed
The date for completion of all work under the Work Order will be: .
EXCEPT AS PROVIDED IN THIS CHANGE ORDER, ALL TERMS AND CONDITIONS OF THE CONTRACT REMAIN UNCHANGED
[Signature Page Follows]
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Acceptance of the terms of this Change Order is acknowledged by the following signatures of the Authorized
Date of Signature
Date of Signature
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