Change Order

CHANGE ORDER ________________________

____________________________ ____________________________ Telephone:___________________ Facsimile:____________________



Project: Contract Job No.:



Change Order (CO) Request Number: Date:___________________________________________ Original Contract Amount: $ Net Change by Previous COs: $ Contract Sum Prior to this CO: $ Amount of this CO: $



Total Contract and COs: $ --------------------------------------------------------------------------------------------------------------------------------------Pursuant to your ______ written/_____ oral request of (date), by ___________________________________, we propose to perform the following change order work on the Project:



The time of completion for our work will be _______ increased/ _______ decreased by _____ calendar days (the exact amount of time cannot be determined at this point). Approval of this Change Order must be received by _____ in order to avoid labor inefficiencies and other related costs to our work. If approval is not received on a timely basis, shut-downs may occur which will necessarily add re-mobilization and other costs to these change orders. This Change Order does not waive Contractor’s right to recover damages resulting from any alterations of, delays to, acceleration of, interferences with, hindrances to and/or interruptions of original contract work, this or other change order/ modifications. The work covered by this Change Order shall be performed under the Terms and Conditions of the Contract unless otherwise stipulated herein. OWNER’S SIGNATURE ________________________________

By: Print name: Date: Print Name: