[Your Company Name]
[Street Address]
[City, State ZIP]
[Phone Number] | [Email Address]
License # [License Number]
Your
Logo
Here
Logo
Here
Change Order
Change Order Details
Change Order #:
[CO-001]
Date:
[MM/DD/YYYY]
Original Contract #:
[Contract Number]
Original Contract Date:
[MM/DD/YYYY]
Client Information
Client Name:
[Client Name]
Project Address:
[Project Address]
Phone:
[Client Phone]
Email:
[Client Email]
Description of Change
| # | Description of Change | Reason for Change |
|---|---|---|
| 1 | [Describe the change to the original scope of work] | [Reason this change is needed] |
| 2 | [Additional change description] | [Reason for change] |
| 3 | [Additional change description] | [Reason for change] |
Cost Adjustment
| # | Item | Qty | Unit Price | Total |
|---|---|---|---|---|
| 1 | [Added item description] | [Qty] | $0.00 | $0.00 |
| 2 | [Added item description] | [Qty] | $0.00 | $0.00 |
| 3 | [Removed/credited item description] | [Qty] | -$0.00 | -$0.00 |
| Original Contract Amount: | $0.00 |
| This Change Order: | $0.00 |
| Tax: | $0.00 |
| New Contract Total: | $0.00 |
Timeline Impact
Original Completion Date:
[MM/DD/YYYY]
Additional Days Required:
[Number of days]
Revised Completion Date:
[MM/DD/YYYY]
Work described in this change order will not proceed until this document is signed and approved by both parties. All other terms and conditions of the original contract remain in full force and effect. This change order, once signed, becomes part of and is subject to all provisions of the original contract.
Contractor
Signature
Printed Name
Date
Client / Property Owner
Signature
Printed Name
Date
