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Project Change Order Request Form

The document is a project change order request form that details a requested change to a construction project's contract. It provides information such as the project name and location, contract details, a description of the requested changes and their potential impacts. It also lists supporting documentation and requires signatures from the project manager, contractor, engineer and owner to approve or deny the requested changes.

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Bara Daniel
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47 views2 pages

Project Change Order Request Form

The document is a project change order request form that details a requested change to a construction project's contract. It provides information such as the project name and location, contract details, a description of the requested changes and their potential impacts. It also lists supporting documentation and requires signatures from the project manager, contractor, engineer and owner to approve or deny the requested changes.

Uploaded by

Bara Daniel
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

PROJECT CHANGE ORDER REQUEST FORM

PROJECT NAME

LOCATION OF WORK

CONTRACT NO. CHANGE ORDER NO.

REQUESTING PARTY DATE OF REQUEST

PROJECT MANAGER CONTRACTOR

OWNER ENGINEER

PROJECT DETAILS

PROJECT CHANGE REQUEST DESCRIPTION

DESCRIPTION
OF CHANGES
NEEDED

REASON FOR
CHANGE

List all attached documents which support the requested change and justify any increased cost and time.
SUPPORT AND
JUSTIFICATION
DOCUMENTS

SPECIFICATIONS

IMPACT OF
CHANGE

RISK
MANAGEMENT
PROJECT NAME

LOCATION OF WORK

CONTRACT NO. CHANGE ORDER NO.

CHANGE IN PRICE CHANGE IN TIMES

ORIGINAL PRICE ORIGINAL TIMES

NET CHANGES OF PREVIOUS NET CHANGES OF PREVIOUS


CHANGE ORDERS CHANGE ORDERS IN DAYS

NET INCREASE / DECREASE NET INCREASE / DECREASE

TOTAL CONTRACT PRICE TOTAL CONTRACT TIME


WITH APPROVED CHANGES WITH APPROVED CHANGES

CHANGE REQUEST PRIORITY LEVEL


PRIORITY LEVEL JUSTIFICATION

PROJECT CHANGE ORDER DISCUSSION DOCUMENTATION | Change Has Been Discussed With

NAME & TITLE NAME & TITLE DATE

By

By

By

By

By

By

RECOMMENDED BY APPROVED BY
ENGINEER OWNER

DATE DATE

ACCEPTED BY REVIEWED BY
CONTRACTOR FUNDER

DATE DATE

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