Change Order No.
____________
Date: Owner:
Job name / location: Job number: Job phone:
Original contract number: Original contract date:
Change (add or delete) the following work to the original contract:
Change the original contract amount by:
Previous contract amount:
Revised contract amount:
We agree to furnish labor & materials complete in accordance with the above Above additional work to be performed under the same conditions as specified
specifications at the price stated above. in the original contract unless otherwise stipulated.
General Contractor Date Owner Date
Note: This change order becomes part of the original contract.