[ Builder's Company Name ]


[ Builder's Business Address ]


CONTRACT CHANGE ORDER

Change Order Number:  ____________

Project:  ______________________________________________________________________

Contract:  _____________________________________________________________________

We agree to make the following change(s) in the contract scope of work:

_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Change(s) will affect the following plans and/or specifications:                                

_____________________________________________________________________________

Subject to the following adjustment to the contract value:

Cost of this Change: ______________________________
Previous Contract Amount:  ________________________
Revised Contract Amount:  _________________________
Revised Completion Date:  _________________________
Builder:  [Builder's Company Name ]				

By:	>_____________________________________________  Date: ___________________
 	Authorized Signature/Title
																
Subcontractor:  [ Trade Contractor's Company Name ]
	
By:	>_____________________________________________ Date: ___________________
        Authorized Signature/Title