CHANGE ORDER

Formal agreement for scope, cost & schedule changes

CHANGE ORDER

Project Name

Job Address

Original Contract Date

Client / Property Owner

Client Phone

Change Order Date

Contractor / Company

Contractor License #

Foreman / PM

REASON FOR CHANGE ORDER

Client-requested addition to scope Unforeseen site condition Material price increase / supply chain Code / permit requirement discovered Original estimate error or omission Third-party delay (inspector, utility, etc.)

Detailed Description of Change (attach photos if applicable)

COST BREAKDOWN FOR THIS CHANGE ORDER

Item / Description	Unit	Qty	Unit Price	Line Total





CHANGE ORDER TOTAL (before tax)

CONTRACT VALUE IMPACT

Original Contract Value

This Change Order (+/-)

Revised Contract Total

SCHEDULE IMPACT

Original Completion Date

Additional Days Required

Revised Completion Date

PAYMENT TERMS FOR THIS CHANGE ORDER

Payment Due

Approved By (Client) — Verbal Confirmation Date

Terms & Conditions: This change order constitutes a written amendment to the original contract. Work described above will not begin until this document is signed by both parties. Client signature below authorizes StructTech to proceed with the described work and agrees to pay the revised contract total per the payment terms stated. All other terms of the original contract remain in full force and effect. Disputes arising from this change order shall be resolved per the dispute resolution provisions of the original agreement.

CONTRACTOR AUTHORIZATION

Signature

Printed Name

Title

Company

Date

CLIENT AUTHORIZATION

Signature — I authorize this change order and agree to the revised contract total

Printed Name

Relationship to Property

Phone at Time of Signing

Date