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Proactive Disclosure
Change Order
Disclaimer: The HTML version of these forms is a representation of the content only. Please download the PDF version to use with your procurement. If you encounter problems or have questions regarding the PDF please contact Acquisitions.
Contractor (Name and Address):
Change Order No.:
Contract No.:
Project No.:
Description and Location of Project:
Original Amount of Contract:
Approved C.O. Amount to Date:
Present C.O. Amount:
Revised Contract Amount:
Description of Change:
Recommended:
Signature:
Date:
Approved:
Signature:
Date:
Contractor (Name and Address):
Change Order No.:
Contract No.:
Project No.:
Description and Location of Project:
Reasons for Change:
Category:
Description:
This page is not to be distributed to the contractor
