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Proactive Disclosure
Contemplated Change Notice
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):
Contemplated Change No.:
Contract No.:
Project No.:
Description and Location of Project:
It is proposed to make the following change in the work. You are requested to quote a firm price for any revision to the contract amount arising from this change. No work should be undertaken on this change until a change order/written authorization has been signed and issued.
Quotation to be submitted within _______ days of the date of this notice.
Description of Change:
The work shall conform to the contract documents where applicable unless otherwise stated.
Departmental Representative:
Date:
Contractor (Name and Address):
Contemplated Change No.:
Contract No.:
Project No.:
Estimate:
Description and Location of Project:
Reasons for Change:
Category:
Description:
This page is not to be distributed to the contractor
