# Construction Change Order

**Original Contract:** _______________ (date: _______________)
**Project:** _______________________________________
**Project Address:** _______________________________________

| Change Order # | Date | Owner | Contractor |
|---|---|---|---|
| CO-_____ | _______ | _______________ | _______________ |

---

## 1. Description of Change

### Requested by

☐ Owner
☐ Architect / Designer
☐ Engineer
☐ Contractor (field condition)
☐ Code official / Inspector
☐ Other: _______________

### Reason for change

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

### Detailed scope of changes

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

### Work to be ADDED to original contract

_________________________________________________________________
_________________________________________________________________

### Work to be DELETED from original contract

_________________________________________________________________
_________________________________________________________________

### Drawings / specifications affected

☐ Drawing(s) attached: _______________
☐ Specification sections affected: _______________
☐ Revised drawings will follow within _____ days
☐ No drawing changes required

---

## 2. Cost Breakdown

### Added Work

| Item | Description | Quantity | Unit Cost | Subtotal |
|---|---|---|---|---|
| Labor | | _____ hrs | $_____ | $_____ |
| Materials | | | | $_____ |
| Subcontractor | | | | $_____ |
| Equipment | | | | $_____ |
| Other | | | | $_____ |
| **Direct cost subtotal** | | | | **$_____** |
| Overhead (_____%) | | | | $_____ |
| Profit (_____%) | | | | $_____ |
| **Total addition** | | | | **$_____** |

### Deleted Work (Credit to Owner)

| Item | Description | Subtotal |
|---|---|---|
| | | $_____ |
| | | $_____ |
| **Credit subtotal** | | **$_____** |

### Net Change

| | |
|---|---|
| Added | + $_____ |
| Deleted | - $_____ |
| **Net change in contract value** | **$_____** |

---

## 3. Contract Value Adjustment

| | |
|---|---|
| Original contract sum | $_____ |
| Net change from previous COs | $_____ |
| Contract sum prior to this CO | $_____ |
| Net change this CO | $_____ |
| **NEW CONTRACT SUM** | **$_____** |

---

## 4. Schedule Impact

### Time Extension Requested

☐ No time extension required (work fits within current schedule)
☐ Time extension requested: _____ calendar days (or _____ working days)

**Original substantial completion date:** _______________
**Revised substantial completion date:** _______________

### Schedule activities affected

_________________________________________________________________
_________________________________________________________________

### Critical path impact

☐ Change affects critical path
☐ Change does not affect critical path

### Subcontractors affected

| Subcontractor | Impact | Schedule Change |
|---|---|---|
| | | _____ days |
| | | _____ days |

---

## 5. Reason / Justification

### Justification for cost

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

### Backup documentation attached

☐ Subcontractor quotes
☐ Material price quotes (from suppliers)
☐ Labor estimate with rates
☐ Photos / field documentation
☐ Engineering / design changes
☐ Code compliance requirements
☐ Other: _______________

---

## 6. Special Conditions

☐ This change requires owner-provided items: _______________
☐ Specific scheduling required: _______________
☐ Inspection required after this work: _______________
☐ Affected by other ongoing trades: _______________
☐ Permit modification required: _______________
☐ HOA / utility approval required before proceeding: _______________

---

## 7. Owner / Architect Comments

_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

---

## 8. Approval

### Approval to Proceed

Owner must approve change order before work proceeds. Verbal approvals are NOT binding — written approval required.

If owner has not approved within _____ business days, contractor:
☐ Will proceed with original scope (skip changes)
☐ Will continue at risk pending approval (NOT recommended)
☐ Will stop work in affected areas only
☐ Other: _______________

### Acknowledgments

Owner acknowledges that:
- Contract sum will be modified as shown above
- Project schedule may be impacted as shown above
- All other contract terms remain in effect
- Final payment will reflect this change order
- This change is binding upon signature by both parties

---

## 9. Signatures

### Owner / Owner's Representative
Signature: _______________________________
Printed: _______________________________
Title: _______________
Date: __________

### Architect / Engineer (if required for approval)
Signature: _______________________________
Printed: _______________________________
Title: _______________
Date: __________

### General Contractor
Signature: _______________________________
Printed: _______________________________
Title: _______________
Date: __________
Contractor License #: _______________

---

## Summary of Change Orders to Date

| CO # | Date | Description | Net Change | Cumulative |
|---|---|---|---|---|
| 1 | | | $_____ | $_____ |
| 2 | | | $_____ | $_____ |
| 3 | | | $_____ | $_____ |
| **TOTAL** | | | **$_____** | **$_____** |

---

*This change order is part of the original contract documents. Retain all change orders for permanent project records and final closeout.*

*Original contract terms regarding payment schedule, warranty, lien rights, and dispute resolution continue to apply to this changed work.*

*For complex changes involving significant cost or schedule, consider involving construction attorney or consultant to ensure proper documentation.*