
Change Order
 
Construction Company 
Date:
 
Address 
Owner:
 
City, State, ZIP 
Contractor:
 
Phone Number 
Project name:
 
  Change order number:
 
Original contract date: ____________________ 
You are directed to make the following changes in this contract:  
 
 
 
 
 
 
 
The original contract sum was:     $ 
Net amount of previous change orders:     
Total original contract amount plus or minus net change orders:   
Total amount of this change order:     
The new contract amount including this change order will be:   
The contract time will be changed by the following number of days:     (       ) Days 
The date of completion as of the date of this change order is:   
Contractor:    Owner:   
  
Company name    Name 
   
Address  Address 
   
City, State, Zip    City, State, Zip 
   
Date  Date 
   
Signature 
 
 Signature