Sample Change Order Form

Sample Change Order Form
Client's Name
First NameLast Name
Client's Phone Number
Format: (000) 000-0000.
Client's Email Address
example@example.com
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Project Title
Project No.
Project Description
These are the following changes that we need:
Rows Changes Description (e.g add windows, fix wiring, installation) Quantity (materials, workers, hours) Amount ($) Cost ($)
1
2
3
4
5
6
7
8
9
Total Amount ($)
Original Contract Budget ($)
Adjusted Contract Budget ($)
Detailed Explanation or Reasons for Change Order
The information about the change of orders above has been reviewed and by signing below, it means that both parties involved approved the changes.
Client Signature
Signed Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Authorized Contractor Signature
Signed Date
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Rows	Changes Description (e.g add windows, fix wiring, installation)	Quantity (materials, workers, hours)	Amount ($)	Cost ($)
1
2
3
4
5
6
7
8
9