Change Order

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Change Order Number ___

Pursuant to that agreement between _________________, described herein as OWNER and __________________, described herein as CONTRACTOR, dated _____________ the following change is made in the specifications and scope of work to be performed:

____________________________________________________________.

This results in an increase of the total contract price in the amount of $ ______ (______&___/100 dollars) and an adjusted total contract price of $ _____ (______________&___/100 dollars). This Change order shall be due and paid separately on a Net 30 Day basis from the date of completion which is estimated to be ________________.

Dated: _______________________________________

Accepted by:

______________________________________________________ OWNER

______________________________________________________ CONTRACTOR