Additional Work Authorization Form

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Additional Work Authorization Form
Company Name & Address:
Ref
No
Page
of
No
Owner’s name
Phone
Date
/
/
Street
Job Name
City, State, Zip
Job Ref no
Existing Order no
Date
/
/
Job Location
You are authorized to perform the following additional work, as described:
The additional work is to be performed under the same terms & conditions as the original contract, unless otherwise stipulated.
Payment to be made as follows:
$:
Additional work Authorized by:
Date
/
/
Signature
We hereby agree to furnish the labor and materials required
Authorized by:
and complete the additional work as specified above.
Signature:
Date:
Change Order No:

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