Form Rd 1924-7 - Usda Rural Development And Farm Service Agency

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FORM APPROVED

OMB NO. 0575-0042

Form RD 1924-7

ORDER NO.

UNITED STATES DEPARTMENT OF AGRICULTURE

(Rev. 2-97)

RURAL DEVELOPMENT AND

DATE

FARM SERVICE AGENCY

STATE

CONTRACT CHANGE ORDER

CONTRACT FOR

COUNTY

OWNER

(Contractor)

You are hereby requested to comply with the following changes from the contract plans and specifications:

INCREASE

Description of Changes

DECREASE

(Supplemental Plans and Specifications Attached)

in Contract Price

0.00

TOTALS

0.00

NET CHANGE IN CONTRACT PRICE

JUSTIFICATION:

The amount of the Contract will be (Decreased) (Increased) By The Sum Of:

Dollars ($

The Contract Total Including this and previous Change Orders Will Be:

Dollars ($

The Contract Period Provided for Completion Will Be (Increased) (Decreased) (Unchanged) :

Days.

This document will become a supplement to the contract and all provisions will apply hereto.

Requested

(Owner)

(Date)

Recommended

(Owner's Architect/Engineer)

(Date)

Accepted

(Contractor)

(Date)

Approved by Agency

(Date)

(Name and Title)

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid

OMB control number. The valid OMB control number for this information collection is 0575-01042. The time required to complete this information collection is estimated to average 15 minutes

per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of

information.

ORIGINAL-BORROWER'S CASE FOLDER

Form RD 1924-7 (Rev. 2-97)

COPY-CONTRACTOR

POSITION 6

COPY-BORROWER