Change Order Form
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1Client # ______________
CHANGE ORDER #_________________
Homeowner:
_______________________________________
Contractor
______________________
Property Address:
_______________________________________
_______________________________________
Rehabilitation Contract Dated ________________________________
The following change(s) is/are authorized to the above identified Rehabilitation Contract:
Increase/
Original
Description of Change
Decrease
Item
Cost
Cost
Reason for Change
TOTAL
Initial Contract Amount
$_________________
Plus Previously Approved Change Orders
$_________________
Plus Change Order Requested
$_________________
Total New Contract Amount
$_________________
Signed:
_____________________________________________
___________________________
Homeowner
Date
_____________________________________________
___________________________
Contractor
Date
_____________________________________________
___________________________
Construction Advisor
Date
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