Contract Amendment Form
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CONTRACT AMENDMENT FORM
CONTRACT # ___________________
Contract Administrator Name:
Department
Date received by Purchasing
Contract Administrator’s Address
Phone #
Date
CONTRACTOR’S NAME & ADDRESS
Address Change only
REQUIRED ATTACHMENT:
___________________________________________________________________
Amending Agreement (Schedule D)
PLUS (as required):
___________________________________________________________________
Schedule A
Schedule B
___________________________________________________________________
Schedule C
COMPLETE QUESTIONS PERTINANT TO THE CHANGES BEING REQUESTED:
Extend the end date of the contract. The contract is being extended because ____________________________________________
_____________________________________________________________________________________________________________
Change the services to those indicated on the attached Schedule A because______________________________________________
_____________________________________________________________________________________________________________
Increase the maximum dollar amount or change the payment schedule as indicated on the attached Schedule B because __________
____________________________________________________________________________________________________________
Addition of expense Schedule C or change the expenses as indicated on the attached Schedule C because______________________
_____________________________________________________________________________________________________________
ORGANIZATIONAL UNIT’S APPROVALS:
I certify that sufficient monies have been allocated from my unit budget/grant to honour the University of Manitoba’s financial
obligations under this agreement.
$__________________ Schedule B
_______________________________
__________________________________________
Signature of Signing Authority (required)
(original + amendment)
F O A P
$_________________ Schedule C
_______________________________
__________________________________________
Signature of Signing Authority (required)
(original + amendment)
F O A P
Original effective date of contract ____________________________ New end date of contract___________________________
I agree with the Organizational Unit’s recommendations (as listed above) and acknowledge the financial obligations of the
faculty/school/administrative unit.
_____________________________________
__________________________________________
Signature of Department Head (optional)
Signature of Dean/Director (required)
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Parent category: Business