Project Project No Contractor Contract No Architect Date FIELD

project project no. contractor contract no. architect date field instruction no. if a change order is

Project Project No.
Contractor Contract No.
Architect Date
FIELD INSTRUCTION NO.
If a Change Order is contemplated, fill out and check boxes as
appropriate:
Estimated Cost:
Cost Basis:
 Lump Sum  Time and Material
Prepared by:
Signature and Title
Date:
Copies to:
• Project Manager/Construction Inspector  If a Change Order is
contemplated (or this is an item in dispute), this
• Architect instruction shall be authorized by the Construction
Administrator.
• Construction Administrator
• Contractor
Authorized by:
Signature of Construction Administrator
Date:
cc: Architect/Engineer
Project Manager/Construction Inspector Construction Management
University 703.24 12/94