Cal. Code Regs. Tit. 21, div. 1, ch. 1, subch. 1, Applical Forms, app (g)
(g) Sample of Change Order.
SAMPLE CHANGE ORDER GEORGE WASHINGTON HIGH SCHOOL CAFETERIA BUILDING
PALOMARES HIGH SCHOOL DISTRICT
Change Order No. 1
December 1, 1966
File No. Application
To: Smith Construction Co., Contractors
You are hereby authorized to make the following changes, when this order has been approved by the Department of General Services:
Item 1. Lower the footing at the north end as shown on the attached sketch numbered XI.
Reason: Necessary to found footings on firm soil.
Requested by the Structural Engineer.
Extra--$150.00
Item 2. Furnish and install galvanized plate bolts of size shown on the attached sketch numbered XII with a three-inch length of the stem at bottom bent at 90 degrees to the axis, in lieu of the washer and nut on the embedded end as indicated on approved drawings.
Reason: Necessary to prevent turning of bolt in the concrete.
Requested by the Contractor.
| No change in price | |
| Original Contract Price.......................... | .......................... $25,245.00 |
| This Change Plus.................................. | .......................... 150.00 |
| $25,395.00 |
Approved
___________________________
School Authority
___________________________
Architect
___________________________
Structural Engineer or Other Applicable Professional Engineer Accepted
___________________________
Contractor
(See Section 38)
Cal. Code Regs. Tit. 21, div. 1, ch. 1, subch. 1, Applical Forms, app (g)