CHANGE ORDER

Date:			***INSERT DATA HERE***
Project:		***INSERT DATA HERE***		
Change Order #:	***INSERT DATA HERE***		Bid No. :***INSERT DATA HERE***
DSA File #:   		***INSERT DATA HERE***		DSA Application #: ****INSERT DATA HERE****
Owner:		Sacramento City Unified School District
Contractor:		***INSERT DATA HERE***		Architect/Engineer: ****INSERT DATA HERE***

TYPE OF CHANGE ORDER (Check one:)		Standard Change Order
			Unforeseen Site Condition (Justification attached)
								Emergency (Authorization attached)
								Substantial (Authorization attached)

Description of Change:

The following Proposed Change Order(s) are incorporated into the Contract by reference:

Ref. #	Summary Description:	Amount:	Initiated by:	

				
				
Original Contract Amount:			
Previous Change Order(s):			
Contract Amount Prior to this Change Order:			
Amount of this Change Order:			
			
New Contract Amount Including this Change Order:			

Contract Time will be ****INSERT DATA HERE**** by ****INSERT DATA HERE**** days.

Reviewed by:

Engineer/Architect:								Date:

Consultant:									Date:

Contractor agrees to perform the above-described work in accordance with the above terms and in compliance with applicable sections of the Project documents.  The amount of the charges under this Change Order is limited to the charges allowed under Article 41 of the General Conditions.  The adjustment in the contract sum, if any, and the adjustment in the contract time, if any, set out in this Change Order shall constitute the entire compensation and/or adjustment in the contract time due Contractor arising out of the change in the work covered by this Change Order, unless otherwise provided in this Change Order.  No additions or deletions to this Change Order shall be allowed, except with written permission of  the District.  Contractor accepts the terms and conditions stated above as full and final settlement of any and all claims arising from this Change Order.

This Change Order is hereby agreed to, accepted and approved by:

Contractor:									Date:

Owner:									Date:
		Project Manager, District Operations

Owner:									Date:
		***INSERT DATA HERE***, Deputy Superintendent/CFO

	
*****Name of Contractor *******
*****Address of Contractor *****