SUBCONTRACTOR CHANGE ORDER

PROJECT NAME
LOCATION OF WORK
CONTRACT NO.	CHANGE ORDER NO.
REQUESTING PARTY	DATE OF REQUEST
PROJECT MANAGER	CONTRACTOR
OWNER	ENGINEER

SUBCONTACTOR ITEMIZED BREAKDOWN OF WORK
MATERIAL NAME	DESCRIPTION	QUANTITIY	UNIT PRICE	AMOUNT
TOTAL
LABOR	NO. OF HRS	RATE	AMOUNT
REGULAR PAY
OVERTIME PAY
TOTAL	TOTAL
EQUIPMENT	NO. OF HRS	RATE	AMOUNT
RENTED
OWNED
TRUCKING
TOTAL
OVERHEAD (MATERIAL, LABOR, & EQUIPMENT TOTAL)	x 15%
GRAND TOTAL

RECOMMENDED BY ENGINEER	APPROVED BY OWNER
DATE	DATE
ACCEPTED BY CONTRACTOR	REVIEWED BY FUNDER
DATE	DATE