Common use of Project Title Clause in Contracts

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑ No cost change: N/A ❑ Increase cost by $ ❑ Decrease cost by $ Request for Extension of Contract Time (check one): ❑ No Change to Contract Time ❑ Time Extension Requested for _ days* o days Excusable Delay o days Compensable Delay ❑ Decrease time by _ days * Include all information and documentation required by Section 8.5 of the Contract General Conditions Basis for requested change in cost: ❑ Unit pricing ❑ Lump sum: $ _ ❑ Time and Materials not to exceed: * $ _ ❑ Compensable Delay Costs: $ ❑ Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): CHANGE ORDER REQUEST CITY OF PALO ALTO DEPARTMENT OF PUBLIC WORKS * Provide specific number/section/sheet references as applicable Line Time and Materials Breakdown (Reference Section 7.2 of General Conditions for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑  No cost change: N/A ❑  Increase cost by $ ❑  Decrease cost by $ Request for Extension of Contract Time (check one): ❑  No Change to Contract Time ❑  Time Extension Requested for _ days* o days Excusable Delay o days Compensable Delay ❑  Decrease time by _ days * Include all information and documentation required by Section 8.5 of the Contract General Conditions Basis for requested change in cost: ❑  Unit pricing ❑  Lump sum: $ _ ❑  Time and Materials not to exceed: * $ _ ❑  Compensable Delay Costs: $ ❑  Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): CHANGE ORDER REQUEST CITY OF PALO ALTO DEPARTMENT OF PUBLIC WORKS * Provide specific number/section/sheet references as applicable Line Time and Materials Breakdown (Reference Section 7.2 of General Conditions for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑  No cost change: N/A ❑  Increase cost by $ ❑  Decrease cost by $ Request for Extension of Contract Time (check one): ❑  No Change to Contract Time ❑  Time Extension Requested for _ days* o days Excusable Delay o days Compensable Delay ❑  Decrease time by _ days * Include all information and documentation required by Section 8.5 of the Contract General Conditions Conditions. Basis for requested change in cost: ❑  Unit pricing ❑  Lump sum: $ _ ❑  Time and Materials not to exceed: * $ _ ❑  Compensable Delay Costs: $ ❑  Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page page. Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): CHANGE ORDER REQUEST CITY OF PALO ALTO DEPARTMENT OF PUBLIC WORKS * Provide specific number/section/sheet references as applicable Contract Change Order Request – continued Line Time and Materials Breakdown (Reference Section 7.2 of General Conditions Conditions, e.g. Sections 1 and 7.2, for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑ No cost change: N/A ❑ Increase cost by $ ❑ Decrease cost by $ Request for Extension of Contract Time (check one): ❑  No cost change: N/A  No Change to Contract Time ❑  Increase cost by $  Decrease cost by $  Time Extension Requested for _ days* o days Excusable Delay o days Compensable Delay ❑  Decrease time by _ days * Include all information and documentation required by Section 8.5 of the Contract General Conditions Basis for requested change in cost: ❑  Unit pricing ❑  Lump sum: $ _ ❑  Time and Materials not to exceed: * $ _ ❑  Compensable Delay Costs: $ ❑  Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): CHANGE ORDER REQUEST CITY OF PALO ALTO DEPARTMENT OF PUBLIC WORKS * Provide specific number/section/sheet references as applicable Line Time and Materials Breakdown (Reference Section 7.2 of General Conditions for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK