RD2.31 CHANGE ORDER
(see [II]:3.2)

University of California

Facility:_________________________________________________________________________

Project Number:__________________________________________________________________

CHANGE ORDER NO. _____________

Project Name: ____________________________________________________________________

Project Location: _________________________________________________________________

Contract Number: _____________________ Contract Date: ______________________________

To Contractor: ____________________________________________________________________

Address:__________________________________________________________________________

DESCRIPTION OF CHANGE:

Adjustment of Contract Sum: Adjustment of Contract Time:
Original Contract Sum (Days):_____________ Original Contract Time:______________
Prior Adjustments: ______________Prior Adjustments: ______________(Days)
Contract Sum Prior to this Change:______________Contract Time Prior to this Change: ______________(Days)
Adjustment for this Change:______________Adjustment for this Change:______________(Days)
Revised Contract Sum (Days): ______________ Revised Contract Time:______________

Contractor waives any claim for further adjustments of the Contract Sum and the Contract Time related to the above described change in the Work.
Recommended:

__________________________________
(University's Representative)

Accepted:

__________________________________
(Contractor)

Reviewed and Recommended:

__________________________________
(University's Project Manager)

By:_______________________________
(Name)

__________________________________
(Title)

Funds Sufficient:

__________________________________
(University's Accounting Office)

Approved:

UNIVERSITY: THE REGENTS OF THE UNIVERSITY OF CALIFORNIA

By:__________________________________ (Name)

_____________________________________ (Title)

Date: ________________________________

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