Contract Change Order - Water Pollution Control Loan Fund

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WATER POLLUTION CONTROL LOAN FUND (WPCLF/SRF)
CONTRACT CHANGE ORDER
RECIPIENT
CHANGE ORDER NBR
LOAN NUMBER
CONTRACT
OWDA PROJECT No.
DATE
Description of Change:
RECOMMENDED BY:
DATE:
(Engineer)
APPROVED BY:
DATE:
(Recipient)
ACCEPTED BY:
DATE:
(Contractor)
(Company)
OWDA APPROVAL
Original Contract Amt
The above proposal is hereby accepted and
I recommend that it be approved and made
Previous Changes (+ / --)
a part of the contract noted above. The approval does
not constitute an increase in the total loan amount, but
represents approval for the work.
This Change (+ / --)
Adjusted Contract Amt
Chief Engineer
Ohio EPA Acceptance
Date
Date

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Related Categories

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