SAGANA AT LIGTAS NA TUBIG SA LAHAT

City/Municipality _______________

MEMORANDUM

FOR: City/Municipal Mayor

SUBJECT: VARIATION (CHANGE/EXTRA WORK) ORDER NO.____

(TITLE)______________________________
______________________________________

DATE: ___________________

In connection with the implementation of the subject project, we are submitting

herewith for your approval Change/Extra Work Order No.___ in the amount of
Php.___________.

This variation order covers adjustment of the quantities to suit actual office/field
conditions and/or revisions of plans and specifications.

A. Description of Works
________________________________________________
________________________________________________

B. Justification/Reasons for this Variation Order

________________________________________________
________________________________________________

C. Cost of Variation Order No.

Description Original Previous Revised New Revised Difference

Contract Contract Amount Contract
Amount due to EW/CO # 01 Amount due to
Final VO

Construction Works
Finishing Works
Doors and Accessories
Electrical Works
Miscellaneous
Total

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D. Variation Order to Date

Original Contract Amount ________________________

Amount from Previous Change Order ________________________
Amount this Extra Work/Change Order ________________________
Revised Contact Amount ________________________

E. Effects in Contract Time

Original Contract Time ________________________

No. of Days this EWO/CO#01 ________________________
No. of Days this EWO/CO#02 ________________________
Revised Contract Time ________________________
Revised Expiry Date ________________________

_________________________
Municipal Engineer

Funds Allocated Funds Available

________________________ _____________________
City/Municipal Budget Officer City/Municipal Treasurer

Approved by:

________________________
Mayor

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