EMPLOYER: CONTRACTOR: ENGINEER:

CONFIRMATION OF VERBAL INSTRUCTION

Project: Project No:

Date
Location: C.V.I. No.

DETAILS OF VERBAL INSTRUCTIONS:

Subject:

Instruction given by:

Date:

Location:

Contractor's Representative: Attachment:

This instruction is hereby confirmed in writing and unless contradicted in writing forthwith shall be
deemed to be an order in writing by the Engineer pursuant to conditions of contract.

Signed for Comp. : Date:

Response by the Engineer:

Signed for Engineer: Date