Republic of the Philippines

PROVINCE OF
Municipality of

CHANGE/EXTRA WORK ORDER NO.1

To ____________________ you are hereby directed to take the here describe change
from plan and specification of the described work not include in the Original Program of Work:

PROJECT: CONSTRUCTION OF SLOPE PROTECTION

DESCRIPTION OF WORK TO BE DONE:

1. Increase in volume of boulders.
2. Removal of Item IX – Hand Railing
3. Additional of Item X - Hauling of Materials from point source to Project Site(Double
Handling).

REASON (S) FOR CHANGE:

1. It was necessary to increase the height of the boulders because the ground is still
collapsing. Due to this, additional materials for slope protection were needed.
2. The additional item for labor that will haul the materials into the alley upto the project
site.

CHANGE REQUESTED BY: Municipal Engineer

WORK TO BE PERFORMED AT : Government Estimate

Different in Cost this change :P 0.00
Net Cost of Previous Changes : 0.00
Original Contract Award : 698,791.20
Estimated Revised Contract Amount : 698,791.20

By reason, this proposed change gives no calendar day (s) extension of contract time.

Total Extension of Time to Date including this Change Order cd.

PREPARED BY: CHECKED BY:

Building Inspector Municipal Engineer

Municipal Mayor
 I, the undersigned contractor has given careful consideration to the proposed change and
hereby agree if the proposal is approved, that I will provide all equipment, furnish all materials
except as may otherwise be noted above and perform all services necessary of the work above
specified and will accept as full payment, therefore the prices shown on the attached sheet:

CONTRACTOR

Date Accepted: ______________