Common use of Project Title Clause in Contracts

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑ No cost change: N/A ❑ Increase cost by $ ❑ Decrease cost by $ Request for Extension of Contract Time (check one): ❑ No Change to Contract Time ❑ Time Extension Requested for days* o days Excusable Delay o days Compensable Delay ❑ Decrease time by days * Include all information and documentation required by Section 8.5 of the Contract General Conditions. Basis for requested change in cost: ❑ Unit pricing ❑ Lump sum: $ _ ❑ Time and Materials not to exceed: * $ _ ❑ Compensable Delay Costs: $ ❑ Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page. Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): * Provide specific number/section/sheet references as applicable Contract Change Order Request – continued Line Time and Materials Breakdown (Reference General Conditions, e.g. Sections 1 and 7.2, for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑  No cost change: N/A ❑  Increase cost by $ ❑  Decrease cost by $ Request for Extension of Contract Time (check one): ❑  No Change to Contract Time ❑  Time Extension Requested for _ days* o days Excusable Delay o days Compensable Delay ❑  Decrease time by _ days * Include all information and documentation required by Section 8.5 of the Contract General Conditions. Conditions Basis for requested change in cost: ❑  Unit pricing ❑  Lump sum: $ _ ❑  Time and Materials not to exceed: * $ _ ❑  Compensable Delay Costs: $ ❑  Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page. page Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): CHANGE ORDER REQUEST CITY OF PALO ALTO DEPARTMENT OF PUBLIC WORKS * Provide specific number/section/sheet references as applicable Contract Change Order Request – continued Line Time and Materials Breakdown (Reference Section 7.2 of General Conditions, e.g. Sections 1 and 7.2, Conditions for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑ No cost change: N/A ❑ Increase cost by $ ❑ Decrease cost by $ Request for Extension of Contract Time (check one): ❑ No Change to Contract Time ❑ Time Extension Requested for _ days* o days Excusable Delay o days Compensable Delay ❑ Decrease time by _ days * Include all information and documentation required by Section 8.5 of the Contract General Conditions. Conditions Basis for requested change in cost: ❑ Unit pricing ❑ Lump sum: $ _ ❑ Time and Materials not to exceed: * $ _ ❑ Compensable Delay Costs: $ ❑ Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page. page Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): CHANGE ORDER REQUEST CITY OF PALO ALTO DEPARTMENT OF PUBLIC WORKS * Provide specific number/section/sheet references as applicable Contract Change Order Request – continued Line Time and Materials Breakdown (Reference Section 7.2 of General Conditions, e.g. Sections 1 and 7.2, Conditions for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑ No cost change: N/A ❑ Increase cost by $ ❑ Decrease cost by $ Request for Extension of Contract Time (check one): ❑  No cost change: N/A  No Change to Contract Time ❑  Increase cost by $  Decrease cost by $  Time Extension Requested for _ days* o days Excusable Delay o days Compensable Delay ❑  Decrease time by _ days * Include all information and documentation required by Section 8.5 of the Contract General Conditions. Conditions Basis for requested change in cost: ❑  Unit pricing ❑  Lump sum: $ _ ❑  Time and Materials not to exceed: * $ _ ❑  Compensable Delay Costs: $ ❑  Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page. page Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): CHANGE ORDER REQUEST CITY OF PALO ALTO DEPARTMENT OF PUBLIC WORKS * Provide specific number/section/sheet references as applicable Contract Change Order Request – continued Line Time and Materials Breakdown (Reference Section 7.2 of General Conditions, e.g. Sections 1 and 7.2, Conditions for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑  No cost change: N/A ❑  Increase cost by $ ❑  Decrease cost by $ Request for Extension of Contract Time (check one): ❑  No Change to Contract Time ❑  Time Extension Requested for days* o days Excusable Delay o days Compensable Delay ❑  Decrease time by days * Include all information and documentation required by Section 8.5 of the Contract General Conditions. Basis for requested change in cost: ❑  Unit pricing ❑  Lump sum: $ _ ❑  Time and Materials not to exceed: * $ _ ❑  Compensable Delay Costs: $ ❑  Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page. Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): * Provide specific number/section/sheet references as applicable Contract Change Order Request – continued Line Time and Materials Breakdown (Reference General Conditions, e.g. Sections 1 and 7.2, for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK

Project Title. Project No.: Contract Number: Date: Contractor: Change Order Request No.: Description of Change Order Request (Attach additional sheets as needed) Reason for Change Order Request: Description of Work to be Performed: Requested Change to Contract Sum: ❑ No cost change: N/A ❑ Increase cost by $ ❑ Decrease cost by $ Request for Extension of Contract Time (check one): ❑ No Change to Contract Time ❑ Time Extension Requested for days* o days Excusable Delay o days Compensable Delay ❑ Decrease time by days * Include all information and documentation required by Section 8.5 of the Contract General Conditions. Basis for requested change in cost: ❑ Unit pricing ❑ Lump sum: $ _ ❑ Time and Materials not to exceed: * $ _ ❑ Compensable Delay Costs: $ ❑ Other: _ * Final value shall not exceed amount shown without additional written CO authorization. Complete Time and Materials Breakdown on following page. Reference Documents:* RFI: ASI: Field Order: Specifications: Plans: Other: (specify): * Provide specific number/section/sheet references as applicable Contract Change Order Request – continued Line Time and Materials Breakdown (Reference General Conditions, e.g. Sections 1 and 7.2, for Allowable Costs and markup) Added Credit All lines shall be filled in (zero values acceptable) CONTRACTOR’S WORK