CONSTRUCTION CHANGE ORDER WORKSHEET
Free field resource from BuildSlip — https://buildslip.com/change-order-template

Project / site:
Contract reference:
Change order number / revision:
Date:
Contractor / contact:
Customer / authorized representative:
Requested by / request date:

REQUESTED CHANGE
Original scope reference:
Work added / removed / revised:
Reason for change:
Included work:
Excluded work:
Supporting photos / drawings / written request:

PRICING
Basis: agreed lump sum / time and materials / pending review
Labor: role | hours | rate | amount
Materials: description | quantity | unit | unit cost | amount
Equipment: description | quantity | unit | rate | amount
Subtotal:
Agreed markup (basis and amount):
Applicable tax (basis and amount):
Proposed total / currency:

SCHEDULE
Additional days / dependency / to be confirmed:

APPROVAL
Status: draft / submitted / approved / rejected
What this signature acknowledges:
Authorized signer's name and role:
Signature:
Date:
Conditions / unresolved items:

RECORD CONTROL
Previous revision reference:
Sent to / date / method:
Related invoice reference (if any):

Keep the signed original and issue a new numbered revision for corrections.
This worksheet is not legal advice, a complete contract, or proof of payment.
Use the approval process and authorization required by your project contract.