Additional Work Info

Change Order #

Customer Name:

Job Address:

We Hereby Submit the Following Specifically Described Additional Work:

Additional Charge for above describe work is: $

Additional work to be performed under same condition as specified in original contract unless stipulated.

Acceptance of Additional Work

Respectfully Submitted:

The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.

Date of Acceptance:

Signature:
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.