Form RD 1924-07 RD 1924-07 Contract Change Order

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FORM APPROVED
OMB NO. 0575-0042
Form RD 1924-7
(Rev. 2-97)

ORDER NO.

UNITED STATES DEPARTMENT OF AGRICULTURE
RURAL DEVELOPMENT AND
FARM SERVICE AGENCY

DATE
STATE

CONTRACT CHANGE ORDER

COUNTY

CONTRACT FOR
OWNER

To
(Contractor)

You are hereby requested to comply with the following changes from the contract plans and specifications:
INCREASE
in Contract Price

DECREASE
in Contract Price

Description of Changes
(Supplemental Plans and Specifications Attached)

$

$

TOTALS

$

NET CHANGE IN CONTRACT PRICE $

0.00

0.00

0.00

0.00

JUSTIFICATION:

The amount of the Contract will be (Decreased) (Increased) By The Sum Of:
Dollars ($

).

Dollars ($

).

The Contract Total Including this and previous Change Orders Will Be:

Days.

The Contract Period Provided for Completion Will Be (Increased) (Decreased) (Unchanged) :
This document will become a supplement to the contract and all provisions will apply hereto.
Requested
(Owner)

(Date)

(Owner's Architect/Engineer)

(Date)

(Contractor)

(Date)

(Name and Title)

(Date)

Recommended
Accepted
Approved by Agency
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid
OMB control number. The valid OMB control number for this information collection is 0575-01042. The time required to complete this information collection is estimated to average 15 minutes
per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of
information.
ORIGINAL-BORROWER'S CASE FOLDER
COPY-CONTRACTOR
COPY-BORROWER

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Form RD 1924-7 (Rev. 2-97)
POSITION 6