U.S. Department of Agriculture Rural Utilities Service |
1. Borrower Designation
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2. Date
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CONSTRUCTION OR EQUIPMENT CONTRACT AMENDMENT
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3. Amendment No.
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4. Contract No.
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5. Bond Extension Attached Yes No |
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6. Delivery or Completion Date |
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a. Original
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b. As Amended
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Instructions: 1.
The Architect-Engineer shall submit three (3) copies of this
form to the Owner. |
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7. Reasons for, and Details and Description of the Amendment (If additional space is needed, use reverse or separate sheet.) |
8. A Summary of the Original Contract Price and Amendments thereto, Including this Amendment, follows: (Amendments which decreased the price are preceded by a (-) minus sign.) |
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Original Contract Price.................. |
$ |
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Amendment Number 1..................... |
$ |
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Amendment Number 2..................... |
$ |
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Amendment Number 3..................... |
$ |
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Amendment Number 4..................... |
$ |
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Amendment Number 5..................... |
$ |
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Amendment Number 6..................... |
$ |
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Amendment Number 7..................... |
$ |
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Amendment Number 8..................... |
$ |
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Amended Contract Price................ |
$ |
This amendment, providing
for an increase of $_________________________ / decrease of
$__________________________
in the contract price is
submitted pursuant to the provisions of said contract. This
amendment does _____ , does not_____ , require approval of the
Administrator of RUS . To the extent the items hereof are approved,
the contract shall be amended.
RECOMMENDED
Architect-Engineer Date
ACCEPTED
Contractor Owner
By By
President President
Date Date
This Amendment must be signed with the full name of the Contractor. If the Contractor is a partnership, this Amendment must be signed in the partnership name by a partner. If the Contractor is a corporation, this Amendment must be signed in the corporate name by a duly authorized officer.
CONSTRUCTION OR EQUIPMENT CONTRACT AMENDMENT (continued) |
1. Borrower Designation
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2. Contract No.
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Item No. |
Reasons for and Description of Contract Amendment No.__________ |
Changes in Cost (decrease preceded by (-) minus sign) |
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Labor or Installation |
Material or Equipment * |
Total |
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* To be completed when applicable. |
File Type | application/msword |
Author | USDA/RUS |
Last Modified By | joyce.mcneil |
File Modified | 2008-07-15 |
File Created | 2008-07-15 |