RUS Form 238, Construction for Equipment

RUS-238.pdf

Telecommunications System Construction Policies and Procedures

RUS Form 238, Construction for Equipment

OMB: 0572-0059

Document [pdf]
Download: pdf | pdf
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 0572–0107. The time required to complete this information collection is estimated to average 1 minute 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.

2. Date

1. Borrower Designation

U.S. Department of Agriculture
Rural Utilities Service

03/17/2004

CONSTRUCTION OR EQUIPMENT
CONTRACT AMENDMENT

3. Amendment No.

4. Contract No.

5. Bond Extension Attached

a. Original

Yes
6. Delivery or Completion Date
b. As Amended

†

† No

Instructions:

1. The Architect-Engineer shall submit three (3) copies of this form to the Owner.
2. If applicable, the Owner shall submit the three (3) copies of this form to RUS for approval.
8. A Summary of the Original Contract Price and
7. Reasons for, and Details and Description of the Amendment
Amendments thereto, Including this Amendment, follows:
(If additional space is needed, use reverse or separate sheet.)

(Amendments which decreased the price are preceded by a (-) minus
sign.)

Original Contract Price..................

$

Amendment Number 1.....................

$

Amendment Number 2.....................

$

Amendment Number 3.....................

$

Amendment Number 4.....................

$

Amendment Number 5.....................

$

Amendment Number 6.....................

$

Amendment Number 7.....................

$

Amendment Number 8.....................

$

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.

RUS Form 238 (Rev. 2-04)

1. Borrower Designation

2. Contract No.

CONSTRUCTION OR EQUIPMENT CONTRACT AMENDMENT (continued)
Item
No.

Reasons for and Description of Contract Amendment No.__________

* To be completed when applicable.

RUS Form 238 (Rev. 2-04)

Changes in Cost (decrease preceded by (-) minus sign)
Labor or
Material or
Installation
Equipment *
Total


File Typeapplication/pdf
File TitleForm 238 - Construction or Equipment Contract Amendment
AuthorUSDA/RUS
File Modified2004-03-23
File Created2004-01-29

© 2024 OMB.report | Privacy Policy