Form 526-Construction Contract Amendment

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 0572-0059. The time
required to complete this information collection is estimated to average 3 hours 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.

RUS FORM 526
REV. 8-66
U. S. DEPARTMENT OF AGRICULTURE
RURAL UTILITIES SERVICE

1. PROJECT DESIGNATION

CONSTRUCTION CONTRACT AMENDMENT

2. AMENDMENT NO.

INSTRUCTIONS – Submit three (3) copies of this form
And three (3) copies of all attachments.
To: THE ADMINISTRATOR
RURAL UTILITIES SERVICE
U. S. DEPT. OF AGRICULTURE , WASHINGTON, D.C. 20250

3. DATE

4.
DETAILS OF CHANGES ARE TABULATED ON SHEET 2
T0
ATTACHED AND ARE PART OF THIS AMENDMENT.

5.
THE FOLLOWING CHANGES IN CONSTRUCTION CONTRACT NUMBER

20

,

DATED

ARE HEREBY MERELY SUBMITTED FOR YOUR APPROVAL.
6. DATA PERTINENT TO THE ORIGINAL CONTRACT, AND AMENDMENTS INCLUDING THIS AMENDMENT ARE AS FOLLOWS (DECREASE TO
BE PRECEDED BY (-) MINUS SIGN).

ROUTE
MILES

SUBSCRIBERS
SIGNED

PRICE

POTENTIAL

$

ORIGINAL CONTRACT
AMENDMENT NO.1
AMENDMENT NO. 2
AMENDMENT NO. 3
AMENDMENT NO. 4
AMENDMENT NO. 5
AMENDMENT NO. 6

$

TOTAL WITH THIS AMENDMENT
7. FOR ADDITIONAL DATA REFER TO STATEMENT OF CONSTRUCTION, RUS FORM 527 DATED

,

20

,

WHICH

ARE ATTACH ED HEREBY AND MADE A PART HEREOF.
8. BOND EXTENSION ATTACHED
YES

9. THE CONSTRUCTION PERIOD WILL BE CHANGE TO

DAYS.

NO

10. NEW COUNTIES ( IF ANY)]
11. DESCRIPTION AND REASON FOR CHANGE:

This amendment, providing for an increase/decrease of $
in the amount of said construction
contract, is submitted pursuant to the provisions thereof and pursuant to the loan contract between the United States of
America and the undersigned Borrower. You are hereby authorized to approve this amendment either in whole or in part and
to delete such items as do not meet with your approval. To the extent the items hereof are approved by you, the construction
contract shall be amended.
ACCEPTED

By

By
CONTRACTOR

BORROWER

By
PRESIDENT – OWNER –PARTNER*

By
PRESIDENT

APPROVED

DATE

ENGINEER FOR THE BORROWER

*Strike out inapplicable tittle. If signed by other than above, power of attorney should be attached or on file with RUS.

RUS Form 526

Rev. 8-66

OMB Control No. 0572-0059
Expiration Date: November 2020

SHEET
RUS FORM 526
REV 8-66
ATTACHMENT

ITEM
NO.

PROJECT DESIGNATION

U.S. DEPARTMENT OF AGRICULTURE
RURAL UTILITIES SERVICE

ASSEMBLY
UNIT
DESIGNATION

AMENDMENT NUMBER

CONSTRUCTION CONTRACT AMENDMENT
D E T A I LS O F C O N T R A C T A M E N D M E N T
*CONTRACT AMENDED TO READ

**------ ---------------------

QUANTITY
PREVIOUSLY
APPROVED

NET CHANGE
NUMBER
OF UNITS

NUMBER
OF UNITS

OF

UNIT PRICE

TOTAL

MATERIAL
TOTAL
LABOR
-------------------- -------------------- --------------------- --------------- --------------- ---------------

PRICE

TOTAL
INCREASE
PRICE

TOTAL
DECREASE
PRICE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
TOTALS F
NET TOTAL

* Show quantities and prices as revised by this amendment.

RUS Form 526

Rev. 8-66

**Carried forward from previous page.

OMB Control No. 0572-0059
Expiration Date: November 2020