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CHANGE ORDER # DATE JOB NAME ORIGINAL CONTRACT AMT JOB LOCATION We propose the following changes in the scope of work: We propose the above changes in the scope of work for the added sum of: ($ ) dollars. The new contract amount is: dollars ($ ) Payment as follows: All material is guaranteed to be as specified. All work to be completed in a substantial workmanlike manner according to specifications submitted, per standard practices. Any alteration or deviation from above specificatio.

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