Document Date
Meeting Description
Document Type
Meeting Date
Page Number
93
Attachment 12 — Customer Change Order Authorizations Form
CUSTOMER CHANGE ORDER AUTHORIZATION FORM
DESCRIPTION OF CHANGE:
Sample Language - EET was given Notice to Proceed (NTP) on xx/xx’‘xx and proceeded with the
final design and procurement of ...... This Change Order reflects the .....
See Attachment A — Additional Supportmg Documents;
a
Reference Documents — Email from / to Subject, Date
CONTRACT VALUE:
ount
£ o
- o
The Change Order becomes part of and is in conformance with the existing Agreement. All rere ond conditions of
the agreement apply.
Customer Authorized
Signature:
Name:
Title:
Date:
EE] Authorized Signature
Signature:
Name:
Title:
Date:
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