Electrical Work Change Order Form
Project Name
Client Name
Change Order No.
Date
Reference No.
Change Order Details
Description of Change
Scope of Work
Scope of Electrical Work (materials, labor, location, etc.)
Cost Breakdown
Item
Description
Qty
Unit Cost
Total
Subtotal
Tax/Additional Charges
Total
Schedule Impact
Summary of impact on timeline/schedule
Signatures
Contractor Name
Client Name
Contractor Signature
Client Signature
Date
Date