125-22 Attachment - Admin Procedures Appendices Final Revised March 2022.pdf

APPENDIX E Change Directive (Field Work Order) Form Township of West Orange To _______________________________________ Field Work Order No. __________________________________________ _______________________________________ Project No. __________________________________________ _______________________________________ Project Name __________________________________________ __________________________________________ Basis of Field Work Order Project Location __________________________________________ Error / Omission Differing Site Condition Owner Request Field Resolution Contract Price (indicate if zero cost) Value Engineering ___________________ Add: $______________ Deduct: $_____________ Contract Time Cost Basis (check all that apply) No Change ___ Days Added ___ Days Deducted Time and Material Not to Exceed Fixed Price Allowance (described below) Unit Price Your company is authorized and directed to proceed with the following (attach additional sheets if needed): Justification: Special Notice: This Field Work Order identifies satisfaction of all compensation and time adjustments related to this change to the Work . Construction Manager (CM) Recommendation (if applicable) Township of West Orange

is change to the Work . Construction Manager (CM) Recommendation (if applicable) Township of West Orange Name: ___________________________________________________ Department of Administration __________________________________________ _____________ Division of Engineering Signature Date Architect / Engineer (A / E) Recommendation Project Manager Approval Name ________________________________________________ Name ____________________________________________ __________________________________________ ____________ __________________________________________ _________ Signature Date Signature Date Contractor Concurrence Name _________________________________________________ __________________________________________ _____________ Signature Date