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Construction Program Management and Inspection Guide
Appendix G (continued)
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CALIFORNIA DIVISION RECORD OF PRIOR APPROVAL FOR MAJOR CONTRACT CHANGE ORDER |
| PROJECT NO. | CCO NO. | CONTRACT NO. | DIST-CO-RTE-PM |
| REQUESTED BY: | ___ CALTRANS HQ ___ RE/DISTRICT |
DATE: | |
| PROPOSED CHANGE: | |||
| REASON FOR CHANGE: | |||
| AS DISCUSSED IN FIELD (REPORT NO. __________) | |||
TIME EXTENSIONS NONE _____ DAYS DEFERRED |
ACTIVITY ON CRITICAL PATH AFFECTED BY CCO (IF TIME EXTENSION INVOLVED) | ||
| ESTIMATE OF COST: $_____ INCREASE DECREASE |
CCO: METHOD OF PAYMENT CONTRACT ITEMS ADJUSTMENT OF COMPENSATION AGREED PRICE EXTRA WORK AT FORCE ACCOUNT
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| THE WORK COVERED BY THE PROPOSED REVISION AS DESCRIBED ABOVE IS APPROVED SUBJECT TO SUBMISSION OF SUPPORTING DOCUMENTATION INCLUDING COST EVALUATION ANDJUSTIFICATION OF TIME EXTENTIONS. OTHER CONDITIONS: |
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| PRIOR APPROVAL TO PROCEED GRANTED BY: | DATE OF AUTHORIZATION: | ||
Form FHWA CA-358 ©Converted to Word 1/01 (Copy to CT)
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