Change Directive (Field Work Order) Form
Suite 101 Harbourt Hall • 615 Loop Road • P. O. Box 5190 • Kent, Ohio 44242-0001
v: 330-672-3880 • f: 330-672-2648 • web site: www.kent.edu/universityarchitect
OFFICE OF THE
UNIVERSITY ARCHITECT
Field Work Order No.
To
Project No.
Project Name
Basis of Field Work Order
Error / Omission
Differing Site Condition
Project Location
Owner Request
Field Resolution
Contract Price (indicate if zero cost)
Value Engineering
Add:
$
Campus
Deduct: $
Cost Basis (check all that apply)
Contract Time
No Change
Kent State University
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)
KENT STATE UNIVERSITY
OFFICE OF THE UNIVERSITY ARCHITECT
Name
Office of the University Architect
Project Manager Approval
Signature
Date
Architect / Engineer (A / E) Recommendation
Name
Name
Signature
Signature
Date
Date
Contractor Concurrence
Name
cc:
KSU-OUA Director
KSU-OUA Accounting
Signature
KSU-OUA 09/2012
Date
CHANGE DIRECTIVE (FORMERLY FIELD WORK ORDER) FORM