REQUEST FOR CHANGE ORDER – GOVERNMENT FAULT

Date

Mr. Prime Contractor

(Address)

Re: Request for Change Order

(Subject)

Contract number

Dear Sir:

Attached please find the price breakdown and supporting data for my Request for Change Order under this subcontract, for an increase in the contract amount of $ and a contract time extension of calendar days.

I am submitting this request because of

(Describe the problem, differing conditions, direction to proceed with a change, delays, etc.)

If you have any questions, I would be glad to meet and discuss this matter with you. Although I believe the Government to be responsible for this change, my contract is with you and I must reserve my rights to pursue this matter against you should efforts to settle with the Government fail.

Being a small business, I cannot afford to finance this extra cost. I request that you issue a change order to my subcontract for this change as soon as possible.