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CHANGE ORDER REQUEST FORM <br />CONTRACT NO. R 36$81 <br />UPON WRITTEN REQUEST FROM THE ENGINEER, PROVIDE ADDITIONAL DETAIL <br />DATE RECEIVED REQUEST FOR <br />' j �gg !yy� <br />Daly C, L V � <br />SUBMITTAL DATE OF <br />` s� (�q p <br />July if �U 8 <br />ADDITIONAL DETAIL <br />ADDITIONAL DETAIL <br />DETAILED DESCRIPTION /JUSTIFICATION; <br />(include location(s), actions of contractor, owner, and other stakeholders, key events and related cause(s), discoveries, <br />discussions, meetings, and effect on the contract if no action is taken. Also include references to key documents attached <br />or available to support this change order request.) <br />PROPOSED SOLUTION —ADDITIONAL DETAILS. <br />(Include proposed scope of work, means & methods, materials, equipment, utility relocation required, subcontracted <br />scope and the effect on the contract schedule. Also include references to attached documents including, but not limited <br />to, sketches, calculations, photos, material information, and submittals and meeting minutes.) <br />Pg. 2 <br />