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C軸ANGE ORDER REQuES丁FOR州 <br />CO評議慣　董鼠電9軸0 <br />」山 <br />DA細管OF <br />SU露MISSloN <br />NO棺的O競れ2qu跨書方Om Enginee阜e庇e「 de書o洗dくねsc「匝ion o職pOge 2.巨三二正三 <br />PROPOSED COST AND TIME ADJUSTMENT <br />CO§T INCREASE / <br />Co釘“∴∴∴ (D各部王A軍事∴∴∴∴ S <br />104.03巨xt「a WQ「k <br />The cost aqjustme巾Shall include山mp sum and estimated totaled un晒item costs. A請ach a separate shect of un韓price items <br />i鵬luding ifem descrip館on, unit of measurement, eSせmafed quantfty and u面t price, <br />CHECK APPROPRiATE BOXE§ PER APPROPRIATE BASIS OF COST CHANGE: <br />□ 109.03 AItered Quantities　図109.05勘Agreed師誌　□ 109.05胆汁or健Account　口109.05∬2 Delay Costs <br />PROPOSEDCOSTCHANG各INCLuDES:口Labor口Material　□ Equipment　□ LeaseAgreement　図 <br />†-M岬　1NC雌I {脚的;　　《w刷a淘工事二コ <br />CH霊CK APPROPRIA「各BOX書鵜pとR APPROPRIAr惟BASiS OF TIM各CHANGE: <br />□ 108.08(a) ExcusabIe, Non-Compensable　　　　　図108.08(b) Excusable, Compensa馴e <br />NO7f巧軸a請adl ddr穂的sgd on ]Og.05.2佃) A〃owob厄庇佃y Cds糖. <br />SUPPLEMENTAL INFORMA丁ION <br />CHANGE ORD蛾A陣Eぐ「S DBE PARTICIpŶON:　!ロyes図no　笹γeS, a鴫Ch details)