CHANGE PROPOSAL GENERAL CONTRACTOR ________________________________________ Company Name Change Proposal No. ________________________________________ ________________________________________________ Address Project Name ________________________________________ Date Work Changes Proposal Request No. Architect THE BREAKDOWN OF PROPOSED COSTS FOR THIS CHANGE PROPOSAL IS AS FOLLOWS: A. For self-performed work: 1. Cost of Material & Supplies 2. Cost of Equipment 3. Cost of Labor 4. Payroll Tax, Insurance & Fringe Benefits on Labor (Percentage of line 3) (See UGC Article 11) 5. Subtotal 6. Mark-Up (See UGC Article 11) 7. Subtotal $_________________ B. 8. Total cost for subcontractors (from attached Subcontractor change proposal worksheets) 9. Mark-Up See Article 3 of Design-Build or CMAR Agreement 10. Subtotal of Lines 8 & 9 $_________________ (Part B - 8, 9 &10 not applicable if no subcontractor is involved) C. 11. TOTAL COST OF WORK $_________________ (subtotal of lines 7 & 10) 12. Cost of Insurance $_________________ (Builder's Risk only—if Change Order only)
CHANGE PROPOSAL GENERAL CONTRACTOR Company Name Change Proposal No. ________________________________________________ Address Project Name Date Work Changes Proposal Request No. Architect THE BREAKDOWN OF PROPOSED COSTS FOR THIS CHANGE PROPOSAL IS AS FOLLOWS: A. For self-performed work: 1. Cost of Material & Supplies 2. Cost of Equipment 3. Cost of Labor 4. Payroll Tax, Insurance & Fringe Benefits on Labor (Percentage of line 3) (See UGC Article 11) 5. Subtotal 6. Mark-Up (See UGC Article 11) 7. Subtotal $_________________ B. 8. Total cost for subcontractors (from attached Subcontractor change proposal worksheets) 9. Mark-Up See Article 3 of Design-Build or CMAR Agreement 10. Subtotal of Lines 8 & 9 (Part B - 8, 9 &10 not applicable if no subcontractor is involved) $_________________ C. 11. TOTAL COST OF WORK (subtotal of lines 7 & 10) $_________________ 12. Cost of Insurance (Builder's Risk only—if Change Order only) $_________________ ________________________________________ ________________________________________ ________________________________________
ChangeProposalForm.docx