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ADDITIONAL WORK AUTHORIZATION OWNER S PHONE DATE JOB NAME JOB NUMBER NAME STREET CITY EXISTING CONTRACT NO. STATE DATE OF EXISTING CONTRACT We hereby agree to the specified changes and charges listed below ADDITIONAL CHARGE FOR ABOVE WORK IS Payment to be made as follows Owner Above additional work to be performed under same conditions as specified in original contract unless otherwise stipulated* Authorized Signature Date OWNER SIGNS HERE 19 Contractor CONTRACTOR SIGNS HERE CHANGE ORDER NO.
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