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Page 1 of 4 <br />Change Order No._________________________ <br />Change Order Effective Date:________________ <br /> CITY OF EVERETT <br />Unilateral Change Order <br />Project Title <br />Department <br />Work Order No. <br />Contractor: <br />Contract Award Date: <br />City Staff Contact: <br />Change Order No. <br />Change Order <br />Effective Date <br />CONTRACT SUM <br /> Original Contract <br />Sum <br />Total of Previous <br />Change Orders <br />This Change <br />Order <br />Contract Sum <br />After this Change <br />Order <br />Amount $$$$ <br />+ WSST $$$$ <br />Total $$$$ <br />CONTRACT TIME <br />Original Contract Time Working Days / Calendar Days <br />Date of Notice to Proceed <br />Cumulative adjustment to time by prior Change Orders <br />Adjustment to time by this Change Order <br />New Contract Time (including this Change Order)