2024 Construction Change Order Form with Fillable Fields

Page 1

CONSTRUCTION

CHANGE Order Request Date of Request: Borrower: Project Address: Loan Number: Relationship Manager:

LINE-ITEM DESCRIPTION

ORIGINAL BUDGET AMOUNT

PROPOSED BUDGET AMOUNT

$

$

$

$

$

$

$

$

$

$

REASON(S) FOR CHANGE:

The Borrower(s) and General Contractor hereby certify that the requested changes will not impact the project’s viability nor the ability to obtain a Certificate of Occupancy, if applicable. The requested changes will only result in transferring funds between line items. We understand that the overall loan amount is not increasing.

Borrower Signature:

Borrower Signature:

General Contractor (if applicable):

Relationship Manager:

UPDATED 1/2024

MEMBER FDIC


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