Change Order Example: A Filled-In Sample, Field by Field

A useful change order example is one you can copy the structure of, not just look at. The sample below is a worked electrical example, built from a realistic scope: an unforeseen structural brace forced six receptacles to move, and it came to $3,800.60 with a three-day schedule impact. Every field is explained underneath.

Reading the example field by field

The header does the boring but essential work: it ties this document to a specific contract so nobody can argue later about which agreement it amends.

• Change order number — CO-014. Sequential, per project. Gaps in the sequence are what auditors ask about.
• Date — the date you issue it, which should be close to the date the work was directed, not the date you finally got around to invoicing.
• Contract number — BCG-2026-118. This is the line that makes the change order an amendment rather than a loose invoice.

The description is where change orders are won or lost

Compare what the example says with what most change orders say.

Three things make the strong version work: a person's name and a date, a drawing reference that can be independently checked, and an explicit statement of what did not change. The last one prevents the change order from being read as a renegotiation of the whole contract.

The cost breakdown

The example splits five lines rather than quoting one number. Labor is separated by trade level, because a journeyman hour and an apprentice hour are not the same cost and a reviewer will check that. Material is quantified in the unit it is bought in — 140 feet of EMT, not "conduit".

• Journeyman electrician, 18 hr @ $78 = $1,404
• Apprentice, 12 hr @ $44 = $528
• 3/4" EMT conduit and fittings, 140 ft @ $3.85 = $539
• Receptacles, boxes, plates, 6 ea @ $42 = $252
• Cat6 data drops relocated, 2 ea @ $165 = $330

Subtotal $3,053. Overhead and profit at 15% adds $457.95, tax at 8.25% adds $289.65, and the total is $3,800.60. Notice that overhead and profit sits on its own line at a stated percentage. Folding it into the unit prices — charging $90 for a $78 hour — is the single fastest way to make a reviewer distrust the whole document.

Schedule impact and evidence

The example claims three days. That number matters more than it looks: extra work that extends the job but declares zero days is how contractors lose delay claims months later. If the work genuinely has no schedule impact, write zero — but write it deliberately.

The notes line references photos DR-0729-01 through DR-0729-06 and a daily report dated 07/29/2026. This is the quiet part that decides disputes. The change order asserts a condition existed; the daily report and photos prove it did, on that date, before the work started.

What is missing from most examples online

• A named person who directed the change — most templates leave a blank nobody fills
• A reference to the specific drawing or spec section in dispute
• Separate signature blocks for contractor, general contractor, and owner, since contracts often require more than one
• An explicit schedule impact field, rather than assuming zero by omission
• A statement that the rest of the original scope is unchanged

The pillar piece covers the mechanics in more depth: what a change order is and what it must contain.