JV-DP180 Att.03 - Variation Order

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VARIATION ORDER

VO Ref.: Date:

Contractor: RFV Ref.:

Cost Center Name: Cost center No.:

Cost Impact detailes


Amount
Item No Description Quantity Unit Rate JV Remarks
Omit Add

Total

Net Omission/Addition
Impact on Contract Value
Original Contract Value:………………
Previous approved VO's Value (up to VO No. ):…………………….
Current Final Value including this VO:………………..
Time Impact

Yes No

If yes, specify, Encluse time impact analysis :


Requester

Name Job title Signature Date

JV Decision

Cost Impact : Yes No


Cost Impact Amount
Time Impact : Yes No
Time Impact duration:

Name Job title Signature Date

Requester final confirmation

Name Job title Date Date

JV/DP180 Att.03 Rev.02 28 Jan. 2021 Page 1 of 1 .

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