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HOFFMAN CONSTRUCTION COMPANY

EXTRA WORK AUTHORIZATION

Project Name: Project Number: Date: Authorization Number:

Subcontractor: designated work outlined below. Description of work:

is hereby authorized to perform the

Basis of Payment: The Subcontractor will perform this work on the following basis: Lump sum of $ Cost of time and material based upon approved Daily Extra Work Reports which shall be completed in full and submitted to Hoffman Construction Company on a daily basis. Approval of such reports is a condition of payment to the Subcontractor. Cost of time and materials, as outlined above, with total costs not to exceed $ .

Scope of work: The work should take approximately workers and the following materials and equipment:

days to perform, utilizing a crew of

Requested by: Authorized by:

Hoffman Construction Company

Copies:

Original to Subcontractor Pending File Field Office EWA Log

Project Superintendent Field Superintendent Project Engineer Project Manager

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EXTRA WORK AUTHORIZATION.doc