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Change Order Form
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PROJECT NUMBER: 'NOR) 1701.61Wd4'1" ObaC ro?-I tl
CONTRACTORKcmy Lenasapin9 LLC (PC "1 N22n)
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ORIGINAL CONTRIC COST
TOTAL APPROVED CHANGE ORDERS
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TOTAL PENDING CHANGE ORDERS
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TOTAL THIS CHANGE ORDER
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TOTAL M OF THIS CRA NGE ORDER
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TOTAL L.O. T OF ORIGINAL CONTRACT
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ADJUSTED CO COST
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