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ATTACHMENT 5 - CHANGE ORDER PROPOSAL FORMAT

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General

Date: "Edit to Current Date"
Task Order: "Edit to task order #"
"Edit to Change Description"
Contractor: "Add Name"
Materials
Quanity (Q)Unit (U)DescriptionUnit cost (MU)Total Cost (Q x MU)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Subtotal$0.00
10% Overhead$0.00
10% Profit$0.00
Total Material Cost$0.00
Labor
No. WorkersDurationHours (H)ClassificationHourly Base Rate (BR)Total Hourly Benefit Rate (BenR)Base Rate Costs (H x BR)Benefits Rate Cost (H x BenR)
Project Manager - Coordination$0.00$0.00$0.00$0.00
Superintendent$0.00$0.00$0.00$0.00
Laborer$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
--
Total Base Rate Cost (TBR)$0.00$0.00

Total Wage Rate Cost (TWR) $0.00

RateMandated Burden
0.00%Social Securty (on TBR)$0.00
0.00%Unemployment taxes (on TBR)$0.00
0.00%FUTA (on TBR)$0.00
0.00%Workmans Compensation Ins. (on TBR)$0.00
0.00%Vacation (on TBR)$0.00
0.00%Truck (on TBR)$0.00
0.00%Employee Health Ins. (on TBR)$0.00
0.00%Employee Disability Ins. (on TBR)$0.00
0.00%Public Liab. Ins. (on TBR)$0.00
0.00%
Total Mandated Burden (TBR)$0.00$0.00
Subtotal Labor Cost (TWR + TMB)$0.00
10% Overhead$0.00
10% Profit$0.00
Total Labor Cost$0.00
Equipment
QuantityDurationUnit (day, wk, mo.)DescriptionRental Rate for DurationRental Cost
Sub Total$0.00
Sales Tax 6%$0.00
Sub Total$0.00
10% Overhead$0.00
10% Profit$0.00
Total Equipment Cost$0.00
Subcontractor Work
DescriptionTotal Cost
Sub Total$0.00
10% Overhead$0.00
10% Profit$0.00
Total Subcontractor Cost$0.00
Summary
Total Material Cost$0.00
Total Labor Cost$0.00
Total Equipment Cost$0.00
Total Subcontractor Cost$0.00
Sub Total$0.00
2% bond Cost$0.00
Total$0.00

Subcontractor

Date: "Edit to Current Date"
Task Order: "Edit to task order #"
Edit to Change Description
Contractor: "Add Name"
Materials
Quanity (Q)Unit (U)DescriptionUnit cost (MU)Total Cost (Q x MU)
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Subtotal$0.00
10% Overhead$0.00
10% Profit$0.00
Total Material Cost$0.00
Labor
No. WorkersDurationHours (H)ClassificationHourly Base Rate (BR)Total Hourly Benefit Rate (BenR)Base Rate Costs (H x BR)Benefits Rate Cost (H x BenR)
Laborer$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
$0.00$0.00
--
Total Base Rate Cost (TBR)$0.00$0.00

Total Wage Rate Cost (TWR) $0.00

RateMandated Burden
0.00%Social Securty (on TWR)$0.00
0.00%Unemployment taxes (on TWR)$0.00
0.00%FUTA (on TWBR)$0.00
0.00%Workmans Compensation Ins. (on TWR)$0.00
0.00%Vacation (on TWR)$0.00
0.00%Truck (on TWR)$0.00
0.00%Employee Health Ins. (on TWR)$0.00
0.00%Employee Disability Ins. (on TWR)$0.00
0.00%Public Liab. Ins. (on TWR)$0.00
0.00%
Total Mandated Burden (TMB)$0.00$0.00
Subtotal Labor Cost (TWR + TMB)$0.00
10% Overhead$0.00
10% Profit$0.00
Total Labor Cost$0.00
Equipment
QuantityDurationUnit (day, wk, mo.)DescriptionRental Rate for DurationRental Cost
Sub Total$0.00
Sales Tax 6%$0.00
Sub Total$0.00
10% Overhead$0.00
10% Profit$0.00
Total Equipment Cost$0.00
Summary
Total Material Cost$0.00
Total Labor Cost$0.00
Total Equipment Cost$0.00
Sub Total$0.00
2% bond Cost$0.00
Total$0.00

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