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CONSTRUCTION EXTRA WORK AUTHORIZATION
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Authorization Control
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Authorization Number
Revision Number
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Authorization Status
Work Status
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Project Name
Project Number
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Site Address
Customer Name
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Main Contractor Name
Subcontractor Name
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Contract Reference
Subcontract Reference
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Purchase-order Number
Work-order Number
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Cost CodeTrade
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Work PackageProject Phase
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Building / Floor / Zone
Pricing Method
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Authorization Basis
Instruction Type
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Request and Authorization
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Requested By
Requester Company / Role
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Requested Date
Authorized By
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Authorizer Company / Role
Authorization Date
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Required Start Date
Required Completion Date
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Pricing Valid Until
Instruction Reference
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Scope and Commercial Basis
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Reason for Extra Work
Extra Work Description
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Original Scope Reference
Scope Exclusion Reference
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Authorization Limitations
Assumptions
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Exclusions
Access / Safety / Permit Requirements
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Estimated Authorization Value
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Estimated Direct Cost
Estimated Overhead
Estimated Profit
Estimated Tax
Estimated Authorization Value
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Not-to-Exceed Amount
Unit-rate Reference
Cost-plus Terms
Schedule Impact
Additional Days Requested
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Documentation Requirements
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Daily Ticket Required
Receipt Required
Photograph Required
Customer Verification Required
Overtime Required
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Resequencing Required
Safety Review Required
Permit Required
Work Complete
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Actual Cost and Commercial Closeout
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Actual Total Cost
Remaining Authorized Value
Final Submitted Value
Final Approved Value
Variance from Authorization
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Verification, Billing and Closeout
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Daily Ticket Status
Work Verified By
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Verification Date
Supporting-document Status
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Change-order Number
Invoice Reference
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Payment-application Reference
Billing Status
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Payment Status
Closed Date
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Comments and Attachments
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Attachment Checklist
Verification Comments
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Customer Comments
Internal Notes
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