CATALOGUE ORDER FORM
Low Value Change Request                      Dated …………………………

To be completed by Authority Representative

Change no:

Brief description of the Change

Change of Law

Catalogue reference number (if applicable)

Catalogue price of Change (if applicable)

Budget for the Change (if not Catalogue)

Date for completion/implementation

To be completed by Contractor Representative

Confirmation of Catalogue Price/Time (if applicable)

If not Change in Catalogue:

(i)  cost of labour rates

(ii)  lifecycle cost (if appropriate)

(iii)  additional FM cost (if appropriate)

(iv)  plant/equipment costs (if appropriate)

Total cost