FCN

FIELD CHANGE NOTICE

(FCN # ….)

From : (“Buyer”)

To : (“Seller”)

Buyer hereby orders Seller and Seller accepts to make the change(s), addition(s) or omission(s) as
described below subject to the terms and conditions contained herein and in the original Purchase Order
or Contract referred to hereafter.

Purchase Order No.: Date of FCN:

Description of the change(s), addition(s) or omission(s):

(Specify amount of labor, material and other things required or deleted)

Cost variations for below items:

Price
# Description
(US $)
1 Supply material for stainless steel -

2 PMI with %carbon content -

Grand Total:

Seller’s commitment or estimate for:

Impact on the original price

(currency of the contract)
Impact on contractual delivery time

(working days)

Buyer’s representative: Buyer’s representative:

------------------------------- -------------------------------
(signature) (signature)

--------------------------------- ---------------------------------
(name) (name)
Distribution: Original copy: Procurement Manager
Copies: Project Manager
Commercial manager

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