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Issue No.

01
CONS/EOT/42 FORMS/RECORDS
Rev. No 00
FORM 42: CLAIM FOR EXTENSION OF TIME
Project Name EOT NO.

Contract Start Date Contract Initial Completion Date

Contract Completion Date

EOT Request Details


No. of Calendar Projected Completion Reasons for requesting EOT Attach
days dates
☐ CVI NO…….
☐ RFI No……..
☐ Drawing
No……..

REQUESTED FROM
Site Manager Name Signature Date

PROJECT MANAGER APPROVAL


☐ EOT Approved for ……………Calendar days
☐ EOT Not Approved for (Include reasons)
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
…………………………………………………………………………………………………………

Name: Signature Date

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IC: PAD/CONS/01

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