Sample Variation Form

Variations Approval Request Form

Project: Variation Summary No.:

Principal: PCG No.:
Contractor: Date:
Project Manager:

AGREED CONTINGENCY: $ -
VARIATIONS APPROVED TO DATE: $ -
ADD THIS VARIATION SUMMARY No. $ -
REMAINING CONTINGENCY: $ -
Recommended Variations (For PCG Endorsement and DH Formal Approval)
Variation No. Site Variation Variation Variation Variation PCG
(VARQT) Inst. Title Description Estimate Recommended Rec
No. (SI)
             
             
             
             
$
      TOTALS: - $ -  
Pending Variations (For PCG ‘In-principle’ approval)
Variation No. Site Variation Variation Variation Variation PCG
(VARQT) Inst. Title Description Estimate Recommended Rec
No. (SI) (Upper Limit)
             
             
             
             
$
      TOTALS: - $ -  
Capital Projects & Service Planning Approval      
Project Manager: Signed:
Date:  
Director, Capital Projects and Service Planning    
Authorised by: Signed:
Date:  
Reviewed and Recommended in PCG Number:  PCG Date:  
Note: All amounts exclude GST