Republic of the Philippines

Department of Public Works and Highways

Implementing Office
PROPOSED VARIATION ORDER NO.: __________
Contract ID :
Contract Name & Location :
Name of Contractor:

You are hereby directed to make herein described changes from the plans and specifications of the following described work not included in the plans
and specifications:
DESCRIPTION OF WORK TO BE DONE : _________________________________________________________________________________________________________
REASON FOR CHANGE : _____________________________________________________________________________________________________
CHANGE REQUESTED BY : ______________________________________

ITEMIZED QUANTITIES AND COST OF REVISION IS SHOWN IN THE ATTACHED BILL OF QUANTITIES AND COST ESTIMATE

Original Contract Cost:

We the undersigned Contractor/s have given careful consideration to the change Difference in Cost due to this Change:
proposed and hereby agree, if this proposal is approved that we will provide all equipment,
Net Cost of Previous Change:
furnish all materials except as maybe otherwise be noted and perform all services necessary
Total Cost of Change:
for work above specified and will accept as full payment thereto the prices shown on the
second page of the attached sheet. Estimated Revised Contract Amount:
Percentage Change in Original Contract Value (+) or (-):

Concured by: Original Contract Duration:

Total Approved Contract Time Extension Prior to this VO:
Time Extension due to this V.O.
NAME & SIGNATURE Revised Contract Duration
Contractor Effectivity of Contract
ACCEPTED DATE : Original Contract Expiry Date
Revised Contract Date

Prepared by: Checked & Submitted by: Recommending Approval: APPROVED :

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE
Project Engineer Chief of Implementing Sec/Div. Asst. District Engr./Asst. Regional Dir. District Engineer/Regional Director
Date : __________________________
Note: This Variation Order is not effective until approved.

PIF-12-VO-01A Rev 00
 Republic of the Philippines
Department of Public Works and Highways
Implementing Office
PROPOSED VARIATION ORDER NO.: __________
Contract ID :
Contract Name & Location :
Name of Contractor:

You are hereby directed to make herein described changes from the plans and specifications of the following described work not included in the plans
and specifications:
DESCRIPTION OF WORK TO BE DONE :____________________________________________________________________________________________
REASON FOR CHANGE : ___________________________________________________________________________________________________________
CHANGE REQUESTED BY : ______________________________________

ITEMIZED QUANTITIES AND COST OF REVISION IS SHOWN IN THE ATTACHED BILL OF QUANTITIES AND COST ESTIMATE

Original Contract Cost:

We the undersigned Contractor/s have given careful consideration to the change Difference in Cost due to this Change:
proposed and hereby agree, if this proposal is approved that we will provide all equipment,
Net Cost of Previous Change:
furnish all materials except as maybe otherwise be noted and perform all services necessary
Total Cost of Change:
for work above specified and will accept as full payment thereto the prices shown on the
second page of the attached sheet. Estimated Revised Contract Amount:
Percentage Change in Original Contract Value (+) or (-):

Concured by: Original Contract Duration:

Total Approved Contract Time Extension Prior to this VO:
Time Extension due to this V.O.
NAME & SIGNATURE Revised Contract Duration
Contractor Effectivity of Contract
ACCEPTED DATE : Original Contract Expiry Date
Revised Contract Date

Prepared by: Checked & Submitted by: Recommending Approval: APPROVED :

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE
Project Engineer Project Manager Project/Bureau Director Undersecretary
DPWH & Consultant, if any DPWH & Consultant, if any Date : _________________________

Note: This Variation Order is not effective until approved.

PIF-12-VO-01B Rev 00
Contract ID :

Contract Name :

Location :

Contractor :

ITEMIZED COST OF REVISION

Proposed Variation Order No. ___

ORIGINAL CONTRACT PROPOSED VARIATION ORDER No. ___

CHANGE ORDER PROPOSED REVISED CONTRACT COST DUE TO
Pay Item No. Pay Item Description TOTAL EXTRA WORK ORDER VARIATION ORDER No. ___ REMARKS
UNIT QTY UNIT PRICE ADDITIVE DEDUCTIVE
AMOUNT
QTY AMOUNT QTY AMOUNT QTY AMOUNT QTY AMOUNT

Prepared by: Verified as to Unit Cost: Verified as to Quantities

NAME & SIGNATURE NAME & SIGNATURE

Chief, Implementing Sec./Div. NAME & SIGNATURE
Chief, Planning & Design Sec/Div
Project Engineer

Conformed:

NAME & SIGNATURE

Contractor

PIF-12-VO-02A Rev 00
Contract ID :
Contract Name :
Location :
Contractor :

ITEMIZED COST OF REVISION

Proposed Variation Order No. ___

ORIGINAL CONTRACT PROPOSED VARIATION ORDER No. ___

PROPOSED REVISED CONTRACT
CHANGE ORDER COST DUE TO VARIATION ORDER No.
Pay Item
Pay Item Description UNIT TOTAL EXTRA WORK ORDER ___ REMARKS
No. UNIT QTY ADDITIVE DEDUCTIVE
PRICE AMOUNT
QTY AMOUNT QTY AMOUNT QTY AMOUNT QTY AMOUNT

Prepared by: Checked by: Submitted by : Verified as to Unit Cost: Verified as to Quantities

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE
BOC
Project Engineer Project Manager Project Director BOD Director
Director
DPWH & Consultant, if any DPWH & Consultant, if any (if BOC is not the IO)

Conformed:

NAME & SIGNATURE

Contractor

PIF-12-VO-02B Rev 00
 Republic of the Philippines
Department of Public Works and Highways
(IMPLEMENTING OFFICE)
(Adress)

PROPOSED VARIATION ORDER NO. ___

PROJECT/LOCATION :

TO:

You are hereby directed to make herein described changes from the plans and specifications of the following described work not included in the plans and specifications:

DESCRIPTION OF WORK TO BE DONE :

REASON FOR CHANGE :

CHANGE REQUESTED BY :

ITEMIZED QUANTITIES AND COST OF REVISION IS SHOWN ON THE ATTACHED BILL OF QUANTITIES

We the undersigned Contractor/s have given careful consirderation to the change proposed and hereby agree, if Original Contract Amount : :
this proposal is approved that we will provide all equipment, furnish all materials except as maybe otherwise be Revised Contract Amount :
noted and perform all service necessary for work above specified and will accept as full payment thereto the (+) Additive :
prices shown on the attached sheet. (-) Deductive :
Difference of Cost to this Change: :
Net Cost of Previous Change :
Total Cost of Change :
Estimated Revised Contract Amount :
ACCEPTED BY: Percentage of Change in Original Contract :
Original Contract Time :
NAME & SIGNATURE Approved additional Contract Time due to V.O. :
Contractor Revised Contract Time :
DATE: Effectivity of Contract :
Original Expiry Date :
Revised Expiry Date :

SUBMITTEDY: CHECKED BY: RECOMMENDING APPROVAL:

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

Project Engineer Chief Construction Sect./ Asst. District Engineer/
Chief Construction Div./ Asst. Regional Director/
Project Manager/ Undersecretary
Project Director
APPROVED:

NAME & SIGNATURE

District Engr./Regional Director/ Undersecretary/Secretary

Note: This Variation Order is not effective until approved.

 Republic of the Philippines
Department of Public Works and Highways
(IMPLEMENTING OFFICE)
(Adress)

PROPOSED VARIATION ORDER NO. ___

PROJECT/LOCATION :

TO:

You are hereby directed to make herein described changes from the plans and specifications of the following described work not included in the plans and specifications:

DESCRIPTION OF WORK TO BE DONE :

REASON FOR CHANGE :

CHANGE REQUESTED BY :

ITEMIZED QUANTITIES AND COST OF REVISION IS SHOWN ON THE ATTACHED BILL OF QUANTITIES

We the undersigned Contractor/s have given careful consirderation to the change proposed and hereby agree, if this proposal is approved Original Contract Amount : :
that we will provide all equipment, furnish all materials except as maybe otherwise be noted and perform all service necessary for work Revised Contract Amount :
above specified and will accept as full payment thereto the prices shown on the attached sheet. (+) Additive :
(-) Deductive :
Difference of Cost to this Change: :
Net Cost of Previous Change :
Total Cost of Change :
Estimated Revised Contract Amount :
ACCEPTED BY: Percentage of Change in Original Contract :
Original Contract Time :
NAME & SIGNATURE Approved additional Contract Time due to V.O. :
Contractor Revised Contract Time :
Effectivity of Contract :
Original Expiry Date :
Revised Expiry Date :

RECOMMENDING APPROVAL:
PREPARED BY:

NAME & SIGNATURE

NAME & SIGNATURE Assistant Secretary
Project Engineer Asst. District Engineer/ Asst. Regional Director

SUBMITTED BY APPROVED:

NAME & SIGNATURE NAME & SIGNATURE

Section/Division Chief Undersecretary
Construction Section/Division District Engineer/Regional Director
Contract ID :
Contract Nam:
Location :
Contractor :

ITEMIZED COST OF REVISION

Proposed Variation Order No. ___

REVISED CONTRACT DUE TO

ORIGINAL CONTRACT PROPOSED VARIATION ORDER No. ___
PREVIOUS V.O. PROPOSED REVISED CONTRACT
COST DUE TO VARIATION ORDER
Pay Item No. Pay Item Description CHANGE ORDER REMARKS
UNIT TOTAL UNIT TOTAL EXTRA WORK ORDER No. ___
UNIT QTY UNIT QTY ADDITIVE DEDUCTIVE
PRICE AMOUNT PRICE AMOUNT
QTY AMOUNT QTY AMOUNT QTY AMOUNT QTY AMOUNT

Prepared by: Verified as to Unit Cost: Verified as to Quantities

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

Project Engineer Chief, Implementing Sec/Div. Chief, Planning & Design Sec/Div

Concurred:

NAME & SIGNATURE

Contractor

PIF-12-VO-03A Rev 00
Contract ID :
Contract Nam:
Location :
Contractor :

ITEMIZED COST OF REVISION

Proposed Variation Order No. ___

REVISED CONTRACT DUE TO

ORIGINAL CONTRACT PROPOSED VARIATION ORDER No. ___
PREVIOUS V.O. PROPOSED REVISED CONTRACT
COST DUE TO VARIATION ORDER
Pay Item No. Pay Item Description CHANGE ORDER REMARKS
UNIT TOTAL UNIT TOTAL EXTRA WORK ORDER No. ___
UNIT QTY UNIT QTY ADDITIVE DEDUCTIVE
PRICE AMOUNT PRICE AMOUNT
QTY AMOUNT QTY AMOUNT QTY AMOUNT QTY AMOUNT

Prepared by: Checked and Submitted by : Submitted by : Verified as to Unit Cost: Verified as to Quantities

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE
Project Engineer Project Manager Project Director BOC Director BOD Director
DPWH & Consultant, if any DPWH & Consultant, if any (if BOC is not the IO)

Concurred:

NAME & SIGNATURE

Contractor

PIF-12-VO-03B Rev 00
Contract ID :

Name of Projec
:

Location :

Contractor :

ITEMIZED COST OF REVISION

Proposed Variation Order No. ___

ORIGINAL CONTRACT PROPOSED VARIATION ORDER No. ___

CHANGE ORDER PROPOSED REVISED CONTRACT COST DUE TO
SCOPE OF WORKS TOTAL EXTRA WORK ORDER VARIATION ORDER No. ___ REMARKS
UNIT QTY UNIT PRICE ADDITIVE DEDUCTIVE
AMOUNT
QTY AMOUNT QTY AMOUNT QTY AMOUNT QTY AMOUNT
Item No. Description

Prepared by: Verified as to Unit Cost: Verified as to Quantities

NAME & SIGNATURE NAME & SIGNATURE NAME & SIGNATURE

Project Engineer Chief, Implementing Sec./Div. Chief, Planning & Design Sec/Div

Concurred:

NAME & SIGNATURE

Contractor
 IO's LETTERHEAD

Contract ID:
Contract Name:
Location:
Contractor :

DETAILED TECHNICAL JUSTIFICATION FOR

THE PROPOSED VARIATION ORDER No.___/FINAL VARIATION ORDER

ADDITIVE QUANTITIES
Items Reason

(Include Brief Description of

changes and Legal Basis)

DEDUCTIVE QUANTITIES
Items Reason

(Include Brief Description of

changes and Legal Basis)

NEW ITEMS

(Include Brief Description of

changes and Legal Basis)

DELETED ITEMS
Items Reason

(Include Brief Description of

changes and Legal Basis)

Prepared by: Checked by:

NAME & SIGNATURE NAME & SIGNATURE

Project Engineer Chief, Implementing Sec./Div./Project Manager
DPWH & Consultant, if any DPWH & Consultant, if any

PIF-12-VO-04 Rev 00