MEMORANDUM	Missouri Department of Transportation Bridge Division Central Office

TO:	RE Name

Location Project Office

CC/ATT:	District Engineer – d

Dave Ahlvers - cm

Rhonda Luck - br

Chad Daniel- br

Review Section Leader- br

Kent Nelson - br (2)

FROM:	SPM

Structural Project Manager

DATE:	Date

SUBJECT:	Change Order

Bridge No.

Rte.

Job No. , County

MonthYear Letting

Please find attached six sets of half-sized prints showing revisions to Bridge Sheet No. ##of the above referenced structure.

This change order (description of change).

Change requested by your office, our office, contractor. (Clarify reasons for change order, i.e. plans error, contractor error/ request, field condition different than planned, fabrication error, etc.)

Initials

Attachments

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