Form 109 "Construction Change Directive" - Montana

What Is Form 109?

This is a legal form that was released by the Montana Department of Administration - a government authority operating within Montana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2019;
  • The latest edition provided by the Montana Department of Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 109 by clicking the link below or browse more documents and templates provided by the Montana Department of Administration.

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Download Form 109 "Construction Change Directive" - Montana

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STATE OF MONTANA
DEPARTMENT OF AD MI NISTRAT ION
ARCHITECTURE AND ENGINEERING DIVISION
1520 East Sixth Avenue • P.O. Box 200103 • Helena MT
59620-0103 Phone: 406 444-3104 • Fax: 406 444-3399
CONSTRUCTION CHANGE DIRECTIVE
A/E #:
Project Name:
Date:
Location:
Contractor:
Change Directive #: CCD-
Owner:
MONTANA DEPARTMENT OF ADMINISTRATION
ARCHITECTURE AND ENGINEERING DIVISION
1520 EAST SIXTH AVENUE, P. O. BOX 200103
HELENA MT 59620
Architect/Engineer:
The Contractor is directed to proceed as described below. Proceed with this Work promptly. Costs for the Work (if any)
involved and change in Contract Time (if any) will be included in a subsequent Change Order.
Description:
Attachments:
(insert listing of documents that support description)
The following is based on information provided by the Contractor:
Lump Sum
Change in Contract Sum
Fixed
Change in Contract Time
Unit Price
of
Estimated
of
Calendar Days.
Estimated Not To Exceed
Maximum
Issued By:
Architect / Engineer
Signature
Date
Accepted By:
Company / Contractor
Signature
Date
Accepted By:
MT Dept. of Administration, A&E Division
Signature
Date
Construction Change Directive (Rev 3/19)
Form 109
1 of 1
Clear Form
STATE OF MONTANA
DEPARTMENT OF AD MI NISTRAT ION
ARCHITECTURE AND ENGINEERING DIVISION
1520 East Sixth Avenue • P.O. Box 200103 • Helena MT
59620-0103 Phone: 406 444-3104 • Fax: 406 444-3399
CONSTRUCTION CHANGE DIRECTIVE
A/E #:
Project Name:
Date:
Location:
Contractor:
Change Directive #: CCD-
Owner:
MONTANA DEPARTMENT OF ADMINISTRATION
ARCHITECTURE AND ENGINEERING DIVISION
1520 EAST SIXTH AVENUE, P. O. BOX 200103
HELENA MT 59620
Architect/Engineer:
The Contractor is directed to proceed as described below. Proceed with this Work promptly. Costs for the Work (if any)
involved and change in Contract Time (if any) will be included in a subsequent Change Order.
Description:
Attachments:
(insert listing of documents that support description)
The following is based on information provided by the Contractor:
Lump Sum
Change in Contract Sum
Fixed
Change in Contract Time
Unit Price
of
Estimated
of
Calendar Days.
Estimated Not To Exceed
Maximum
Issued By:
Architect / Engineer
Signature
Date
Accepted By:
Company / Contractor
Signature
Date
Accepted By:
MT Dept. of Administration, A&E Division
Signature
Date
Construction Change Directive (Rev 3/19)
Form 109
1 of 1