Time and Materials Extra Work Order

Understanding that the Work described here is an EXTRA to ICON GROUP Contract and that it will be reimbursed on a Time and Material basis, I/we , authorize ICON GROUP to perform the following work.

Labors to perform work

EmployeesHoursTotal

Scope of work description:

Suffolk
Suffolk Superintendent's signature is for
the verification of labor and material
quantities only
Contractor:
By:
Authorized Signature:
Date:
Print Name:
Job #: