📍 When to use this template
- When any party (Client, PMC, Contractor) proposes a change from the original scope, drawing, or specification.
- Updated continuously throughout the project lifecycle whenever a new change is identified or an existing one's status changes.
- Maintained by the PMC/Engineer's contracts or planning team, with inputs from site execution staff.
Sections & fields
Preview of the template structure. Download Excel to fill on site.
1Header / Project Information6 fields
Project Name
_____________
Contract / Package No.
_____________
Register Title
_____________
Document No.
_____________
Revision No.
_____________
Date of Issue
_____________
2Change Identification7 fields
Change Request No. (CRN)
_____________
Raised By (Client/PMC/Contractor)
_____________
Description of Proposed Change
_____________
Reason for Change (e.g., Site Condition, Design Error, Client Request, Value Engineering)
_____________
Reference Drawing/Specification No.
_____________
Location / Chainage / Grid Line
_____________
3Initial Impact Assessment5 fields
Nature of Change (Addition/Deletion/Substitution)
_____________
Anticipated Impact on Cost (Increase/Decrease/Nil)
_____________
Anticipated Impact on Time (Extension/Acceleration/Nil)
_____________
Impact on Quality/Performance
_____________
Urgency (High/Medium/Low)
_____________
4Analysis & Approval Status8 fields
Date Sent for Analysis
_____________
Contractor's Cost Proposal Ref.
_____________
Contractor's Time Impact Analysis (TIA) Ref.
_____________
PMC/Engineer's Recommendation
_____________
Date Submitted to Client
_____________
Client's Decision (Approved/Rejected/On Hold/Info Only)
_____________
Approval Date
_____________
Variation Order (VO) / Change Order (CO) No.
_____________
5Financial Impact6 fields
Estimated Cost (Initial)
_____________
Quoted Cost (by Contractor)
_____________
Approved Cost (Final)
_____________
Rate Analysis Reference No.
_____________
Related BOQ Item No. (if applicable)
_____________
Budget Head / Cost Code
_____________
6Schedule Impact4 fields
Estimated Time Impact (Days)
_____________
Approved Extension of Time (EOT) in Days
_____________
Impact on Critical Path (Yes/No)
_____________
Revised Milestone Dates (if any)
_____________
7Closure Status5 fields
Implementation Status (Implemented/Not Implemented/In Progress)
_____________
Date of Completion of Varied Work
_____________
RA Bill No. where claimed
_____________
Remarks / Final Notes
_____________
💡 Sample filled excerpt
CRN: CR-PKG1-015 | Date Raised: 15-Jul-2023 | Raised By: Client | Description: Provide additional 200mm thick RCC retaining wall at Grid A/5-10 due to revised soil report. | Status: Approved | VO No.: VO-007 | Approved Cost: ₹ 4,50,000
⚖ Compliance notes
- Helps administer variation claims under FIDIC Conditions of Contract (e.g., Sub-Clause 13.1 Right to Vary, 13.3 Variation Procedure).
- Provides documentation for Extra/Substituted Items as per CPWD Works Manual, essential for processing deviation statements and supplementary agreements.
- Forms the basis for justifying Extension of Time (EOT) claims under the contract (e.g., FIDIC Sub-Clause 8.4/8.5).
- Creates a crucial audit trail for financial approvals and budget revisions, often scrutinized by internal and external auditors.