11197687_Change Order Exterior_Shutoff CO (1) (1)110 Home Services Exteriors Change Order (27 Jul. 22)Generated Date Lead/PO#v 0.1.21
Home Services Exteriors Change Order(Amend Scope of Work)
Home Depot License #'s
Home Depot license numbers are listed below, and at www.homedepot.com/licensenumbers
AL: 05972, 06238, 51289, 1924, 16036, EMP-5701; AK: CONE25084; AZ: ROC092581, ROC252435; AR: 228160519, MP6616; CA: 602331;CO: ME-30122, EC-7930, PC.0003126, MP.00190074; CT: HIC.533772, ELC.0203352-E1, HTG.0406972-D1, PLM.0288547-P1 DE: HM-0000772,PL-0002473; DC: 410517000372, DRM300281, PL-0002473; FL: EC0001440, EC13007199, CGC1514813, CGC1522717, CGC061641, CRC046858,CAC1813767, CAC1818831, CFC1426021, CCC1331113, CCC1331130, CCC058300; GA: GCCO005540, RBCO005730, EN216765, GAREGCN208589;GU: CLB-08-0124, R-0514-0062; HI: CT-22120; ID: 005190, RCE-19683, 022877, 024086, 024087, 022876; IL: 104017473; IN: PL11700034; IA:C091302, 24602, 24602; KS: 16-009627; KY: CE65260, ME65140, HM05813, M7838; LA: 883162, 43690, 43690, 557308, 43960, 883162, LMP 6987,LMNGF9285; ME: See link above; MD: 13793, 85434 42144, 76141, 404011589; MA: 9875, 112785, CS-107774; MI: 2102119069, 2101089942;MN: BC147263, EA731567, MB732457, PC147263, PM-093715, PM-093716; MS: 22222-MC; MO: See link above; MT: 37730, ELE-EM-LIC-31718,PLU-PM-LIC-13784; NE: 26085, 33118; NV: 38686, 84011, 84052, 82439, 82440, 82441, 82442; NH: 4324, GFE0802907, MBE1801069; NJ:13VH09277500, 34EB0158400, 34EI0158400; NM: C86302; NY: See link above; NC: 31521, U.30834, 34277, 33747; ND: 29073, M-3759, 1634,1636, 1638; OH: 46992, 46992; OK: 106339, 0135514, 80003095; OR: 95843; PA: PA142212; PR: SJ-14328-CN; RI: 9480, 8422; SC: GLG110120,CLG.110120 , M104779; SD: EC3363, Wal-MD-R1104-16-1963-C, FLM-TX-R1108-16-1965C; TN: 47781, 47781, 47781, 3899, 3877; TX: TECL24447,TICL113, TACLA1574C, TACLB14980C, M16451; REGULATED BY THE TEXAS DEPARTMENT OF LICENSING AND REGULATION, P. O.BOX 12157, AUSTIN, TEXAS 78711, 1-800-803-9202, 512-463-6599; WEBSITE: WWW.TDLR.TEXAS.GOV; RESPONSIBLE MASTER PLUMBERRICHARD W. MOORE, JR., LICENSE M16451 STATE BOARD OF PLUMBING EXAMINERS, 919 EAST 41ST STREET P.O. BOX 4200 AUSTIN,TEXAS 78745 1-800-845-6584; WT4195; DALLAS BU120698;VI: See link above; UT: 286936-5501, 286936-5501; VT: PM04663; VA: 2705068841;WA: HOMED088RH, MOOREJR934LN, HOMEDDU825KQ, WASHICR849P6; WV: WV036104, WV036104, WV036104; WI: 1046796, 1375416,DC-030700030; WY: C-40136
Customer Last Name Customer First Name Store #Lead or PO #Email
Customer Address City State Zip
THIS CHANGE ORDER (“Change Order”) amends and changes (as described below) the Home Improvement Agreement between Customer and Home
Depot dated (the “Customer Agreement”). Customer acknowledges that by signing below: (i) Customer authorizes the changes to the Scope
of Work listed on Exhibit “A”, including any changes to plans and specifications; (ii) the Services will not continue until payment of additional charges (ifapplicable) has been received by Home Depot; and (iii) all terms and conditions of the Customer Agreement remain in full force and effect and apply to thisChange Order.
Customer's Signature Service Provider Full Personal Name (Print)
Service Provider Full Business/Trade Name Service Provider Signature
Service Provider License Number(if applicable)
12/23/2022 11197687
Shutoff Kelly 11197687 kelly.shutoff@gmail.com
55 Summer ST Salem MA 01970
James Burke
172.58.223.20812/23/2022, 2:00:56
110 Home Services Exteriors Change Order (27 Jul. 22)Generated Date Lead/PO#v 0.1.21
Home Services Exteriors Change Order - EXHIBIT “A”(Amend Scope of Work)
Windows and Patio Doors
Color Opening
Size Grids Hinges/Handings
Add/Delete/ChangeRoom/FloorLine ItemStyle Series
InteriorExteriorWidthHeightTypeInt. ColorExt. ColorPattern1st LocationVerticalHorizontal2nd LocationVerticalHorizontalPanel 1Panel 2Panel 3Panel 4Panel 5Panel 6Panel 7Panel 8Window
& Glass
Options
$ Increase/
Decrease
$
$
$
$
$
$
$
$Miscellaneous Change
(Do not use for CSAT)$
Reason for Change
Entry Doors
DESCRIPTION OF CHANGE REASON FOR CHANGE $ Increase/
Decrease
$
$
Original Contract Amount:$
Change to Scope of Work Amount:$
Change to Promo (if applicable):$
Sales Tax (if applicable):$
New Contract Amount:$
Less Original Deposit:$
Customer Initial Balance Due:$
12/23/2022 11197687
0Add colonial white sculptured grids to line 4. 2V1H on both sashes.
4599.42
4599.42
1149.86
3449.56
12/23/2022, 2:00:56 172.58.223.208