Public Services and Procurement Canada
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Contractor to complete Part 1 and submit to departmental Representative along with consent of bonding company whose bond forms part of the contract security.
Contractor (Name and Address):
Description and Location of Work:
Contract No.:
Project No.:
Current Completion Date (YYYY-MM-DD):
Date Applied For (YYYY-MM-DD):
Reasons for Requesting Extension:
Signature: ________________________________________
Date of Application (YYYY-MM-DD):
Reason for recommendation:
Departmental Representative: ________________________________________
Date (YYYY-MM-DD):
Approved: ________________________________________
Date Approved (YYYY-MM-DD):
Clear Data