Vendor+Change+Order.docx

DOCX document 105 KB Posted

Attached to
IT - Professional Services Vendor Contract Pool
Contract number
095-HOUS
Issued by
North Dakota

About this file

This document is a Vendor Change Order template used by the State of North Dakota, specifically designed for modifying existing state contracts. The form provides a structured framework for agencies and vendors to document and process contract modifications, with designated sections for capturing request details, recommendations, impacts, and final approvals from both the state agency and vendor representatives.

While the specific contract details are not populated in this template, the form is structured to capture critical change order information including project name, work order number, change order number, agency details, vendor information, request description, reasons/goals for changes, potential recommendations, and comprehensive impacts on cost, scope, schedule, and quality. The document includes signature lines for both state and vendor representatives to formally document and approve any proposed contract modifications, indicating a formal, systematic approach to managing contract amendments within North Dakota's government procurement processes.

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Text version

VENDOR CHANGE ORDER

STATE OF NORTH DAKOTA

SFN 54385 (11-2017)

Work Order Requested Under State Contract (Insert Number)

Project Name

Work Order Number

Change Order Number

Agency Name

Vendor Name

Requested By

Request Description

Reasons/Goals for Change

Recommendations (Include recommendations by the party that is bringing the change request forward. There is a potential for multiple recommendations for solutions based on analysis.)

Impacts on Cost, Scope, Schedule, Quality (For each recommendation, a narrative of the impacts to cost, scope, schedule and quality should be included.)

Solution (Define the most appropriate solution to attain the desired objective. This is determined by the approving authority.)

Approval Signature(s) and Date(s). The project manager will identify the appropriate approval body and forward for final approval.

State of North Dakota
Vendor
Agency Name
Vendor Name
Signature
Signature
Printed Name
Printed Name
Title
Title

image1.png

File details come from the government source that posted it. Updated .