Vendor+Change+Order.docx

DOCX document 105 KB Posted

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

About this file

This document is a Vendor Change Order form template specifically designed for the State of North Dakota, identified by form number SFN 54385 and dated November 2017. The template is structured to facilitate modifications to an existing state contract, providing a standardized framework for documenting and approving changes to vendor agreements across state agencies.

The form is designed to capture critical details about proposed contract modifications, including the specific work order, change order number, involved agency and vendor, and comprehensive change request information. Key sections include request description, reasons/goals for the change, recommended solutions, and potential impacts on cost, scope, schedule, and quality. The document requires signatures from both the state representative and vendor representative to validate and approve any proposed changes, ensuring a formal and transparent process for contract amendments.

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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

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