Vendor+Change+Order.docx
DOCX document 105 KB Posted
- Attached to
- IT - Professional Services Vendor Contract Pool
- Contract number
- 095-ROSE
- Issued by
- North Dakota
About this file
This document is a Vendor Change Order template for the State of North Dakota, specifically State Form Number (SFN) 54385 dated November 2017. The form is designed to facilitate modifications to existing state contracts, providing a standardized mechanism for agencies and vendors to document and approve changes to work orders, projects, or contract parameters.
The template includes sections for detailing change requests, including project name, work order number, change order number, requesting agency, vendor information, and comprehensive fields for describing change rationale, recommendations, and potential impacts on cost, scope, schedule, and quality. The document concludes with signature lines for both the state agency representative and the vendor representative, enabling formal documentation and mutual agreement on proposed contract modifications.
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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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