Change+Order+Form.docx
DOCX document 46 KB Posted
- Attached to
- Trail Repair & Maintenance Services
- Contract number
- 187-MAXX
- Issued by
- North Dakota
About this file
This document is a Change Order Form for State Contract #187 related to Trail Repair & Maintenance Services. The form appears to be a standardized template designed to document and process modifications to an existing contract, with designated sections for project details, request description, reasons/goals, recommendations, impact analysis, and approval signatures.
While specific details about the contract's full scope are limited in this document, the form indicates it covers trail repair and maintenance services through a state-level contract vehicle. The template provides a structured approach for proposing changes to the contract, requiring detailed documentation of the proposed modification's rationale, potential recommendations, and impacts on cost, scope, schedule, and quality. The form includes provisions for multiple stakeholder signatures and requires final approval from an identified approving authority.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| Amendment+2+-+Maxx+Excavating+-+signed.pdf | ||
| Task+Order+Request.docx | DOCX document | |
| Trailsource+Contract+Signed+5-22-2023.pdf | ||
| Contract+Amendment+1+Signed+5-23-2023.pdf | ||
| State+Contract+187+Summary.docx | DOCX document |
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Text version
Attachment 4
Working Document - Add-To or Expand Fields As-Needed
CHANGE ORDER FORM
STATE CONTRACT #187 TRAIL REPAIR & MAINTENANCE SERVICES POOL
| Project Name: |
| Date of Request: |
| Task Order Number: |
| Change Order Number: |
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 CSSQ 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.
Signature
Date
Signature
Date
Signature
Date
File details come from the government source that posted it. Updated .