Vendor+Change+Order.docx

DOCX document 105 KB Posted

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

About this file

This document is a Vendor Change Order template from the State of North Dakota (SFN 54385, dated 11-2017), designed to facilitate modifications to existing state contracts. The form provides a structured framework for agencies and vendors to propose, document, and approve changes to ongoing contractual work, with designated sections for capturing request details, recommendations, impacts, and final approvals from both the state agency and vendor representatives.

While the specific document is a template without completed details, it is structured to capture critical contract modification elements including the original state contract number, project name, work order number, change order number, agency name, and vendor name. The form requires comprehensive documentation of change request rationales, potential recommendations, and detailed analysis of impacts on cost, scope, schedule, and quality. The template includes signature lines for both state and vendor representatives, indicating a formal process for mutually agreed-upon contract modifications that ensures transparency and mutual consent in altering contractual terms or deliverables.

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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 .