7360023269Attachment17.docx

DOCX document 48 KB Posted

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Project Based Information Technology Consulting Services - PBITS (Statewide)
Contract number
Not on record
Issued by
New York

About this file

This document is a No Cost Change Request Template for Group 73600, Award 23269, which covers Project Based Information Technology Consulting Services on a statewide contract set to expire in June 2025. The template is designed for authorized users and contractors to propose and review changes to deliverables without increasing costs, requiring written approval from both parties.

The contract appears to be a statewide information technology consulting services agreement that allows for minor scope adjustments without financial modifications. The template provides a structured process for initiating and reviewing proposed changes, with sections for describing the change, assessing its complexity and operational impact, and obtaining formal approvals from both the contractor and the authorized user. The document emphasizes that additional tasks reasonably anticipated to complete a deliverable are considered within the original scope and should not trigger a cost increase.

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7360023269AppendixB.pdf PDF
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Group 73600 - Award 23269 Project Based Information Technology Consulting Services (Statewide) June 2025 Attachment 17 – No Cost Change Request Template Page 1 of 1

No Cost Change Order Request Template (Revised 6/6/25)

The Authorized User reserves the right to reasonably amend a Deliverable, provided the amendment does not materially change the scope of the Deliverable, without a cost increase. Although the Authorized User has endeavored to identify many tasks associated with a Deliverable, additional tasks which can reasonably be anticipated to carry out the Deliverable shall be within the scope of the Deliverable and shall not result in a cost increase. Written approval of the No-Cost Change Request is required from both the Authorized User and the Contractor.

INITIATOR OF PROPOSED CHANGE

Name Project Role Phone Number Email

Project Title Request Date

DESCRIPTION OF PROPOSED CHANGE

Mini-Bid Number

Description of Proposed Change

Reason for Change and Impact of Not Making Change

CONTRACTOR RESPONSE

Complexity

Impact on Operations

CONTRACTOR NO COST CHANGE REVIEW

Name
Role
Recommendation
Signature
Date

Proposed Change is ☐ Approved ☐ Rejected by the Contractor

Signature: ____________________________________ Title:

Printed Name: Date:

Comments (Add attachments as necessary)

AUTHORIZED USER NO COST CHANGE REVIEW

Name
Role
Recommendation
Signature
Date

Proposed Change is ☐ Approved ☐ Rejected by the Authorized User

Signature: ____________________________________ Title:

Printed Name: Date:

Comments (Add attachments as necessary)

23269 Attachment 17 – No Cost Change Request Template (Revised 6/6/25)

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