Work+Order+Request+(WOR).docx
DOCX document 27 KB Posted
- Contract number
- 283
- Issued by
- North Dakota
About this file
This document is a Work Order Request (WOR) template for a state contract, designed to facilitate the procurement of services or goods under a master contract. The template is generic and appears to be a standardized form for participating entities to initiate specific work assignments under a broader state contract numbered 283. While no specific state or contractor is named in this sample document, the form provides a structured framework for detailing project requirements, scope of work, and contractual parameters.
The template outlines a flexible work order process with provisions for fixed-cost agreements, defining project start and end dates, deliverable schedules, and reporting requirements. Key elements include sections for specifying the scope of work, staffing needs, budget allocation, project management details, and total contractual amount. The document allows for weekly and monthly status reporting, supports different agreement types, and includes execution provisions that reference an underlying master contract. The form is designed to enable precise project definition while maintaining control over contractual spending through a requirement for written amendments if the total dollar amount needs to be adjusted.
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Text version
Attachment 6 – CONTRACTOR WORK ORDER REQUEST (WOR) State Contract # 283
Participating Entity Name
Work Order Request Number (Participating Entity assigned, if needed, otherwise leave blank or delete.)
Issue Date
Name of Participating Entity Contact
E-mail Address
Telephone Number
Address
City
| State |
| Zip Code |
Reference: In accordance with the terms and conditions of the State Contract noted above between STATE and CONTRACTOR, this Work Order Request authorizes delivery of the Deliverables described in accordance with the Scope of Work, Schedule, and terms specified below.
1. Scope of Work
a. Describe Scope of Work
b. Budget Available (if applicable)
2. Staffing Requirement (if applicable)
| Job Class/Skill Set |
| Number of Staff |
3. Agreement Type ☐ Fixed Cost
4. Project Start Date
5. Project End Date
6. Schedule of Deliverables
| Deliverable |
| Start Date |
| Completion Date |
7. Location of Work
8. Participating Entity Project Manager
9. Contractor Project Proposal Due Date
10. Time and Status Reporting Systems to be Utilized by the Contractor (Mark all that apply)
| ☐ Daily Accountability |
| ☐ Weekly Status Reports |
| ☐ Monthly Reports |
| ☐ Other – Describe below: |
Execution: The parties through their authorized agents have executed this Work Order Request and attached Contractor Project Proposal under terms of the above-mentioned Master Contract, subject to amendments in this Work Order, for the project price and on the dates set out below.
To the extent that there is any inconsistency between this Work Order Request and Master Contract # TBD, the Master Contract shall control.
The total dollar contractual amount specified below for this Work Order and attached Project Proposal shall not be exceeded unless a written amendment is appended to this Work Order, duly executed by the authorized representative of the parties.
Total Contractual Amount
All notices or other communications required under exhibit B of the Technology contract must be provided to the following:
| STATE – PARTICIPATING ENTITY |
| CONTRACTOR |
| Name |
| Name |
| Title |
| Title |
| Address |
| Address |
| City, State, Zip |
| City, State, Zip |
| Phone |
| Phone |
| Participating Entity |
| Contractor |
| Participating Entity Name |
| Contractor Name |
| Signature |
| Signature |
| Printed Name |
| Printed Name |
| Title |
| Title |
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