Vendor+Change+Order.docx

DOCX document 105 KB Posted

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

About this file

This document is a Vendor Change Order form used by the State of North Dakota, specifically designed to document modifications to an existing state contract. The form provides a structured template for capturing change requests, involving a state agency, a vendor, and potentially other stakeholders in a formal contract amendment process.

While the specific details of the underlying contract are not fully populated in this template, the form is structured to capture critical change management elements including request description, reasons/goals, recommendations, impacts on cost/scope/schedule/quality, and a proposed solution. The document requires signatures from both the state agency representative and the vendor to formalize any proposed changes, with space for printed names, titles, and dates to validate the modification.

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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

image1.png

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