Att.1_Exhibit_D_-_Work_Authorization_Form.docx

This is a Work Authorization Form from the State of California, Department of Corrections and Rehabilitation, for the Wheelchair Lift Van Conversion Purchase Order 5225-XXXXX. The form serves as Attachment 1 - Exhibit D and establishes the framework for task and deliverable performance under a designated contract number. The document requires specification of the task or deliverable title, a brief summary of work to be performed, start and completion dates, total labor hours, and total cost. The form includes signature lines for authorized representatives from both the California Department of Corrections and Rehabilitation Division coordinator (or designee) and the contractor, along with printed names, titles, and dates of authorization.

The Work Authorization Form is a template document that does not contain filled-in project-specific details such as contract numbers, task descriptions, labor hour requirements, or cost estimates. It functions as a control mechanism to ensure that work performed under the Wheelchair Lift Van Conversion purchase order aligns with contractual provisions and authorized scope of work. The form requires formal authorization and documentation from both the state agency and contractor prior to task initiation, establishing clear accountability and documentation requirements for the conversion project.