CHANGE+ORDER+Request+Form.docx

DOCX document 105 KB Posted

Attached to
IT - Training Vendor Pool (NDUS Only)
Contract number
310
Issued by
North Dakota

About this file

This document is a Vendor Change Order Request Form (SFN 54385) utilized by the State of North Dakota for modifying existing state contracts. The form provides a standardized template for vendors and state agencies to formally document and propose changes to an existing state contract, with designated sections for describing the request, reasons, recommendations, potential impacts, and required approvals from both the vendor and the state agency.

While the specific details of the contract are not fully populated in this template, the form is designed to capture critical information about proposed modifications, including potential impacts on cost, scope, schedule, and quality. The change order process appears to require detailed documentation and mutual agreement between the vendor and the state agency, with provisions for multiple recommendations and a defined approval process that includes signatures from key stakeholders representing both the vendor and the state of North Dakota.

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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 .