Vendor+Change+Order.docx

DOCX document 105 KB Posted

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

About this file

This document is a Vendor Change Order template from the State of North Dakota, designed for documenting modifications to existing state contracts. The form provides a structured framework for agencies and vendors to propose, analyze, and approve changes to ongoing contractual work, with spaces designated for capturing key details such as the original contract number, project name, work order number, and change order number.

While the specific details of the contract are not populated in this template, the form is engineered to capture critical information about proposed changes, including the requestor's description, reasons and goals for the change, potential recommendations, and comprehensive impacts on cost, scope, schedule, and quality. The document requires signatures from both the state agency representative and the vendor, indicating a formal process for contract amendments that ensures mutual agreement and thorough documentation of any modifications to the original contractual terms.

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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 .