Vendor+Change+Order.docx

DOCX document 105 KB Posted

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

About this file

The document is a Vendor Change Order form from the State of North Dakota (SFN 54385, revised 11-2017), designed to facilitate modifications to an existing state contract. The form provides a structured template for vendors, agencies, and project managers to document and propose changes to an ongoing contract, with spaces for identifying the specific state contract number, project name, work order number, and change order number.

While the specific details of the contract are not fully populated in this template, the form is structured to capture critical change management information including request descriptions, reasons/goals for the change, potential recommendations, impacts on cost, scope, schedule, and quality, and a defined solution. The document requires signatures from both the state agency and vendor representatives to formalize any proposed modifications, ensuring a formal, collaborative approach to contract adjustments.

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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 .