BEN-25-048 Exhibit D Statement of Work (SOW) Change Order Template.docx
DOCX document 52 KB Posted
- Attached to
- BEN-25-048 SNAP/50
- Solicitation number
- RFP-125291
- Issued by
- Virginia
About this file
This is a Statement of Work Change Order Template document prepared by the Virginia Information Technologies Agency (VITA) on behalf of the Virginia Department of Social Services for use in modifying existing Statements of Work under VITA master contracts. The template provides a standardized format for documenting modifications to SOWs between authorized users and suppliers, including changes to project scope, deliverables, timelines, and other contractual terms. The document is designed to accommodate various types of changes while maintaining clear documentation of what is being modified, using a "From/To" structure to identify specific amendments. The Change Order becomes an integral part of the existing SOW upon execution by authorized representatives of both parties and establishes a clear order of precedence in which the master Contract takes priority, followed by the SOW and any previous Change Orders, with more recent Change Orders superseding older ones.
The template maintains that all terms and conditions of the referenced SOW remain unchanged except as explicitly modified in the Change Order. The document requires signature and dated execution by authorized representatives of both the supplier and the authorized user, with provisions for including effective dates and agency head or designee authorization. This template is specifically associated with the SNAP/50 employment and training services contract opportunity, which seeks eligible entities to provide employment and training services to SNAP recipients in Virginia through evidence-based, innovative service approaches designed to support career objectives and wage growth.
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Text version
Contract No. VA-XXXXX-XXXX, Exhibit D
EXHIBIT D – SOW CHANGE ORDER TEMPLATE
Change Order No. XXX for Statement of Work C-X Between Virginia Department of Social Services and (SUPPLIER NAME)
Issued Under
CONTRACT NUMBER VA- BEN-25-037
BETWEEN
VIRGINIA INFORMATION TECHNOLOGIES AGENCY
AND
(SUPPLIER NAME)
This Change Order No. XXX hereby modifies and is made an integral part of Statement of Work C-X (the “SOW”), between NAME OF AGENCY/INSTITUTION (“Authorized User”) and NAME OF SUPPLIER (“Supplier”), which was issued under Contract Number VA-XXXX-XXXX (“Contract”) between the Virginia Information Technologies Agency (“VITA”), on behalf of the Commonwealth of Virginia and Authorized Users, and Supplier.
[[Note: Instructions for using this template to draft a Change Order are in gray and enclosed in double brackets [[ ]]. These instructions should be deleted after the appropriate text has been added to the Change Order. Contractual language is not in gray and should remain in the document. Text that is highlighted in blue is contractual language that is variable based on the nature of the project and in final form should not be highlighted. Agency/Institution should remove the first two lines of the heading, which pertain to this template as an Exhibit to the VITA Contract and remove the Exhibit reference from the header.]]
CHANGE ORDER
This is Change Order No. XXX to SOW C-X issued by Authorized User to Supplier under which Supplier is to provide the Authorized User with a Authorized User Project Name Solution (“Solution”).
The following item(s) is/are hereby modified as follows: [[Note: Include only the sections of the SOW that are being changed. Do not include sections not being modified. Changes should be clearly identified as “From” (copy/paste from current SOW section) and “To” (fully describe the change(s) to the referenced section). Here is an example, using SOW section 1.]] Period of Performance
The following change is made to the Period of Performance:
[The duration of the Period of Performance is increased by four (4) months.] The following is changed with respect to the Period of Performance:
From: twelve (12) months of execution of this Statement of Work To: sixteen (16) months of execution of this Statement of Work
This Change Order No. XXX is issued pursuant to and, upon execution, shall become incorporated in the SOW C-X, which is incorporated in the Contract. In the event of conflict, the following order of precedence shall apply:
1. The Contract, including Exhibit A
1. Statement of Work C-X, as amended by this and previous Change Orders, with the more current Change Orders superseding older Change Orders.
The foregoing is the complete and final expression of the agreement between the parties to modify the SOW and cannot be modified, except by a writing signed by duly authorized representatives of both parties hereto.
ALL OTHER TERMS AND CONDITIONS OF THE REFERENCED SOW REMAIN UNCHANGED.
By signing below, the authorized parties agree to the terms of this Change Order No.XXX to SOW C-X, effective (INSERT EFFECTIVE DATE).
| Supplier | Authorized User | |
| By: ________________________________ | By: __________________________________ | |
| (Signature) | (Signature) | |
| Name: _____________________________ | Name: _______________________________ | |
| (Print) | (Print) | |
| Title: ______________________________ | Title: _________________________________ | |
| Agency Head or Designee | ||
| Date: ______________________________ | Date: _________________________________ |
BEN-25-048- Change Order Template Page 2 of 2
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