Exhibit+E+Work+Order+Request+Form.docx

WORK ORDER REQUEST FORM INSTRUCTIONS

CONTRACT #341 – FACILITY MAINTENANCE MANAGEMENT SOFTWARE

Agency Instructions Complete the Participating Entity contact information at the top of the form. The template includes instructions and notes in blue for an agency to edit/update.

1. Scope of Work – Include information that tells the contractor what is to be done, including the desired outcome Be as specific and comprehensive as possible. Do not assume the contractor will know something or do something if you do not include it in the Scope of Work. You may choose to attach the Statement of Work as an attachment.

1. Project Start Date – Specify the date when work is to start. Consider the time you are allowing for contractors to return their project offers in response to the Work order request when setting the project start date.

1. Project End Date – Specify the date when the project as defined in scope of work (#1) is to be completed.

1. Implementation Type- Implementation options are listed in State Contract 341 Facility Maintenance Management Software Amendment 1, Exhibit D: MicroMain Global Enterprise Pricing

1. Participating Entity Manager – Identify the person from your agency who will act as manager for this project. This person will be the primary contact and liaison between your Participating Entity and the contractor.

Execution

4. When your Participating Entity has received an acceptable project offer from the contractor, the project offer is to be attached to the Work order request form.

4. Both parties must sign and date using the signature blocks in the Execution section of the Work order form.

Delete All Instructions Before Submitting

WORK ORDER REQUEST FORM

State Contract 341 Facility Maintenance Management Software Work Order

PARTICIPATING ENTITY NAME:

DATE:

PARTICIPATING ENTITY CONTACT:

E-MAIL ADDRESS:

TELEPHONE NUMBER:

ADDRESS

CITY

STATE

ZIP

DARRENG@MICROMAIN.COM

The Work Order (WO) is subject to the terms and conditions of the State Contract. Government entities that intend to participate in this cooperative purchasing contract will be required to complete a Work Order. The WO will serve as the contract between the government entity and the contractor.

The participating entity is solely responsible to the Contractor for payment of any services rendered. A copy of the executed WO must be sent to the State Procurement Office Contract Administrator. This copy must be emailed. The Contract Administrator will verify that the government entity is eligible for cooperative purchasing.

In accordance with the terms and conditions of the State Term Contract #341 MICROMAIN GLOBAL agreement between State and Contractor, this Work Order Request authorizes delivery of the Deliverables described in accordance with the Scope of Work, Schedule, and Terms specified below.

1. Scope of Work

a. Description of Services

2. Project Start Date: XX/XX/XXXX

3. Project End Date: XX/XX/XXXX

4. Implementation Type- Basic, Professional, Advanced

5. Training Style (Virtual or Onsite): Insert your expectation for training style Training options are listed in State Contract 341 Facility Maintenance Management Software, Amendment 1, Exhibit D: MicroMain Global Enterprise Pricing.

6. Participation Entity Manager: Name

Vendor Proposal Vendor Response to Work Request

1. Scope of Work

a. Describe how your services align with the needs of the Participating Entity as described above.

2. Project Schedule

3. Implementation Type- Basic, Professional, Advanced

4. Training Style Methodologies: Provide details and proposed schedule for training based on the Participating Entity desired style.

5. Vendor Project Manager: Name

Deliverables- MicroMain Global Total Costs for all Deliverables:

a. MM Global Maintenance Annual Administrator User Login

b. MM Global Maintenance Annual Technician User Login

c. Implementation Type

d. Training

e. Other

Total Dollar Contractual Amount:

Execution: The parties through their authorized agents have executed this Work Order Request and attached Contractor Proposal under terms of the MicroMain Global master agreement, subject to amendments in this Work Order, for the project price and on the dates set out below.

The total dollar contractual amount specified below for this Work Order shall not be exceeded unless a written Change Order is appended to this Work Order, duly executed by the authorized representative of both parties.

SIGNATURE:

PRINTED NAME:

TITLE:

DATE:

SIGNATURE:

PRINTED NAME:

TITLE:

DATE:

STATE OF NORTH DAKOTA – Participating Entity CONTRACTOR- MicroMain Global

The WO must be signed by the government entity, and the contractor, and must be filed with the Office of Management and Budget State Procurement Officer administering the contract.