Vendor+Change+Order.docx

DOCX document 105 KB Posted

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

About this file

This document is a Vendor Change Order template from the State of North Dakota, designed to facilitate modifications to existing state contracts. The form provides a structured approach for state agencies and vendors to document, request, and approve changes to ongoing contractual work, with designated sections for describing the change request, its rationale, potential impacts, and recommended solutions.

While the specific details of a particular contract are not populated in this template, the form allows for comprehensive documentation of contract modifications, including impacts on cost, scope, schedule, and quality. The change order requires signatures from both the state agency representative and the vendor, ensuring mutual agreement and formal documentation of any alterations to the original contract terms. The template is standardized (form SFN 54385, dated 11-2017) to provide a consistent framework for managing contract amendments across North Dakota state government agencies.

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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 .