Vendor+Change+Order.docx

DOCX document 105 KB Posted

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

About this file

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

While the specific details of a particular contract are not filled in on this template, the document outlines a comprehensive process for requesting and approving contract changes. The template requires detailed documentation including the reasons for the change, potential recommendations, impacts on cost, scope, schedule, and quality, and a proposed solution. The form includes signature lines for both the vendor and the state agency representatives, indicating a formal approval mechanism for contract modifications that ensures transparency and mutual agreement between contracting parties.

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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

image1.png

File details come from the government source that posted it. Updated .