Vendor+Change+Order.docx
DOCX document 105 KB Posted
- Attached to
- IT - Professional Services Vendor Contract Pool
- Contract number
- 095-PUBL
- 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 documenting changes to work orders, with designated sections for agencies, vendors, request descriptions, recommendations, and approvals. While the specific document appears to be a blank template, it is clearly intended to be used by state agencies and vendors to formally process contract amendments.
The change order template includes critical sections for analyzing potential contract modifications, specifically addressing impacts on cost, scope, schedule, and quality. It requires detailed documentation of change reasons, goals, and recommended solutions, with space for signatures from both the state representative and the vendor. The form (SFN 54385) is dated November 2017 and provides a standardized mechanism for state agencies to negotiate and formalize contract adjustments with vendors, ensuring transparency and proper documentation of contractual changes.
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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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