ESBD_395386_1739488177623_SOLICIEXH_F.6_COAF.pdf
PDF 132 KB Posted
- Solicitation number
- 405-24R0015974
- Issued by
- Texas
About this file
This is a Change Order Completion Acceptance Document template used by the Texas Department of Public Safety (TXDPS) to formally document and approve the completion of contract change orders. The document consists of three main sections: General Information which captures the contract number, change order name and number; Contractor Acknowledgement which includes a table to list completed deliverables as required by the Section C Scope of Work; and TXDPS Acceptance which provides formal certification of testing and acceptance of the completed services.
The document requires signatures from both contractor and TXDPS approvers, including their names, titles, and dates of approval. The template is designed to ensure proper documentation and sign-off of completed change order work, creating an audit trail for contract modifications. The form appears to be a standard one-page document used by TXDPS for contract administration purposes.
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Text version
CHANGE ORDER COMPLETION ACCEPTANCE DOCUMENT
TEXAS DEPARTMENT OF PUBLIC SAFETY
Section 1. General Information
Contract # ______________________________________
Change Order Name____________________________________ Change Order # _______
Section 2. Contractor Acknowledgement of Change Order Completion
The following project deliverables, as required by Section C Scope of Work and as assigned by Subsection Change Order Plan, have been completed.
CO Ref. # Completed Deliverable Description
This is to acknowledge that _____________________has completed this Change Order project for the Texas Department of Public Safety.
Contractor Approver Name Title Signature Date
Section 3. TXDPS Acceptance of Change Order Completion
This document certifies that the above-referenced services from Change Order Plan #__________ have hereby been tested and accepted by the Texas Department of Public Safety.
TXDPS Approver Name Title Signature Date
| Section 1. General Information |
| Section 2. Vendor Acknowledgement of Work Order Completion |
| This is to acknowledge that _____________________has completed this Work Order project for the Texas Department of Public Safety. |
| Section 3. TXDPS Acceptance of Work Order Completion |
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