ESBD_472565_1764019715673_SOL_EXH_F.5_405-25R0013810_Change Order Acceptance Form.pdf

This is a Change Order Completion Acceptance Document used by the Texas Department of Public Safety (TXDPS) to formally document and acknowledge the completion of change order deliverables on contracts. The form serves as a dual-authorization document requiring acknowledgment from both the contractor and TXDPS that all project deliverables specified in the Scope of Work and assigned by the Change Order Plan have been successfully completed. The document contains fields for recording the contract number, change order name and number, completed deliverable descriptions with corresponding reference numbers, and requires contractor approval with signature and date confirmation.

The document establishes a two-stage acceptance process in which the contractor first certifies completion of all required services, followed by formal acceptance and testing verification by TXDPS personnel. Both the contractor approver and TXDPS approver must sign the document with their names, titles, and dates to create an official record of project completion. The form also includes a secondary section for Work Order completion acknowledgment, indicating its use across multiple types of project modifications and authorizations within TXDPS contracts.