ESBD_489546_1770939185288_SOL_EXH_F.5_Change Order Acceptance Form.pdf

This is a Change Order Completion Acceptance Document for the Texas Department of Public Safety (TXDPS) that serves as a formal acknowledgment and acceptance form for change order project deliverables. The document is structured in three sections to facilitate the completion and acceptance process. Section 1 captures general information including the contract number, change order name, and change order reference number. Section 2 requires contractor acknowledgment that all project deliverables specified in the Scope of Work and assigned by the Change Order Plan have been completed, with spaces for the contractor approver's name, title, signature, and date. The form also includes a field to list completed deliverables by CO Reference number and description. Section 3 provides the official TXDPS acceptance certification, confirming that the services referenced in the Change Order Plan have been tested and accepted by the department, requiring signature and date from the TXDPS approver with their name and title.

The document is a standardized form with no specified pricing terms, set-asides, funding amounts, or other financial details. It appears to be a universal template applicable to multiple contracts and change orders with the Texas Department of Public Safety, designed to create an auditable record of work completion and departmental acceptance. The form does not establish contract terms, renewal options, or specific project parameters but rather serves as an administrative tool for formalizing the completion and acceptance of change order work once other contractual terms have already been established.