Exhibit 5 - T&M Work Order Approval Authorization MDH OFMD.pdf

This is a Time and Material Work Order Approval Authorization form issued by the Maryland Department of Health (MDH) for use under an existing contract. The form serves as the mechanism for authorizing specific work orders and deliverables within the scope of an established contract between MDH and a contractor. The document provides fields for identifying the work order number, contract number, purpose statement, scope of work requirements, specific deliverables with acceptance criteria, and associated due dates. The authorization process requires signature approval from both the MDH Work Order Request Approver and the Contractor's Authorized Representative, with documented contact information for the Contract Monitor and Points of Contact from both parties.

The work order structure accommodates multiple task line items with associated cost descriptions, quantities, labor hours, labor rates, and estimated totals, with all deliverables subject to MDH review and approval prior to payment. The form establishes a maximum payment amount to be specified by MDH and requires completion acceptance documentation signed by the Contract Monitor upon work order completion. This authorization document does not specify pricing, set-asides, or funding amounts on the template itself, as these details are populated for individual work orders issued under the parent contract for plumbing fixtures and mixing valve repairs services.