Exhibit A_Sample Task Order Form.doc
DOC document 69 KB Posted
- Attached to
- Master Agreement AZ|CTR059035
- Contract number
- CTR059035
- Issued by
- Arizona
About this file
This document is a sample Task Order (TO) Form template for a state or local government contract, likely associated with a primary contract. The template appears to be designed for use by an agency, potentially the Arizona Department of Environmental Quality (referenced in the invoice email address), to issue task orders against an existing contract. The form provides a structured framework for defining specific task order details, including contact information for both the using agency and the contractor project managers.
The template outlines the basic components of a task order, including placeholders for critical contract information such as the task order expiration date, total cost amount, and contract number. Key attachments required with the task order include a Detailed Scope of Work (SOW) and Monthly Performance Reports (MPRs). The document suggests a structured procurement process where specific task orders are issued under a master contract, allowing for flexible, on-demand service or goods procurement with predefined terms and conditions. The form provides space for contractor acknowledgment and signature, indicating a formal agreement process for each specific task order issued.
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Text version
Task Order Form
Contract No:
Effective Date:
Contract Terms and Conditions: This TO with the Contractor’s Scope of Work and Monthly Performance Reports (MPRs) herewith shall constitute the Contract between the parties and supersede all other understanding, oral or written. It is issued pursuant to the original Contract and shall be governed by the Terms and Conditions contained therein, in full force and effect.
Site Name: ________________________________________ Task Order Expiration Date: ______________________ Scope of Work: This TO shall be performed pursuant to:
Contract Number: _______________________ Total Task Order Cost Amount: _________________________ All Correspondence, Deliverables and Invoices between the Contractor and ______ shall be sent to:
Using Agency PM: Name, Position, Email, and Phone Contractor PM: Name, Position, Email, and Phone Invoices: Accounts Payable, AccountsPayable@azdeq.gov Documents to be submitted as attachments to this TO are:
Detailed Scope of Work (SOW) Monthly Performance Report (MPR) CONTRACTOR hereby acknowledges receipt and understanding of the above TO Agreement, and shall adhere to the approved clarification documents submitted.
Contractor Signature:
Printed Name:
Title/Position:
Date:
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