Exhibit D_On-Call Contract Work Order Change Form.pdf
PDF 970 KB Posted
- Solicitation number
- 1012A
- Issued by
- Denver County, Denver City, Colorado
About this file
This document is a General Services On-Call Contract Work Order Change Form administered by the Department of General Services Contracts Office in Denver, Colorado, located at 201 W. Colfax Ave. The form is designed to facilitate modifications to an existing work order, allowing the contractor to execute changes without altering the original contract's fundamental terms. The document provides a structured template for documenting adjustments to the work order, including potential additions or subtractions to the contract value, changes to the completion date, and required approvals from various agency representatives.
The form includes sections for financial tracking, such as the original work order amount, duration, and completion date, as well as spaces to record the proposed changes and resulting new totals. It requires signatures and approvals from the contractor, agency requestor, and the Director of Facilities to validate the work order change. The document stipulates that no work can commence until the change form has been fully signed and distributed to key stakeholders, including the Auditor, Contract Administration, General Services Contract Compliance Technician, DSBO, and the Contractor. The form ensures fiscal accountability by requiring a certification from the using agency that funds are available to cover the modified work order.
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Text version
GENERAL SERVICES ON-CALL CONTRACT WORK ORDER CHANGE FORM
Administered by:
Department of General Services Contracts Office 201 W. Colfax Ave., Dept. 1110 Denver, CO 80202 GScontracts@denvergov.org
Work Order Title:
Contractor Name: On-Call Contract No.:
Supplier ID No.: Workday PO No.:
Agency: Agency Requestor:
Fund/Cost Center/Spend Category:
It is hereby mutually agreed that when this WORK ORDER CHANGE has been signed by the contracting parties, the following described changes shall be executed by the CONTRACTOR without changing the terms of the Contract.
Modifications to the Work Order described in the attached narrative and summarized in the attached scope of work dated and attached as Exhibit A.
THE CONTRACTOR AGREES to furnish all services, material, labor and perform all work/tasks required to complete the scope of work described and any changes in accordance with requirements for similar work covered by the Work Order Change, except as otherwise stipulated herein, for the following considerations:
Add/subtract from the Work Order the sum of: ($XX.XX)
Work Order Revised Completion Date:
Contractor Name: Accepted for Contractor by:
Contractor Signature: Title: Date:
WORKDAY PO NO.: CHANGE REQUEST SUMMARY
Original Work Order Amount: $ Original Work Order Duration:
Original Work Order Completion Date:
This Work Order Change (+/-):
New Work Order Total:
Adjust the Work Order Completion Date by: calendar days New Work Order Completion Date:
USING AGENCY
I hereby certify that funds are available that will be reserved to pay the Contractor in full for the work to be performed under this WORK ORDER CHANGE.
By Using Agency – Administrative or Budget Office Date
APPROVALS
Approved by Requestor, Date
Approved by Director of Facilities, Greg Johnson Date
NOTE: No persons shall authorize or perform any of the above until the Work Order Change has all signatures and has been distributed alongside a Notice to Proceed
DISTRIBUTION: Auditor, Contract Administration, General Services Contract Compliance Technician, DSBO, and Contractor.
Exhibit D mailto:GScontracts@denvergov.org
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